Michael Collins (Cork South West, Independent) | Oireachtas source

The programme for Government has pledged to introduce a statutory scheme to support people to live in their own homes, providing equitable access to high-quality, regulated home care. This commitment is crucial, especially for our elderly population who often prefer to age in the comfort of their own homes. The Department of Health is responsible for developing the regulatory framework for home support service providers. Its goal is to ensure that all service users receive regulated care. The Department is currently working across four broad areas to fulfil this commitment: the regulation of home support providers; collaboration with the HSE to develop a reformed model of service delivery for home support; and the implementation of the recommendations of the strategic workforce advisory group. However, the Minister for Health's recent home care Bill, the Health Bill 2024, has been met with frustration and disappointment. The Bill focuses solely on the regulation of home care service providers and fails to address access to services or affordability. This falls significantly short of the promises made in Sláintecare and the expectations set in the programme for Government. The programme for Government had promised a statutory home care scheme as part of the Government's commitment to fair and affordable healthcare. This promise was made alongside pledges to introduce GP cards,to remove inpatient charges, and to reduce medicine costs. It was universally accepted in the Sláintecare report that a statutory entitlement to home care and community care, equivalent to the fair deal scheme for nursing home care, is necessary. Yet, seven years later, all the Government has managed to produce is a limited and underwhelming licensing scheme. This Bill has become entirely about regulating a market of providers, instead of providing a statutory right of access. The expectation was an improved version of the nursing home support scheme that would deliver equitable access to home care. This is widely recognised as essential to reducing pressure on hospitals.

The Sláintecare report also recognises that, in the absence of an entitlement to home care services, many people pay out of their own pocket for private home care services. This should be addressed by ending the overreliance on market mechanisms to deliver new healthcare services by the expansion of public nursing homes and home care. However, the Health Bill 2024 does the opposite, by designing the home care regulatory system around the private market, further embedding privatisation, instead of resetting the balance within a genuinely public health system with universal access that is free at the point of access.

This Government has failed to deliver meaningful home care reform, to reduce hospital waiting lists, to expand medical card eligibility, or to deliver an entitlement-based system of care. Fianna Fáil, Fine Gael and the Greens have turned their backs on the core community and home care reforms that underpin Sláintecare - if they ever believed in them in the first place. For example, in 2022 alone, nearly 3 million hours of home care promised by the HSE could not be provided, mainly due to a shortage of staff. This is a recurring theme where the HSE sets a target and then fails to meet it. In 2022, the target was for 23.67 million hours of home care but only 20.79 million hours were provided, despite more than 6,000 people being on waiting lists. The Cork and Kerry area lost out on 744,797 hours, followed by the south and south-western area of Dublin, as well as parts of Kildare and Wicklow. Approximately 6,500 mostly older people are on waiting lists, more than half of whom are seeking the service for the first time, with others in need of additional support.

In Cork alone, more than 700 people are on the list. This situation highlights the urgent need for reform in the provision of home care services. The State's approach is failing to meet the needs of our elderly population, who deserve to receive care in their own homes. It is time for the Government to deliver on its promises and to ensure all citizens have access to the care they need.

Care comes in many ways when people are ill. I would like to mention the critical issue of the pending funding for Cancer Connect in County Cork. This esteemed organisation has been instrumental in providing daily transfer for individuals undergoing chemotherapy or radiotherapy across Cork county. In a single month of 2024, Cancer Connect facilitated more than 730 journeys, underscoring the vital nature of its services. The operational funds for Cancer Connect have been predominantly sourced through local fundraising efforts. However, this method of financing is not viable in the long term and State support is imperative for the continuation of this incredible service.

Approximately two years ago, the chairman and manager of Cancer Connect met with the Tánaiste, who was then the Taoiseach, in Cork to discuss the necessity for substantial State funding. Specifically, an annual contribution of €100,000 was mentioned. A commitment to this effect was also made in the Dáil. Regrettably, as of 18 June this year, Cancer Connect had yet to receive any portion of the promised funding, despite numerous public assurances by Government officials. I urge the Minister of State to provide clarity - if she cannot, she might pass it on to the Minister who can - on when Cancer Connect can expect to receive the pledged financial support, ensuring the sustainability of its essential services. I have contacted the Minister's office many times in relation to this, and am still awaiting clarity. The funny thing is it was openly publicised by a TD over a year and a half ago in west Cork that the money was there. It was announced it would get it. Imagine, the care people needed, they had to get it from their own families.

When Cancer Connect was set up, I was involved initially. It probably never expected to expand as it has. It has expanded and other countries are trying to copy the service. People are picked up from the door. For some people, it is a one-to-one service. More can be picked up by bus, taken up for chemotherapy, all organised in CUH, and brought back down again within a few hours. The service cannot continue without funding. It has been promised funding. Why has it not been given the funding? It is slightly different from the issue at hand, but it is all to do with health. I would appreciate if the Minister of State or someone could intervene and give Cancer Connect what it deserves. It cannot continue on voluntary contributions from the people of Cork county or west Cork. It has to get State aid and €100,000 is not a lot to ask for after having been in operation for ten years, if not more.

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