Darren O'Rourke (Meath East, Sinn Fein)
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117. To ask the Minister for Health the number of people issued with a home care package but unable to fulfil it due to staffing shortages, or other reasons, in 2024 and to date in 2025; and if she will make a statement on the matter. [23593/25]

Darren O'Rourke (Meath East, Sinn Fein)
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I wish to ask the Minister the number of people issued with a home care package but unable to fulfil it due to staffing shortages or other reasons in 2024 and to date in 2025 and if she will make a statement on the matter.

Kieran O'Donnell (Limerick City, Fine Gael)
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Improving access to home support is a priority for this Government. Home support hours have increased every year since 2020, from 17.8 million hours in 2020 to a funded target of over 24 million hours in 2025, including intensive and complex home support. The HSE has reported that 5,556 people were assessed and waiting on the provision of home support at the end of 2024, including those waiting for a carer to be assigned and those waiting on funding to be allocated. This is a substantial reduction since the start of 2020, when over 9,000 people were waiting across both categories. Of the people assessed and waiting, 3,073 had a home support service in place but required additional hours, while 2,483 people were waiting for a new package.

As at the end of March 2025, the latest preliminary data indicates that 5.97 million hours had been delivered, an increase of approximately 5.5% since March last year. Nationally, the waiting list for home support reduced to 4,888 people at the end of March, with 2,693 people waiting for additional home support hours and 2,195 people waiting for a new package. No one was waiting for funding to be allocated. The waiting list was approximately 17% higher at the same time last year. Priority is given to those in the community with acute needs and those assessed and in hospitals who can return home with supports.

Darren O'Rourke (Meath East, Sinn Fein)
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It is significant. It is acknowledged that the figures are always very high. We are talking about millions of hours of home care packages and these are real services and important ones. We must always think about these things, though, in terms of unmet need. The system does not work if these services are not in place. Is there an analysis of whether there are specific geographical challenges and-or challenges with specific service areas? Is it in complex needs, for example? Does it involve people coming out of hospital and going into the community? Are there particular areas where challenges are encountered? Is it in disability services or care of the elderly, for example?

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the Deputy. I gave him global figures. I assumed he was going to ask me about CHO 8, his own area.

Darren O'Rourke (Meath East, Sinn Fein)
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Yes, I am.

Kieran O'Donnell (Limerick City, Fine Gael)
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It is across the spectrum and there are different areas. As regards the Deputy's area of CHO 8, the additional hours provided to March 2025 were 434 in terms of people waiting. The total number of people waiting was 791. At the end of December 2024, that number was 932. We have seen a reduction of 141 in the number of people waiting. This is a positive. At the end of December 2024, then, the figure for people waiting was 932, while at the end of March 2025 it was 791. This is an improvement of 141 people, which is a 15% improvement. In terms of the number of people receiving home care support packages in CHO 8, there were 9,113 at the end of March 2025. This was an improvement from March 2024, when the figure was 8,137. This was an increase of 676 people, which equals 8%. We are always seeking to improve the system and deliver. There are two elements here. There are people who have existing hours and need more and there are people who need new services.

Darren O'Rourke (Meath East, Sinn Fein)
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Some things are coming through these figures consistently. There is a pattern within them. I expect this would be the case if we were to look at the geographic variation. I know much of the challenge in CHO 8 concerns the fact that it is very difficult to get staff because it is exceptionally expensive to live in Dublin or the greater Dublin area.

There is then a variation across the State in the demographic and the demand on these services. It is incredibly important that these supports are in place when needed because they are so vital to ensuring the overall system functions properly and people have the care as close to home as possible.

On recruitment and retention of staff into these services, I know there were recent announcements about companies opening up in the sector, which are welcome, but it is a question of general recruitment and retention and the recent pay negotiations.

Thomas Gould (Cork North-Central, Sinn Fein)
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The Minister of State has outlined a lot of figures, but from the human point of view, I know a lady who had her own business and who had to work part time to look after her mother. She was sanctioned, she was passed for the hours and they had hours Monday to Friday, but on Saturday and Sunday and in the evening, she had to go in. This is a woman with her own family, and she is travelling to look after her mother. The situation is that it was sanctioned and the hours were passed, but that is not enough. People need the supports. The Minister of State needs to come up with a plan. I am not here to criticise him. I am saying there are people who have had the hours passed but who need help and support and it is not coming. I have seen families in recent weeks and people are coming out of hospital without care packages and wrap-around services in place. That needs to be worked on. People should not be let home unless the care packages are in place. People want to go home, we want to support them at home, but we need to put it around them.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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I tabled a similar parliamentary question a couple of weeks ago regarding Sligo-Leitrim. One thing I noticed was that, in both counties, the number of hours that were sanctioned but unmet in Leitrim had doubled in the 12 months between 2023 and 2024 and in Sligo had trebled, particularly for older people. One thing I discovered is that what normally happens is the district nurse or some professional recommends a specific number of hours for Lily, Mary, John or whoever as the hours they need but they are never given those hours. The hours sanctioned are less than that, probably one third less. In fact, the need is greater than what is sanctioned. That is the first point.

The second point is that people who work in the service tell me the HSE puts out recruitment programmes that are advertised, brings people in and interviews them, but that it is three, six or 12 months later before they get a call back from the HSE offering them a job. They are not going to be sitting at home for six months. They are finding that the HSE, in many people's view, is not serious about recruiting people in a timely manner in order that they can take up the positions.

Kieran O'Donnell (Limerick City, Fine Gael)
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We can say we are always looking to increase the level of funding that has gone into home care, but it has increased to €838 million from a base of just over €400 million in 2020. It is such that between 58,000 and 60,000 people are receiving the service. The key thing is that, since last December, we have seen a significant reduction in the numbers. Deputy Gould might want to bring me the particular human case he spoke about because there is a huge human factor here. I am obviously engaging with the officials and with the HSE. Furthermore, I will meet again with the HSE on the particular matter to see what we can do to make further improvements to reduce the numbers on the waiting lists. It is fair to say there has been significant investment in the area, certainly over the past five years. It is my role to see if we can improve delivery of the service for people who have existing hours and are looking for additional hours and for people who need a new service. There is a key focus on people coming out of hospitals who have that acute need.