Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

Senator O'Donovan knows me long enough to know I would share his sentiments in regard to people who receive home help. They are not all elderly, although the majority are, but most definitely they are in need of assistance to support them in the community. I am afraid we will not know if there is good or bad news until after the budget which is still under negotiation.

The Government's policy firmly remains to support older people to live at home and in their communities for as long as possible. This is realised by the Health Service Executive through a range of community-based services, such as mainstream home help, enhanced home care packages or by other supports such as meals-on-wheels, respite care or day care. These services, often delivered in partnership with non-statutory agencies, are designed to be as flexible as possible to best meet the needs of individual recipients and their families. Overall, approximately 100,000 people - 20% of those over 65 years of age - receive some form of HSE community-based supports each year, whether home care, day care, respite, etc.

On the immediate front, this has been a challenging year for the health services overall, including maintaining home care services in line with evolving resource pressures. The overall provision of these services is, therefore, regularly reviewed at national and local levels in the context of assessed client need against resource availability.

The HSE has a statutory responsibility to live within its budget voted by the Oireachtas. In this context, the HSE developed a range of proposals to reduce spending between now and the end of the year. In my opinion, that was way too short a framework and that is why the difficulty arose. It is a priority for the HSE to minimise the impact on clients of any spending reductions in the home help area. The HSE service plan target for this year was to deliver 10.7 million home help hours. The measures now being implemented envisage that almost 10.3 million home help hours will be provided this year to more than 50,000 people. Again, I think it was the timeline that caused the most difficulty.

The HSE is making every effort to ensure that services are provided in the first instance for direct patient care. Decisions in regard to the provision of home help hours will continue to be based on an assessment of individual needs and no current recipient of home help, who has an assessed need for this, will be without a service. That message has gone out very loud and clear from the Minister for Health in the past few weeks.

The particular focus now is to identify those who are most dependent and require personal care services and maintain these clients by, if necessary, reducing the lesser dependent household duties such as shopping, cleaning, etc., even though I know it is these things which sometimes maintain people at home. The current review will also identify those whose health or circumstances have improved and whose hours can be reduced in order to facilitate new applicants or those requiring increased care. Home help hours are, therefore, recycled back into the system on a regular basis. The action originally planned by the HSE was to save approximately ¤8 million by reducing home help hours between now and the end of December - approximately 400,000 hours - and to save approximately ¤1.2 million by reducing home care packages.

The latest information available indicates that in trying to balance overall projected financial savings for the home help budget nationally, against maintaining adequate service in individual cases, the HSE will probably not meet the savings target envisaged. The position is being kept under review by the HSE and the Department of Health to ensure that the objective of reducing overall expenditure does not compromise maintaining assessed service to existing recipients. The HSE and the Department of Health are monitoring activity and financial trends in regard to home help on a weekly basis. Whatever action is deemed necessary between now and year end will be undertaken to balance the objectives I have outlined.