Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I welcome the opportunity to address the House on the issues raised by Deputies tabling the motion. I would like to begin by echoing my colleague, the Minister of State, Deputy Butler, in her opening remarks and to thank the Deputies for their constructive and positive contributions to this important motion on the issue of home support.

I want to acknowledge the input of all Deputies this morning. It is clear to me and the Minister of State, Deputy Butler, that we are all motivated to ensure that our population have access to safe, high-quality and regulated home support services in a timely manner.

Initially, I will speak about what the Government is doing to address some of the immediate challenges we face in home support. Then I will speak more generally about the extensive reforms occurring in social care.

However, before I do so, I would like to take the opportunity to acknowledge the outstanding efforts of front-line carers and all those who work right across our health and social services. They have stepped up and demonstrated their commitment to meeting the needs of service users in our communities throughout the country. They provide millions of hours of care to service users every year. In recent years especially, they have demonstrated incredible commitment and perseverance. As a result of their work, some of the most vulnerable members of our society have received compassionate and expert care in the comfort of their homes. I wish to acknowledge this and thank the carers for their effort and expert care.

Home support is a priority for the Government. Our population is growing and it is also ageing. This means that the demand for home support services is projected to increase substantially. Older people want to age well at home and it is important that the supports that they need are in place, including home support, day service, meals on wheels. I am pleased that funding has kept up with this demand. The Government has delivered unprecedented levels of investment in our home support service in recent years.

As referenced earlier by the Minister of State, Deputy Butler, we had provided an additional €228 million for home support since 2021. This is a 46% increase. This brings the overall budget to €723 million. There should be no doubt that investment in social care and home support has been a substantial priority for the Government but we know it is not only about investment and that meaningful reform is vital. This increased funding is going towards increased supply of home support hours as well as the wider reform of service, including delivery of a statutory scheme for home support services.

We are delivering more hours of home support than ever before. As of April 2023, preliminary data indicate that there are more than 54,000 people receiving home support. More than 50 million hours have been provided in the year to date. This represents an increase of 600,000 hours compared to the same period in 2022.

We have witnessed a significant increase in the number of home support hours being delivered over the past number of years. Last year, 75,000 people benefited from home support services. The service is highly valued by service users and their families because it enables older people to live independently with dignity in their own homes for longer, which is what we all want.

As detailed by the Minister of State, Deputy Butler, work is ongoing to address the waiting list and the HSE is endeavouring to prioritise service for clients with the highest care needs. Currently, the waiting list is predominantly made up of people who have been approved for support but are waiting for a carer to be assigned. To be clear, this is not a funding issue; it is a workforce one.

I will briefly talk about the disability sector. As Deputies will be aware, responsibility for specialist disability service now falls under the remit of the Department of Children, Equality, Disability, Integration and Youth. It is envisaged that the new disability service home support procurement framework will closely align to the older persons service home support procurement framework for consistency across the commissioning agencies and for greater clarity for service providers. The HSE is currently progressing the development of a new disability service procurement framework with the expectation of finalising the framework in quarter 1 2024. Any amendment to the disability service home support rates will be considered in the context of the procurement exercise and officials of my Department are liaising with colleagues in the Department of Health to learn from the authorisation scheme of home support services.

On the reform of home care, the programme for Government commits the Government to introduce a statutory scheme to support people to live in their own homes that will provide equitable access to high-quality regulated home care. The Department of Health is currently developing a regulatory framework for home support providers with the aim of ensuring all service users are provided with high-quality care. This will comprise of primary legislation for the licensing of home support providers, regulations that will set out the minimum requirements that a provider must meet to obtain a licence, and HIQA national standards. The heads of the Bill are currently being drafted by the Department with a view to bringing it before the Houses of the Oireachtas in quarter 4 2023. Regulations are at an advanced stage. Throughout the development of these regulations, the Department has sought the full participation of home care providers, trade unions, NGOs, international colleagues, academics, health and social care professionals, families and, most importantly, service users. The draft regulations have been informed by a public consultation. Legal advice and engagement with key stakeholders will assist with final revision to regulations for providers of home support services.

In parallel to the work of the statutory scheme, a modern needs assessment tool, the interRAI, will be introduced nationwide to determine the appropriate levels of care required. This will facilitate efficient, fair and transparent care needs assessment and planning and appropriate service delivery. Related to this development of a new information technology, IT, system for home support, the process for the development of a home support IT system is under way in the HSE. This significant project is vital to deliver reform in the sector. The business case has been submitted to the digital government oversight unit and was approved by peer-review group. The HSE has established a procurement evaluation group to progress procurement and implementation of the system and it is a fundamental enabler for all other reforms we will deliver.

I am pleased that the proposed referendum is mentioned in the motion. On 8 March 2023, the Government announced its intention to hold a referendum on gender equality as recommended by the citizens' assembly and the Oireachtas Joint Committee on Gender Equality. An interdepartmental working group chaired by my Department was subsequently established to further examine in advance the recommendations. The work of the working group is ongoing. It is important to note that while the interdepartmental group supports the development of proposals, any decision on policy and any wording is for the Government.

It is important to reiterate what the Minister of State, Deputy Butler, said in her opening remarks, namely, that the new tender rate was backdated to July as a gesture of goodwill. The new tender provides for a core rate of €31 per hour for providers, which works out an at average rate of €34 per hour taking into account weekends and evening premiums. The HSE tender for home support providers also commits private and voluntary providers to pay the national living wage of €13.10 per hour, which was set in August, travel time between appointments and reform of legacy rates. The new HSE home support tender has a built-in review process, which will happen every August. Travel time has been included in this at €2.99 per hour. We are paying private providers an average rate of €34 per hour. The issue is how they pass it on.

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