Dáil debates

Tuesday, 31 January 2006

2:30 pm

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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Question 127: To ask the Tánaiste and Minister for Health and Children if suitably trained home help staff and adequate home help hours will be provided at community care level in 2006; and if she will make a statement on the matter. [3278/06]

Photo of Seán PowerSeán Power (Kildare South, Fianna Fail)
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An investment package of €150 million has been put in place for 2006 and 2007. This is the largest ever increase in funding for services for older people and the package has a strong focus on community based supports. Of that investment package, an additional €33 million full year cost was allocated to the home help programme. This represents a significant increase over the Estimates provision of €112 million for 2005.

This development funding will enable the HSE to provide an additional 1.75 million hours nationally in 2006. The additional resource will further enhance the service and facilitate the expressed wish of many more older people to continue to live in their own homes for as long as possible. It should be noted that €55 million was also allocated towards the provision of home care packages, 1,100 of which are provided at present and an extra 2,000 of which will be provided during this year. These comprehensive packages, which include co-ordinated and integrated care provided by nurses, home care attendants and therapy services such as physiotherapy and occupational therapy, may also include an element of home help services.

The funding outlined was provided to the HSE on a national basis. The HSE is responsible for the delivery of the home help service across the country and also for the training of home help staff. The HSE has informed the Department that training programmes have been developed to ensure home helps receive appropriate training and these training programmes have been rolled out in the HSE over the last number of years. These programmes will continue in 2006 to improve skill levels of home helps. In addition, home helps also receive regular, on the job training in conjunction with other health professionals.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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With regard to training of home helps, has the Minister reviewed any of the curricula? Can he list Piaget's four stages of cognitive development or Erikson's eight stages of development? These are included in one of the courses for people who are studying to be home helps. I do not know what they are and I am sure the Ceann Comhairle, who is also a medical doctor, does not know what they are. I wonder about the content of some of these courses which are supposed to teach people to be home helps. Who devises and monitors them? This was a FETAC course. The Minister should investigate the content of these courses. They might not be appropriate to what people are doing.

The lack of transparency regarding the number of home help hours is causing a huge problem for Opposition Members. Even the person in charge of this area in the HSE could not tell me how many home help hours were provided last year. If medical services are to be provided using the home care packages, is VAT at 13.5% being applied to those packages? If there is an element of a social service involved in the home care packages, will VAT be applied at 21%?

As the Minister of State knows, the HSE does not have to pay VAT. There is also tax relief at source for people who put their relative in a residential nursing home. Will VAT be an issue for people accessing these services or in providing value for money for the people getting the services? Will this service be a value for money issue for taxpayers rather than being a service provided by the HSE?

Over past years, especially with regard to the health strategy, Quality and Fairness — A Health Strategy for You, the Department has failed to implement many of the recommendations it promised at community care level with regard to home help services and looking after carers in the community. There are so many contradictions in what has come out and what was announced in the most recent budget that value for money and delivery of the service could continue to be a problem.

Photo of Seán PowerSeán Power (Kildare South, Fianna Fail)
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The Deputy has raised a number of issues, but it is a bit of a joke to talk about contradictions in the recent budget. We announced a package of €150 million in the budget for services for older people, including a number of community supports vital to maintaining people in their own homes and communities, which is the expressed wish of the majority of older people. The Deputy may be as critical as he likes of the past, but we have made a major effort to improve and build on the community support structure in place.

With regard to the content of the various courses undertaken by the HSE, I will have the issue examined and come back to the Deputy on it. The HSE attaches great importance to providing adequate training to people who intend to become involved in the provision of home help. The private sector has become increasingly involved in the provision of home help throughout the country and it too attaches great importance to the training of people before taking up employment. I will check on the content of courses to ensure there is adequate provision. I am happy with the response we have received from the HSE in that regard, but I will seek further information and come back to the Deputy on the matter.

The issue of VAT has been raised by a number of providers. The matter is being investigated and we have taken it up with the Minister for Finance. We realise the difficulties VAT creates and will clarify the matter. This is not something on which I can make a decision, but I will come back to the Deputy on the issue as soon as I have definitive news.

Photo of Liam TwomeyLiam Twomey (Wexford, Fine Gael)
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When does the Minister of State think he can get back to us on that issue? The implementation of the home care packages will be difficult for some providers if there is no change.

Photo of Seán PowerSeán Power (Kildare South, Fianna Fail)
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I know the providers require us to bring some clarity to the issue in order that they can make plans for the future. We will renew our representations to the Minister for Finance. I cannot say how soon he will get back to us. I appreciate the urgency of the situation and know it would be helpful to have an early decision. We will try to get that decision as quickly as we can.