John Paul O'Shea (Cork North-West, Fine Gael)
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I want to raise the issue of home support with the Taoiseach today. Home support, often known as home help, is one of the most essential person-centred supports provided by our health and social care system. It is a service that allows older people and those with additional needs to continue living safely, comfortably and independently in their own homes and communities. For many families across Cork and throughout the country, home support is not just a convenience but a lifeline. Every single day, home support workers carry out dignified and compassionate work that enables people to remain connected to their neighbours, communities and the place they call home. This sense of place, familiarity and independence has been proven to have a profound impact on a person's physical and mental well-being. It gives reassurance to families, reduces isolation and promotes independence, values that must remain at the heart of our health service.

We cannot ignore the critical role the home support service plays in easing pressure on our hospitals. When adequate support is available in the home, unnecessary hospital admissions can be prevented and hospital discharges can happen more smoothly. For older people in particular, remaining at home with proper assistance is often far safer and healthier than spending extended periods in acute settings. Home support services are a vital part of the wider solution to overcrowding, delayed discharges and pressures on our emergency departments. However, to fully realise the benefits of home support, the service must be resourced, properly staffed and delivered in a timely and consistent manner. Too many people are waiting for far too long for essential hours to begin. Too many families are left in distress trying to bridge that gap. This is not acceptable. A service that is so fundamentally important cannot be allowed to operate under strain, uncertainty or chronic staff shortages.

I received a response to a parliamentary question in the past number of days. There are 5,377 people waiting for a service for home support across the country at present. In Cork city and county, 890 clients have been waitlisted for home support, of whom 543 are waiting for a new service with 347 existing clients waiting for the allocation of additional hours.

To give a few local examples from my own area, a man in his eighties, a farmer all his life who paid taxes for over 65 years got a diagnosis and died nine weeks later in his home. He passed away without getting one hour of home support, despite being approved. Another lady in my constituency spent five weeks in hospital following being approved for discharge, waiting for a home care package to be approved. This should not be happening. We need the HSE to respond with a clear plan on how to identify and address this issue. Carrying on like it has been for the past 12 months or more is no longer acceptable. We need an immediate plan for the home care sector. I hope the Taoiseach can use his offices to ensure we can make significant progress over the coming weeks and months.

Micheál Martin (Cork South-Central, Fianna Fail)
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I thank the Deputy for raising what is a very important issue which has been at the heart of Government for the past four to five years and has seen dramatic expansion of supports for home care. There is no question about that. That is part of the challenge. The broader perspective is that population growth and particularly the ageing of the population is a significant backdrop to what we are currently experiencing. I think the population of over-65s has increased by about 37% in the past decade, whereas the overall population has increased by 15% in the past decade. We have a challenge. That is why we set up the Future Ireland Fund, that is, to try to provide guarantees and security for the medium and longer term in respect of a population that will age dramatically over the next two decades. That is the backdrop to it.

In terms of overall allocation, the 2026 investment in older persons' services now will exceed €3 billion compared to under €2 billion five years ago. That is a €1 billion increase. The home support is a priority, which I fully accept, with about €840 million provided for in 2025. That was an increase of €120 million on 2024 and a 70% increase compared to 2020. The resources are going in and 2026 will have a further €82 million, an 11% increase. It is more home support than has ever been delivered before. There is 43% more home support delivered now compared to 2020.

The issue, however, is fundamentally in terms of the workforce and enabling us to recruit a sufficiency of people qualified to provide such home support. About 18.8 million hours have been provided this year to date, which is about 5% more than target and 7.5% more than the same period last year. The Minister is, in the first instance, delivering on the recommendations of the strategic workforce advisory group on home carers and nursing home healthcare assistants. The enhanced HSE home support authorisation scheme has been in place since August 2023 for payments to approved private and voluntary providers to deliver home support on behalf of the HSE. This delivers on commitments for sectoral reform, such as payment for travel time, for example, for home support providers, paying carers the national living wage at a minimum and bringing legacy rates in line with the new revised rates of funding.

The ESRI's capacity review has now been published. That report projects future demand for older people's services in terms of long-term residential care and home support to 2040. That will inform policy developments. The key issue is around recruitment and getting qualified people in place to meet the undoubted needs. As the Deputy said, there are about 5,000 plus on the waiting list. That includes about 2,200 new applicants and about 3,100 who are already receiving some supports but who require additional hours.

John Paul O'Shea (Cork North-West, Fine Gael)
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I thank the Taoiseach. I agree with him that the resources are there; the problem is in recruitment and ensuring we get enough staff in place to continue. Our population is ageing and needs are increasing. The State must respond proactively, not reactively. The principle here is simple. People should be supported to live at home for as long as possible. The State must ensure the supports required are available when needed, not months later. Home support is one of the most empowering, cost effective and socially valuable services we provide. Strengthening it must be a priority for the Government, the HSE and for us all. I will continue to work with families and their carers to ensure that every individual who needs assistance can receive it promptly and reliably. A strong home support system is central to a compassionate and functioning healthcare system. We owe it to our older citizens and those who rely on those services to ensure it is properly delivered, fully staffed and adequately funded. The HSE must act with urgency here. Sadly, the recruitment I have seen in Cork is nowhere near the urgency that is required in this situation. We need immediate and targeted measures to recruit and retain home support workers across the country and in our own county of Cork.

Micheál Martin (Cork South-Central, Fianna Fail)
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I fully agree that we have to continue. There is urgency there, certainly at Government level in respect of this issue. The expansion has been quite dramatic and significant but so has been the growth in the population, the need and the demand. The Deputy is correct in saying that we have to concentrate and focus our resources on the home and keeping people living at home for as long as we possibly can. That is in the interests of the individual, of course, the family and broader society. We also have to recruit qualified people. There has to be a degree of vetting involved here as well in terms of safeguarding and protection of people who need care. There is potential, which we discussed earlier, in terms of overseas recruitment and bringing more carers in who can provide the service that is required. The issue now is recruitment of suitable people to staff the requirement. The resources have been increasing.