Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I acknowledge the input of all Deputies today. I thank all those who stayed to speak on a Thursday afternoon. We know the numbers are always a bit less on a Thursday afternoon but many Deputies contributed, which is very welcome.

The thrust of the conversation concerns older people, statutory home care and the provision of home care. I will not use the full time allocated but I will say a couple of things. As Minister of State with responsibility for older people, I am extremely proud that, in 2019, before I was in this role, Ireland became the first country in the world, to receive age-friendly status. That was achieved through the hard work of various organisations and the HSE.

When we speak of Ireland and our older people, it is important to mention that we have the highest life expectancy in the EU 27, as determined by the World Health Organization. These are not my words but those of the World Health Organization. Last Friday, I was in Luxembourg for a meeting with the Ministers of Health of the EU 27. Many of the challenges we have with staff and waiting lists affect the whole of Europe. There is a real shortage of nurses and health and social care workers. Every single Minister I met said this was an area in which they are really challenged.

Before I address the matters raised, I will acknowledge the outstanding efforts of front-line carers and all those who work right across our health and social services. They work extremely hard seven days per week, including bank holidays. They work split shifts where they work mornings and evenings. That must be acknowledged.

We hear some people say that not everyone is encouraged to go into providing home care supports and services. Home care supports and services must be regulated. The point has been made that the delivery of regulated home care is not the same as the delivery of a statutory scheme. I agree it is not and there is no ambiguity in that regard. However, we cannot have a statutory scheme without a regulated system of care. The home supports sector has never been subjected to any kind of scheme, with the oversight or regulation we are looking at now. Unlike with residential care, we do not currently have any oversight of or insight into a significant proportion of privately commissioned services. Similar to HIQA regulations, it is important we do not compromise on regulations. This legislation is extremely important.

In the context of statutory home care, I will repeat a little of what I said earlier because it is important. I want to see a statutory scheme. For some, a statutory scheme is a right to care. For others, it is about having a financial support scheme, ensuring everyone gets the same amount of care, giving more care to those who need it most or enhancing the statutory framework. It is important to note, as many speakers acknowledged, that since I took up this role four years ago, an additional 4 million hours of home care have been delivered. As I stand here, 560,000 people in the country are receiving home care. Some will receive that care this evening while others received it this morning. Some will receive care three times per day. A total of 70,000 people received home care last year. It supports people to live in their own home with the correct wrap-around supports. I acknowledge there are people waiting on supports. It is not a funding issue but rather a matter of providing enough staff. I welcome the 917 people outside the EU who availed of permits last year and this year to come here to provide home care. It is important we acknowledge that. We have had debates about people from other countries coming into Ireland. These people are coming here with permits and earning set money delivering home care, which is really important. We were able to deliver more home care last year because we had more people to deliver it.

Currently, the budget for home care is €730 million, which will provide approximately 22 million hours this year. For the approximately 70,000 people who will receive home care this year, I have done a huge amount of work on the issue of a statutory scheme and have given it an awful lot of thought, with my team. I am not minded to charge people for home care. When we introduce a statutory scheme, we will have to work out how that is possible. For example, if we introduce a scheme similar to the fair deal scheme for statutory home care, it will mean people will have to contribute. Families with a loved one in a nursing home pay on average between €300 and €400 per week on top of the supports they get from the State. We also would need an enormous number of additional staff to deliver home care. A statutory scheme can be delivered but we must be able to fund it and must have the staff to deliver it.

As Minister of State with responsibility for older people, I am not minded to charge people for home care. Home care means that you can get care in your home, similar to what we want in Sláintecare, that is, the right care in the right place, as close to home as possible. I will continue to work on this. I will do the regulatory piece first and work out the best scheme possible. The message I want to go out from this House today is that I am completely supportive of statutory home care. People should be able to get home care when they need it but I am not minded to charge them for it.

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