Lisa Chambers (Mayo, Fianna Fail)
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10. To ask the Minister for Health the reason CHO 2 was 45,000 home support hours behind target in the first quarter of 2018; and if he will make a statement on the matter. [28190/18]

Lisa Chambers (Mayo, Fianna Fail)
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Home support hours allow loved ones to be cared for in their homes and save the State a considerable amount. That should be rewarded and respected.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy. This year, the HSE consolidated the funding for home help and standard home care packages, which now operate as a single home support service. This new approach will provide significant benefits: the services will be easier to understand; the application and decision-making processes will be streamlined; and it will be easier for people availing of home support to move to changed levels of service as their assessed needs change without the need for an additional application process.

Home support services were a particular area of focus in budget 2018, with an additional €18.25 million allocated. This brought the total funding for home support services to €408 million. As a result, the HSE has been able to increase the provision of home support services. Its national service plan provides for a target of just over 17 million home support hours to be provided to 50,500 people. This represents an increase of 754,000 hours and home support for 500 more people compared to last year. In addition, 235 intensive home care packages will provide 360,000 home support hours for people with complex needs. Earlier this year, a further initiative saw 324 people being provided with home support services in the context of the recent adverse weather events.

The overall budget for home support services for people living in the CHO 2 catchment area increased in 2017 and 2018 and is now just over €43 million. This funding will deliver more than 1.9 million home support hours. During the first three months of this year, 430,832 hours were delivered against a target of 475,893 hours, which is 45,000 hours below target.

Some parts of the country, including CHO 2, are experiencing capacity issues relating to the availability of home care staff. I have been advised by the HSE that CHO 2 is working towards increasing capacity and is committed to providing its targeted hours by year end. With that in mind, CHO 2 is increasing its monthly spend on home support services to ensure delivery of full year service plan targets.

Lisa Chambers (Mayo, Fianna Fail)
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At the end of March, 6,458 older people were on a waiting list for home support nationwide and 1,482 were in CHO 2, which is Mayo, Galway and Roscommon. Almost a quarter of those waiting are in those three counties alone. Across the three counties, 5,791 were receiving home care or home help and for the first three months of the year, there was a target of 475,893 support hours. According to figures released to our health spokesperson, Deputy Donnelly, just 430,832 hours were provided in those three months. That represents a considerable shortfall by any measure, heading towards 10% in the first quarter.

Almost one in four of those waiting is in Mayo, Galway or Roscommon and these people are waiting for basic supports. Many families are making do with what they have and are struggling at home. They are in great difficulty and are making a choice to stay at home and not put an extra strain on an already overburdened health service. If people are pushed too far, they will eventually break. What is going on? Why are the targets being missed when we know demand will increase? The Minister of State said we are experiencing capacity issues. That is as plain as day. What action is the Minister of State taking to ensure that those capacity issues will be dealt with swiftly?

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy. There are local and national issues. As the Deputy will be aware, I published the results of a public consultation which I launched after taking office last October. I have stood over my commitment to bring about the scheme for home care to mirror the fair deal scheme and ensure people will be guaranteed access to the home care they require under statute, in a similar manner to the fair deal scheme, which we developed and which has grown and been committed to. Nobody has to wait for more four weeks under the commitments in the fair deal scheme. It is guaranteed by statute that everybody who wants to avail of it will get it, and will not have to wait any more than four weeks.

I want a similar scheme to be established to allow people to continue to live in their homes. I have put a timeline of two to three years on that and we are about nine or ten months into the process. It will take another two years to bring about the scheme and ensure it is delivered by statute and properly funded, as well as to address the issues the Deputy has raised, which are affecting Mayo and west Cork. The issues include the availability of staff to fill posts and their terms and conditions. Home helps having to travel a 14-mile round trip to deliver half an hour of service does not make sense to anybody. I have said on the record that the current system is not fit for purpose and that is why I want to design a properly funded, equitable, fair, transparent and efficient service for home help.

Lisa Chambers (Mayo, Fianna Fail)
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CHO 6, which has 4,290 waiting on home support, was some 45,000 hours ahead of target. Why, for the purposes of reporting home care and home help, are they being counted together as there is a significant difference between the two? Despite pledges in the programme for Government and the Fine Gael manifesto, there has been no increase in home help provision. Have the two categories been merged to disguise the lack of an increase?

I am glad the Minister of State touched on the provision of half an hour of help. Many families are being given half an hour per day, which is of no use to anybody. By the time a person gets to a house, says hello, makes the person who is there a couple of tea and gets him or her dressed the half an hour is gone. It is a waste of hours to cut them into such small portions. A wait of two years is too long for those affected. We cannot allow families to languish in what I can only imagine are the most difficult circumstances and let them continue to care for their loved ones without the proper State supports they need and deserve.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I fully support what Deputy Chambers has said. I have raised the issue in respect of the constituency of Roscommon-Galway numerous times.

I have had families cry in my office, not just on one or two occasions but at least 12 different families. What is going on in the CHO 2 area with home care is shocking and appalling. Will the Minister of State examine our area on the strength of what Deputy Chambers has said today? Something is not right. I have been told it involves resources but the Minister of State said that is not the case. I do not believe it is a staff issue. I ask the Minister of State to examine the issue because what is happening is not correct.

Jim Daly (Cork South West, Fine Gael)
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I can assure the Deputy that there are not enough resources but the particular issue he is experiencing in his area is a capacity issue involving staff availability. It is the same in my area of west Cork, as I mentioned. There are 45,000 hours which have been paid for but not used in CHO 2, which is a management issue for the HSE to address. It has assured me that it will up the ante in that regard and spend every euro it has been given on home help by year end. I will continue to monitor the situation. We spent €409 million on the provision of home help hours and increased funding by €18.25 million this year. We hope to increase it again next year; we have increased it every year.

Deputy Chambers asked about the two-year timeline. It took seven years to bring about the fair deal scheme, from conception to implementation. I do not intend to spend seven years on this but it will take time to address the myriad issues and faults which exist, many of which are structural such as standards, inspection, funding, availability, qualifications, complaints procedures, standardisation, equity and transparency.

Deputy Chambers asked about the coming together of the two funding models. That has been done for a very progressive and positive reason, that is, to ensure people do not have to apply a second time when they move to a more intensive home care package and to ensure increased transparency.