Fergus O'Dowd (Louth, Fine Gael)
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90. To ask the Minister for Health to provide an update on the expected timelines on the establishment of a new statutory home support scheme; the way he intends to scope and plan for such a scheme; and if he will make a statement on the matter. [7520/23]

Fergus O'Dowd (Louth, Fine Gael)
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Many more people are living longer in our society. The latest census indicated there are over 1 million people aged over 60 years in the State, of whom 150,000 are aged over 80 years. I am thankful that hundreds of people are reaching the celebration mark of 100 years of age every year. Older people want to age in place, not in nursing homes or institutions. Will the Minister give an update on the Government commitment to establish a new statutory home care support scheme? I welcome the work the Minister of State, Deputy Butler, is doing on this matter.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this issue. He is correct that we have an ageing population. It is something we must endorse and embrace and that is what we are doing. The World Health Organization, WHO, has determined that we have the highest life expectancy in Europe, at 82 years of age. I am conscious of the Minister's comment a few minutes ago that we hear a lot of negativity but to have the highest life expectancy in Europe means we are doing something right.

Fergus O'Dowd (Louth, Fine Gael)
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Absolutely.

Mary Butler (Waterford, Fianna Fail)
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Work is ongoing in the Department to progress the development of the new home support scheme. This involves a lot of complicated work, as the Deputy will understand. There is a regulatory framework comprising primary legislation for the licensing of home support providers, secondary legislation in the form of regulations and HIQA national standards that are in development. All this has the aim of ensuring all service users are provided with high-quality care.

Two Bills are being worked on and I hope to have them in the House before the summer recess. These relate to the licensing of home support providers and the HIQA national standards that are in development. In order to put the scheme in place we need regulation, funding and reform of service delivery.

We commenced a pilot in November 2021 in east Westmeath in community healthcare organisation, CHO, 8. This was the first of the four pilot sites. The three others came into operation in January 2022 in Tuam, Athenry and Loughrea in CHO 2, in Bandon, Kinsale and Carrigaline in CHO 4 and in Ballyfermot and Palmerston in CHO 7. They all started but because we were in the throes of Covid at the time, we allowed the pilot to operate for longer than initially expected. The data collection phase of the home support pilot concluded in August 2022 and I expect that report in the next couple of weeks.

Fergus O'Dowd (Louth, Fine Gael)
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I thank the Minister of State for her reply. One of the biggest problems we have is getting people to work in the home care area. The Government is dealing with that in some respects. I welcome that over 1,000 visas are being issued to people to come to work in Ireland as healthcare assistants and healthcare workers. Would it not also make sense to look at the thousands of people who are in this country seeking international protection? If they have qualifications in healthcare, home care or in the health field generally, we should fast-track them into the vacancies that exist in our system. That is a constructive engagement the Government must make. It does not make sense that many of the thousands of people staying in our country and who could work usefully in an area they are qualified to work in are not doing so. I welcome the initiatives for people who can speak Ukrainian and have medical and other qualifications, for example, in dentistry, to work in our healthcare system because of the shortage of GPs and other qualified people.

Mary Butler (Waterford, Fianna Fail)
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The Deputy makes a valid point. There are many people in our country who are not in a position to work and are highly qualified and skilled. They can work now after six months but we are sitting on a lot of people who have expertise.

Fergus O'Dowd (Louth, Fine Gael)
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Hear, hear.

Mary Butler (Waterford, Fianna Fail)
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We want to promote home care as a viable career opportunity. I worked very closely with the former Minister of State, Deputy English. On 1 January this year - we are six weeks into the process now - 1,000 permits were issued for people from outside the EU to come here and provide home care. We hope they will do so. This approach worked in the nursing home sector, where 2,640 permits have been issued. That is important.

On the Deputy's initial question, in order to put in place this statutory home care we need the interRAI assessors. We have funding for 128 of them and we are currently recruiting them.

Fergus O'Dowd (Louth, Fine Gael)
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The future for older people is ageing in place and ageing at home and I welcome the Minister of State's commitments in that regard.

I will comment on the criticism by nursing homes of the regulator, HIQA, and the Department of Health. They claim there is over-regulation. I have examined the homes that have closed recently. Fire has been a big issue, in that fire hazards cannot be, and are not being, dealt with. There are governance issues that are not being addressed. There are significant concerns about infection control and also shortages of staff. There are huge criticisms being made of the appropriate and proper regulation of homes by professional organisations out there that do not add up or make sense.

We need greater involvement by the State in overseeing and helping out nursing homes. I think the Minister of State said as much herself. I do not mean the State should be running homes but it should be providing governance, which is a big issue, especially in smaller homes. It is about keeping smaller homes open. If possible, we should offer interest-free or low-interest loans to deal with structural issues. In a county that has many smaller nursing homes, such as Galway, we could have combined purchasing. We could have people who work for a group of nursing homes, be they private or whatever else, who can go in and offer the additional expertise and support that the smaller homes cannot provide. However, HIQA-----

Fergus O'Dowd (Louth, Fine Gael)
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-----red-risks homes where there is a risk to the safety, health and welfare of people. It is right those homes are brought to account and, if necessary, made to account for what they are not doing.

David Cullinane (Waterford, Sinn Fein)
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Gabhaim buíochas leis an Cathaoirleach Gníomhach. I want to see the statutory home care scheme put in place as quickly as possible. That is one of the things we must do to reduce pressure on emergency departments and hospitals, as the Minister of State knows. In addition to the issues she identified, such as regulation and other measures that need to be put in place to make this happen, the main measure we need to take is increase capacity because if we put this scheme in place, more people are going to be looking for more hours because that is the nature of it.

Mary Butler (Waterford, Fianna Fail)
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Yes.

David Cullinane (Waterford, Sinn Fein)
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What we do not want is to provide a statutory scheme where there is an entitlement but people cannot access it. Capacity, therefore, is going to be the biggest issue and that means more staff and resourcing of both public and private providers to deliver the service.

Ruairi Ó Murchú (Louth, Sinn Fein)
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We all welcome and see the need for a legislative framework to deal with home support and give people the capacity to live in their own homes. We have dealt previously with the matter of recruitment and know the issues in that regard. We have had the strategic workforce advisory group. I want a timeline for the recommendations it has proposed and how we can ensure we have, as Deputy Cullinane said, the capacity to be able to deliver what needs to be delivered.

Mary Butler (Waterford, Fianna Fail)
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I thank Deputy O'Dowd for his comments. I am on the same page as him. I will never compromise on standards.

Fergus O'Dowd (Louth, Fine Gael)
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Hear, hear. No compromises.

Mary Butler (Waterford, Fianna Fail)
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We never want to see a Leas Cross again. There is no compromise and I will be bringing in more regulation for HIQA later this year as part of the statutory home care scheme. I also agree with the Deputy that the State must take a more active role in the care of older people and I said so at the weekend. I think all the Deputies present agree with me on this. As they are aware, the care of older people is outsourced, with 80% private and voluntary - just under 4% is voluntary - and 20% provided by the State. We are supporting 22,500 people under the nursing home support scheme every year. That is a position that evolved over many years. I have had many conversations with the Minister on this and I would like to see the State becoming much more involved.

I agree on the strategic workforce advisory group. We put it in place to see if we could build capacity. I am looking forward to seeing how many permits are issued over the next couple of months. There are timelines on all that and I can come back to the Deputy again on it.