Thomas Byrne (Meath East, Fianna Fail)
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37. To ask the Minister for Health the reason for the delay in providing home care services in County Meath [4361/17]

Thomas Byrne (Meath East, Fianna Fail)
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I will not delay the House. The situation in County Meath and many other parts of the country is that there are a lot of people who cannot get out of hospital or who are in need of home care but the home care simply is not available. Needs are being assessed and people are being told that home care will be provided but when it comes to the crunch, they cannot access it. I have received numerous representations on this issue, as have many other Deputies and I am sure the Minister has too.

Helen McEntee (Meath East, Fine Gael)
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As a fellow public representative in Meath, I can confirm that this is an issue that comes across my desk on a weekly if not a daily basis and not just because of my role as Minister of State with responsibility for older people.

To put the issue into context, the overall funding for services for older people this year will be €765 million. This includes additional funding for home care services which is aimed at allowing people to continue to live in their own homes, in their communities and with their families and also at facilitating the discharge of older people from hospitals. In this context, the winter initiative plan for 2016 and 2017 has yielded a significant reduction in delayed discharges with the numbers falling from a record high of 832 in October 2014 to just 436 at the end of last year.

The HSE’s national service plan for this year provides for a target of 10.57 million home help hours to support about 49,000 people. It also includes the provision of 16,750 home care packagesand190intensive home care packages for clients with complex needs, includingclients with dementia who will be supported with co-funding from Atlantic Philanthropies under the Irish national dementia strategy.

It is fair to say that this represents a significant increase on home care in comparison to last year’s service plan, which had a target of 10.4 million hours home help and 15,450 home care packages. This year's plan will see home help hours increase by 170,000 and home care packages by 1,300.

Despite this significant level of service provision, the demand for home care continues to grow. It is important to note that the allocation of funding for home care across the system, though significant, is finite and services must be delivered within the funding available. The level of activity and associated costs must be managed in each of the nine community healthcare organisations, CHOs, in a way that ensures that those with the greatest needs are supported and that the overall expenditure on home care services by the HSE does not exceed the available funding.

County Meath, as Deputy Byrne knows, is part of CHO Area 8.

The 2017 service plan provides for 1,260,000 home help hours and 2,373 home care packages in community health care organisation area 8, including 114 home care packages which, as Deputy Byrne stated, have been allocated to support the acute hospital system as part of the winter initiative. Applications are processed and supports are allocated promptly in line with the greatest need. Where resources are not immediately available, the approved applicant's name is added to the waiting list until such time as home care hours become available.

Thomas Byrne (Meath East, Fianna Fail)
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What is the solution for people in need who are waiting for services? We all know the official line from the Health Service Executive. The Minister of State must deliver on the ground because these services are needed now. People are dying, while others are waiting or are stuck in hospital, which is the root cause of many problems. Will the Minister of State provide an answer for those people? When will they receive care?

Helen McEntee (Meath East, Fine Gael)
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I am aware of the difficulties being faced in County Meath, just as I am aware of the difficulties being faced by people in counties Louth, Cavan, Donegal and every other county. It is for this reason that we are developing a home care scheme which will ensure we no longer have such a level of need. Demand currently far outweighs resources and capacity and we do not have a statutory framework to ensure the levels of services provided to people in County Meath are the same as those provided to people in County Donegal or any other area. The process of developing the home care service we hope to deliver is under way. Last year, the Department issued a report through the Health Research Board which examined the position in other countries with similar frameworks or population sizes. Following the publication of the report, we will open a public consultation process to allow people from County Meath and all other counties to have their say on what a home care support system should look like.

Thomas Byrne (Meath East, Fianna Fail)
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While the strategy is being developed, people in County Meath and elsewhere are not receiving the home care service approved for them by the HSE. They do not know what is happening and they should receive an answer. I have made representations on their behalf through parliamentary questions. They badly need detailed answers.

Helen McEntee (Meath East, Fine Gael)
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It is important to stress that 1,260,000 home help hours and 2,373 home care packages, including 114 home care packages to allow people to be discharged from hospital, are being provided for community health care organisation area 8, of which County Meath forms a part. We now need to develop a system that will allow everyone to avail of a service that is uniform, regulated and fully funded. Until we have a statutory framework in place, we will not be able to provide such a service for anyone in County Meath or any other county. As the Minister of State with responsibility for older people, this is a priority for me. I want to ensure people in County Meath can continue to remain in their homes and receive support at home.