Séamus Kirk (Louth, Fianna Fail)
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I raise this issue in the context of the various cutbacks and adjustments that have been made to home support in the caring sector. For elderly people, the disabled, the immobile and the disadvantaged, the home help scheme, along with the other care schemes, is invaluable. The benefit of the health budget to the economy as a whole is obvious. Supporting and maintaining people in a home setting for as long as is practical and possible is very desirable.

There has been a whole sequence of adjustments and cutbacks to the home help scheme, particularly the number of hours available to particular families. While I will not cite the individual cases that have cropped up in the Louth-Meath East constituency, I am sure they mirror the position across the country. I exhort the Minister of State, Deputy Kathleen Lynch, to take a serious and urgent look at the scheme. It is so valuable to people living in a home setting that this bears reiteration time and again. Even at a time when resources are scarce, there is a need to prioritise, and there is certainly a need to prioritise the home help scheme. I encourage and exhort the Minister of State to urgently re-examine the situation to see whether additional resources can be made available to support this scheme.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for raising this important issue, which is one that needs to be discussed on an ongoing basis. The aim of Government policy remains to support older people in living in dignity and independence in their own homes and communities for as long as possible. This objective is realised through various community-based supports such as mainstream home help, enhanced home care packages, meals-on-wheels and day or respite provision. Our aim is to develop and improve community-based supports where possible, taking account of wider reforms of the health service, the overall resources available and the need for the HSE to meet its statutory budgetary obligations.

The HSE has been developing various operational initiatives to improve its approach nationally to all relevant aspects of its home support services. These include various new guidelines for home care and agreeing a new procurement framework for approved agencies providing such services on a partnership basis on behalf of the executive.

While ongoing developments have been designed to standardise and maximise the use of limited resources in the face of increasing demand, they are also intended to enhance quality, safety and other key aspects of planning and delivering services, for both providers and care recipients alike. The HSE service plan for 2012 originally envisaged some 50,000 recipients of mainstream home help and approximately 11,000 recipients of enhanced home care packages at any one time. Notwithstanding the recently announced reduction in HSE home care towards the end of this year, investment in these services remains significant, with expected outturn expenditure of approximately €320 million for home help and home care packages in the course of 2012.

The recent measures adopted by the executive were designed to secure a reduction of approximately €8 million in expenditure on home help hours to the end of December, equating to some 400,000 hours, and a reduction of approximately €1.2 million on home care packages. Every effort has been made to ensure the impact of these reductions will be minimised for individual recipients so that services are provided, in the first instance, for direct patient care. Decisions in regard to the provision of home help hours continue to be based on a review of individual need and no current recipient of the service who has an assessed need will be without a provision. The latest information available from the HSE indicates that in balancing overall projected financial savings for the home help budget nationally against maintaining adequate service in individual cases, it will probably not meet the savings target envisaged. The Department continues to work closely with the executive to monitor the position between now and year end.

I emphasise again that in addressing very difficult financial realities overall, protecting community-based services for vulnerable older people continues to be a priority for the Government. However, the challenge facing the HSE in drawing up its 2013 service plan should not be underestimated. I am pleased, therefore, to reiterate our commitment to restore to 2012 levels of service the core community services of home help, home care packages and personal assistant hours.

Séamus Kirk (Louth, Fianna Fail)
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I thank the Minister of State for her reply. I am somewhat disappointed, however, that the underlying message seems to be that the position is as it is and the prospect of enhanced provision for those who are down to three quarters of an hour of care under the home help scheme are poor. I ask the Minister of State again to examine those cases where the curtailment of hours is such that it is unrealistic to expect that the type of care and support required by individuals and families can be met within the assigned allocation.

I have no reason to question or doubt the provision contained in the Estimate for this scheme. Moreover, I accept the financial constraints with which the Minister of State is dealing. However, this is an absolutely invaluable scheme. If we get to a position where a person of 82 or 83 years of age can be maintained in a home setting for another 12 months rather than being taken into institutional care, there are benefits not only for the individual but also for the State. The arithmetic dictates that providing more resources in this area is in line with best public policy. I urge the Minister of State to endeavour to secure greater resources for the scheme.

Kathleen Lynch (Cork North Central, Labour)
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I do not doubt for one minute the Deputy's sincerity on this issue. I am not certain, however, that he heard the last part of my reply, which indicates that we have indeed revisited the matter. I stated:

I emphasise again that in addressing very difficult financial realities overall, protecting community-based services for vulnerable older people continues to be a priority for the Government. However, the challenge facing the HSE in drawing up its 2013 service plan should not be underestimated. I am pleased, therefore, to reiterate our commitment to restore to 2012 levels of service the core community services of home help, home care packages and personal assistant hours.

Séamus Kirk (Louth, Fianna Fail)
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The challenge here is the inadequacy of the 2012 provision.

Kathleen Lynch (Cork North Central, Labour)
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We are all agreed that the difficulties which arose midway through 2012 caused undue hardship. However, that budget has been restored.