Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I thank the Minister of State, Deputy English, for attending to deal with this issue. I know he gets this. We made representations to him and the Department previously regarding meat factory workers, and that issue was resolved. While I do not want to compare the issue I am raising tonight with the plight of those in the meat industry, it still surrounds the issue of visas and non-EU workers. I would appreciate the feedback of the Minister of State.

Initially, I want to flag a couple of the positive things that have been achieved by the Government in the past two years. We have gone from 19 million hours to 24 million hours in 2020 and again in 2021, funding was provided for 24 million home care hours, which is most welcome. I understand there are more home help hours being delivered to more patients than ever before in the home, as it should be and as Government policy requires.

That said, yesterday I attended a briefing with my local HSE management. In the three hours I and my Oireachtas colleagues were there, we spoke about the well-documented recruitment crisis in the HSE, with anywhere between a 15% and 25% vacancy rate across the country in respect of the filling of various vacancies. While this difficulty in recruiting employees is obvious among consultants, therapists in disability services, psychologists and other professional fields, it is perhaps most acutely felt in the area of home care. I say this because those other posts I mentioned are in short supply globally and the State’s critical list allows those posts to be filled by international candidates, including non-EU applicants. A non-EU person can also apply for a post in a nursing home care setting and as a healthcare assistant in a hospital setting. However, non-EU candidates cannot be recruited for home care supports.

This policy is discriminatory and flies in the face of what we, as a State, are trying to promote, which is to keep people at home for as long as possible and to target care and support in the home as much as is practicable. I genuinely do not understand why the critical skills list is not amended to reflect the fact we have hundreds of thousands of hours allocated and approved in home care but we cannot source the staff.

I can list dozens of individual cases, as most Deputies can, regarding the much-needed hours allocated to various people where, for one reason or another, the HSE is failing to allocate a carer to them or to arrange for a service provider to be contracted to do the same. I think of one lady in particular who is 92 years of age. She is a dementia sufferer who has been waiting more than 12 months for a carer. After many representations and having waited that length of time, she eventually got half of her entitlement but is still waiting for her full allocation. This is being felt right across the board.

I understand that the reluctance up to now may have related to the fact that certain providers do not meet the same pay and conditions standards set by the HSE itself. These contracts and working visas require a minimum salary of €27,000 in other circumstances and while this approximate salary is not as high as the HSE hourly rate of €16.50 an hour, nonetheless, it is a reasonable starting salary for many of these workers.

I urge the Minister and the Department to revise the criteria for the critical skills occupation list. Let us deliver the whole allocation of hours and get the urgent care that these elderly and vulnerable people need.

Damien English (Meath West, Fine Gael)
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I thank the Deputy for raising this very important issue. He is right it is one that we are aware of, as a Department and as a Government. It has been raised often through questions in the House, with the Taoiseach, Deputy Micheál Martin, also saying that this is something he felt might be addressed and looked at through the permit process this year. As the Deputy knows, the Minister of State, Deputy Butler, is working in the area and has put together the strategic workforce working group to look at this. It is due to report back in September. As I will be taking a Topical Issue matter on that later, I will not give the full answer in respect of it now. However, it is an issue she is trying to address. I have engaged with her on it to see if, before September, there are ways we can bring forward solutions under the categories the Deputy has mentioned in regard to permits. It is something we are aware of and are looking at.

The Deputy is right that many families are waiting for support. The funding is approved through the Government and its Departments, but it is having the personnel to implement this that we need to try to address. We need to look at it as a combination of solutions. The Minister of State, Deputy Butler, is taking the long-term view on how to address this permanently through a workforce planning process. Hopefully, that report will give us something to work on come the autumn.

In regard to the issues around the upcoming review of the permanent situation and how it can be addressed, I want to explain what the permits scheme is about. Ireland's employment permit system is designed to accommodate the arrival of non-EEA nationals to fill skills and labour gaps for the benefit of our economy in the short to medium term, but this objective must be balanced with the need to ensure there are no suitably qualified Irish or EEA nationals available to undertake the work and that the shortage is a genuine one. The Deputy will know this as he has often engaged with the system, and quite successfully too.

The system is managed through the operation of the critical skills and ineligible occupations list which determines employments that are either in high demand or ineligible for an employment permit, where there is evidence that there should be sufficient availability of those skills in the domestic and EEA labour market. In order to ensure that the employment permit system is aligned with current labour market intelligence, these lists undergo regular evidence-based review guided by relevant research and published stakeholder consultation, and incorporate the views of the economic migration interdepartmental group, which includes representatives from the Department of Health.

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Account is also taken of upskilling and training initiatives and other known contextual factors such as the ending of the pandemic unemployment payment schemes, the Ukrainian humanitarian crisis and their impact on the labour market. Currently, home care workers are not eligible for an employment permit, as Deputy O'Sullivan correctly flagged. While submissions from the home care sector were considered, the most recently concluded review announced last October did not recommend removal of the occupation of care workers and home care workers from the ineligible occupations list as the evidence suggested that the contracts of employment on offer and employment terms and conditions being offered are factors in the recruitment challenges faced by the sector rather than a demonstrable labour market shortage. Since then I have engaged with some of the providers in the sector to try to analyse this data with them and to highlight that it is a concern for us that a high percentage of the workers in the sector work part time which points to the possibility that maybe there is an option to have long-term contracts or full hour contracts as well. They understand our concerns and I understand they are now preparing a submission for the next review which will come up quite soon.

In order to add or remove an occupation from the lists, evidence is sought demonstrating that recruitment difficulties are solely due to genuine shortages across the EEA and not to other factors such as salary or employment conditions. This is what I outlined in my meetings with the sector and also in conversation with the Minister of State, Deputy Butler. Sectors in general are also required to engage structurally with the public employment service of the Department of Social Protection. The review process invites stakeholders through the public consultation to provide data to substantiate claims of lack of skills or labour available in a detailed evidence-based business case. While Deputy O'Sullivan correctly highlighted the need from the client point of view and from the point of view of patients who need help and home care, we also expect the providers to show they have made every effort to source staff and to provide good pay and terms and conditions within Ireland and the EEA and to engage with the Department of Social Protection. A longer term approach is required, as was touched on at the start by the Minister of State, Deputy Butler, but in the short term, there will be an opportunity when we open this system again for review of employment permits to make those conditions and have evidence to show it. I hope to have that review open within the next couple of weeks. Then we will be able to judge that over the coming time period and make a decision. Hopefully, it will be timely. In doing that, I will consult directly with the Department of Health and the Minister of State, Deputy Butler, to see if we can find a solution.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I thank the Minister of State. Deputy Marc MacSharry has a Topical Issue matter along similar lines. I welcome the fact the review is coming up in the next couple of months. I hope and pray this suggestion will be taken into consideration. It has been made by a number of Deputies over the past few months. If there was ever a no-brainer, and I do not like to use that kind of language, this is a no-brainer. The Minister of State said the sector must demonstrate that the requirement is there for the additional intake of employees from non-EU countries. The most demonstrable fact of that is that hundreds of thousands of hours are not being utilised. If there was ever a business case to be made, surely that is it. I hope the Department takes that into consideration.

I have to agree with the Minister of State, Deputy English on the role of the Minister of State, Deputy Butler, who has done a good job since assuming office. She has increased the budget considerably and the number of hours since taking over, as I referenced in my opening statement. She has accumulated an additional 5 million hours per annum, which is much needed. Those hours are useless unless people can avail of them. I genuinely hope this can be looked at.

I am aware of the advisory group deliberating in the next couple of months. It is now very important that we get people the care they need. As I said earlier, national policy is to keep people at home as comfortable as possible, giving them their care needs in their own homes as well as possible. This kind of move would provide for that.

As I said, I understand the visa requirement is that these employees would earn a minimum of €27,000 but the sector needs to work on that. Given that many of its staff are part time, it might be able to expand the workforce, improve pay and conditions by doing that. Even a rudimentary sum done on €27,000 a year at 39 hours a week shows it would be equivalent to about €13.50 or €14 an hour, which is above the minimum wage but below the HSE wage. However, €27,000 is not a wage to be sniffed at.

Damien English (Meath West, Fine Gael)
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I thank Deputy O'Sullivan for raising this scenario. We know there are many people who have been approved for hours and need help and it is Government policy to keep people at home as long as possible and to give them the care and support they need to be able to do that. We are very much focused on that and we will work with officials and all Departments to try to make it happen.

Currently, Department officials are actively engaged with the Department of Health in regard to the recruitment challenges outlined and my Department is a member of the cross-departmental strategic workforce advisory group chaired by the Department of Health. Areas being considered by that group include recruitment, retention, training, pay and conditions, and the career development of front-line carers in home support and nursing homes into the future. In some areas where we sanction the use of a permit, it involves training as well. Deputy O'Sullivan mentioned the rate of €27,000, which was set for healthcare assistants last April and which was more than a year ago. That does not have to be the exact amount of money. It can vary for different sectors and different areas but we try to be at the high end. We do not want to undercut the market by bringing in talent from abroad. A figure of that order sounds appropriate.

The group the Minister of State, Deputy Butler, chairs provides a forum for agreement on strategic approaches to address these workforce challenges in the sector and will develop a set of recommendations for the Minister of Health's consideration outlining the group’s key findings and a proposed action plan to support implementation of these recommendations by September 2022. Naturally we hoped that report would have been finished in time to feed into our review of the permits but it does not look like it will be.

The timing of our next review of the occupational list in regard to permits will be kept under consideration by my Department in the context of clearing the current employment permits backlog. It is intended to have it open in the next few weeks if we can do so. We usually have it open around June or July most years, and again in the autumn. When open submissions will be invited from sector representative bodies and interested parties via the public consultation forum accessible on my Department’s website throughout the consultation period.

I will happily engage with the various sectors to make a very strong case. However, it will be important that we capture the evidence that shows every effort was made to try to recruit people on decent contracts, with decent pay, locally and within Europe. It is important they engage with the Department of Social Protection and the EURES advertising portal.