Kieran O'Donnell (Limerick City, Fine Gael)

I welcome the opportunity to discuss fair and sustainable funding for carers, home support and the nursing homes support scheme. The Minister for Health is not opposing the motion.

I echo the motion in acknowledging the indispensable contributions of carers and front-line healthcare workers. We all know that they do phenomenal work. Their valuable work supports older people, people with disabilities and individuals with high care needs to live independently in their homes and communities. This Government is committed to ensuring that carers are supported and that investment in services for older people continues at a high level and grows to meet the changing need of our population.

The programme for Government sets out commitments that are ambitious but achievable. The Government recognises that the demographic challenges of our ageing population are already upon us. Investing heavily in services for older people means we can ensure that their later years can be lived in good health and in their communities for as long as possible. The Government is committed to supporting family carers. The Department of Social Protection provides a range of income supports for family carers. These include the carer's allowance, carer's benefit, carer's support grant and the domiciliary care allowance. The total value of payments in these schemes is estimated to be over €1.9 billion in 2025. Recognising the vital role of carers, the programme for Government sets out a timeline that commits to significantly increasing the income disregard for carer's allowance in each budget. This is being done with a view to gradually phasing out the means test during the lifetime of this Government.

I will make two quick points. Deputy Richard O'Donoghue made reference to supports for carers. Everyone here, as practising politicians, will be aware that the respite care grant will be paid automatically to people who are availing of carer's allowance, carer's benefit or the domiciliary care allowance on 5 June. People who are not in receipt of the carer's allowance can apply for the scheme. It is not means tested and is worth €2,000 this year. It is a contribution towards recognising the work that carers do. That is a practical measure I want to highlight.

In July this year, the income disregard for a single person will increase from €450 to €625 per week and from €900 to €1,150 per week for carers with a spouse or partner. That was part of budget 2025. I make reference to those two practical measures. The increase in the income disregard is being done with a view to gradually phasing out the means test during the lifetime of this Government. That measure is highlighted in the motion.

To provide further supports to people who provide care to their families, since September 2018 individuals in receipt of either a full or half-rate carer's allowance or carer's benefit are automatically eligible for a GP visit card. On foot of this measure, as of 1 January, 7,614 people in receipt of these supports have gained GP visit card eligibility. In addition to these supports, we will deliver on the programme for Government commitment to fully fund the carer's guarantee. At the moment, the carer's guarantee is supported by an annual investment of €2.6 million. It provides a standard package of supports to families in every region in tandem with the community and voluntary sector. The motion highlights regional disparities and one of the areas in which we are addressing that issue is the carer's guarantee. These supports include education and training, community carer supports, intensive and emergency supports, a freefone care line, psychosocial supports and the development and delivery of online supports for family carers. Increased funding for the carer's guarantee will also support the programme for Government commitment to increase support for carers by providing new training opportunities to support them in their caring.

Acknowledging the impact of caring for family members, €62 million in funding is provided annually for respite beds in older persons' services. Respite may be provided in the community within the person's own home, in HSE residential care settings, by agreement with voluntary organisation or by contracted private facilities. Since 2021, the home support emergency respite scheme has been funded by the HSE through Family Carers Ireland to provide emergency respite care. I know how important that is. We want to continually provide additionality in that area.

Deputies O'Flynn, O'Donoghue and others made reference to the role of women in caring. An additional €250,000 has been approved under the women's health fund for a project to support mid-life and older women family carers in collaboration with Family Carers Ireland. The project aims to research the impact of the gendered nature of family caring. Men also do this work but it is predominantly done by women. The project will also aim to develop effective responses to support women carers.

Through the HSE, investing in services for older people has been a national priority in recent years. There has been an increase of approximately €1 billion in funding for services for older people since 2020. This year has seen an increase of €350 million on the amount secured under budget 2024, bringing the total figure to €3 billion in budget 2025.

Improving access to home support is a priority for this Government. The budget secured for home support for older people in 2025 was the largest ever at circa €838 million to support 60,000 people. The budget has increased from just over €400 million in 2020 to €838 million. That increase is to support people to stay in their homes if they wish to do so and is in line with Sláintecare.

It is acknowledged that while progress is being made, disparities in accessing home support services remain. Many Deputies made reference to the fact that rural areas are particularly affected and there are ongoing recruitment challenges. In recognition of this, the strategic workforce advisory group on home carers and nursing home healthcare assistants was established in 2022. It set out to examine the challenges in front-line carer roles in the home support and long-term residential care sectors. The implementation of the group's 16 recommendations is well advanced. Reforms have been delivered as a result, including payment for travel time for home support providers and paying carers the national minimum wage at a minimum. In 2025, the delivery of longer-term recommendations will continue, including a survey of the experience of healthcare assistants, which I am due to launch shortly.

The development of the statutory home care scheme is a priority. It was in the previous programme for Government and has been reiterated in the current programme for Government. It will be a process. Delivery of this scheme requires effort across a range of areas. We must bring in regulation of home care providers. We are doing that through the health (amendment) (licensing of professional home support providers) Bill 2024. It will establish a licensing framework for professional home support services and provide for regulation by HIQA. Final drafting is under way, and I hope to present it to Cabinet in this quarter. The Government is committed to ensuring that home care is regulated and that there are quality standards in place against which services can be inspected. In doing so, everyone can be assured that their provider meets minimum standards of quality, safeguarding and governance.

The desired direction of travel is to provide care as close to one’s home as possible, which is in line with Sláintecare. That said, long-term residential care remains a crucial part of the continuum of care. The programme for Government commits to strengthening the nursing home sector by increasing funding for the nursing homes support scheme, also known as the fair deal scheme. Budget 2025 increased investment in the fair deal scheme by €67.6 million. The allocation for the scheme is now more than €1.2 billion annually.

The following is referenced in the motion. Recent legislative changes recognise the distinctive position of farming and agricultural land. The scope of those eligible to avail of reliefs under the nursing homes support scheme has been expanded, making the fair deal scheme more accessible for farm and business owners who require long-term residential care. As is mentioned in the motion, amendments to the definition of those eligible to be considered as a family successor have expanded to include cousins, great-nephews and great-nieces, and great-grandchildren.

The delivery of additional long-term residential care capacity in community nursing units and community hospitals is required to deliver on the programme for Government, Sláintecare and Project Ireland 2040 commitments. This Government’s commitment to delivering on this goal is demonstrated by the allocation of €4 million in budget 2025 to staff and operationalise an additional 615 community beds. Those are public beds. The new nursing home residential upgrade scheme, with a sanction of €10 million, will provide financial support to private and voluntary nursing homes to improve compliance with HIQA standards.

The programme for Government has a strong focus on community supports for older persons, including day centres and Meals on Wheels. An additional €10 million has been allocated for the community capital funding initiative. This will support improvements to service provision for HSE-funded Meals on Wheels and day centres.

The Government is committed to the area of dementia. Some €19 million in additional recurring funding has been allocated over the past five years for dementia services.

The programme for Government features eight specific commitments on dementia, the majority aiming to continue the expansion of dementia services nationwide. Given the commitments, and we take the trust in which the motion has been put forward, it is clear that the Government is dedicated to sustainable funding and supports, carers, home support and the nursing home support scheme. As I said earlier, the Minister for Health has proposed that the motion not be opposed.

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