Pádraig Rice (Cork South-Central, Social Democrats)
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123. To ask the Minister for Health to provide an update on the programme for Government commitment to design a statutory home care scheme, the timeline she is working towards, and if she will make a statement on the matter. [24093/25]

Pádraig Rice (Cork South-Central, Social Democrats)
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My question concerns the statutory right to home care. In 2017, the then Minister for Health, Deputy Simon Harris, said home care needed to be placed on a statutory footing. The same year, the then Minister of State with responsibility for older people, Deputy Helen McEntee, said a statutory right to home care and necessary regulations would be delivered in two to three years. Eight years on, they remain underdelivered. We know the regulations are finally progressing but what is happening with the statutory scheme? Will the Minister of State provide me with an update on the programme for Government commitment to design a statutory home care scheme and the timelines he is working towards?

Kieran O'Donnell (Limerick City, Fine Gael)
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I wish Deputy Rice well in his new role as Chair of the Oireachtas Committee on Health. No doubt, we will be working with him. The programme for Government commits to designing a statutory home care scheme to allow people to stay in their own home for as long as possible. As Minister of State with responsibility for older people and housing, I am fully committed to delivering the design of the scheme and the operational and legislative reform that will be necessary to underpin it. Achieving this commitment requires a focused effort across several work streams, all contributing towards developing the statutory framework and improving experiences of those receiving home support.

The first legislative element is the health (amendment) (licensing of professional home support providers) Bill 2024, which will establish a licensing framework for professional home support services. The general scheme was approved by Government on 14 May 2024 and has been referred to the Office of Parliamentary Counsel for final drafting with a view to presenting the Bill to Cabinet in quarter 2 of 2025. This Bill will provide for the regulation of the sector by HIQA. Final amendments have been made to draft regulations for home support providers following public consultation. Alongside this legislation, the Department is working to address the future financing of home care, the reform of the model of service delivery and the breadth of issues relating to recruitment and retention in this sector, all in the context of a substantial expansion of the State-funded home support service.

Pádraig Rice (Cork South-Central, Social Democrats)
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It has been a year since the Minister of State, Deputy Butler, told the Oireachtas Committee on Health that the delay was due to the funding model. At the time, the Minister of State said the nut had not been cracked on financing the scheme. In February 2025, the Minister for Health told me no final decision on future funding had been made and that further research was under way to enhance the evidence base. Is this still the case? It has been eight years and the Department should have figured it out by now. Political will is needed to get this over the line. What happened to the promise in the wake of the pandemic that an entirely different model of elder care would be provided? The regulations are important but only a statutory right to home care has the potential to deliver a radically different model. It is the most crucial part of the broader reform programme.

Kieran O'Donnell (Limerick City, Fine Gael)
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As Minister of State, I have a responsibility to navigate the introduction of a statutory home care scheme. I am utterly committed to it but it must be built on solid foundations and process. The home care sector is unregulated so we have to regulate it.

Pádraig Rice (Cork South-Central, Social Democrats)
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I know that.

Kieran O'Donnell (Limerick City, Fine Gael)
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This is a statement of fact. That is the first step. We are looking at the funding model. The ESRI is doing a body of work, which I hope to receive very shortly, looking at capacity in the context of acute, older people and private health services, so it is part of it overall. The first step is to get the legislation passed to regulate the sector. We will look at a funding model to look to introducing a statutory home care scheme that gives people the right to statutory home care.

Pádraig Rice (Cork South-Central, Social Democrats)
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It is taking far too long. The Social Democrats have concerns about the financialisation of elder care. In 2020, at the height of Covid, Simon Harris and Leo Varadkar said the model of care for older people had to change. Since then, the very large-scale commercial nursing home model has increased despite the fact it was deemed to be no longer fit for purpose. Ireland, alongside England, now has the most privatised nursing home system in Europe, with 81% of all nursing home beds in the State being privately run. Of even greater concern is the fact that very large investment funds now hold one third of all nursing home beds in the State. Eight years ago, those firms had virtually no presence here. While successive Ministers have delayed on the statutory right to home care, private equity providers and real estate investment funds have moved in. How many more of these nursing homes will be allowed before an alternative is put in place? I know the Government accepts that older people should be supported to stay in their homes but this rhetoric must be matched with more action. Expensive private nursing homes cannot be the default option for people. People deserve a right to home care and we need to put the regulations and that statutory right in place.

Kieran O'Donnell (Limerick City, Fine Gael)
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It is worth setting out the practical side of it. Since 2020, Government has increased the spending on home care packages by €338 million. That is a considerable amount of money that has clearly allowed people to stay in their homes. It is about choice. We must stick with the process. I am new in the role. A lot of work was done by my predecessor. It is now about bringing the legislation forward and bringing it through the Houses of the Oireachtas. I have no doubt we will be working on it in the Oireachtas Committee on Health, more particularly, in plenary session here and in the Seanad. We will then look to put a model in place that enhances the home care provision people have at home. The fair deal scheme took many years to introduce. It is about getting this right. Bringing it forward is a priority for me and the Government.