Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Senator Dolan for raising this important issue. It is a key priority of the Government and of mine to enable more people to engage with services that allow them to remain independent and live in their own homes with dignity and independence for as long as possible. To advance this, the Government is committed to establishing a new statutory scheme on the financing and regulation of home support.

As the Senator quite rightly said, in July I announced the selection of four sites to test a reformed model of service delivery, through the delivery of 230,000 hours of home support. This pilot will underpin the development of the statutory scheme for home support services and will be fully operational by 1 November. As the Senator quite rightly said, Tuam, Athenry and Loughrea were selected for the pilot in the CHO 2 area.

A national home support office will be established before the end of this year to support the testing of the reformed model of service delivery. In addition, approximately 130 posts have been funded for the national roll-out of the interRAI Ireland system, which the home support pilot will test as the standard assessment tool for care needs. Recruitment of these posts will occur in quarter 4 of this year. In parallel, work is ongoing in the Department to make progress on other aspects of the scheme, including the development of a regulatory framework and the examination of options for the financing model. The ESRI is doing some work on that for us.

While this new home support scheme is under development, the Government is prioritising improving access to home support services for older people. The largest ever investment was made for home support hours for older people in budget 2021. My budget this year for home care supports is €666 million, a phenomenal amount. There has been an allocation of an additional €150 million this year. The national service plan sets a target to provide 24 million hours of home support. This is an ambitious target, the objective being to increase provision by 5 million hours in one year, or to exceed the 2020 target by more than 25%.

The Covid-19 pandemic has led to unprecedented challenges across our health services, the greatest being in older persons services. While there have been challenges in the delivery of home support hours, particularly during the third wave of the pandemic, significant progress has also been made.

Provisional information, which may be subject to change, indicates that at the end of August 2021, over 13.2 million home support hours had been provided to 53,905 people. This is about 2 million more hours than in the same period last year. Approximately 478 people were waiting for funding approval, representing an 88% reduction by comparison with the same period in 2020. As a result, the preliminary figures indicate to me that the extra hours have resulted in 1,200 people not having to enter nursing home care this year. That is a great achievement.

The consumer-directed home support approach facilitates funded clients to deal directly with the HSE approved providers of their choice and to arrange days and times of service delivery. This is available in all CHOs across the country. However, based on a recent evaluation undertaken by the office of the assistant national director responsible for older people, it has been found that the uptake of this approach nationally has been minimal since its launch in 2018.

To answer the Senator's questions, provisional data from the HSE indicate only one person was waiting for funding approval in CHO 2 at the end of August 2021. However, 651 are waiting on carers – 212 in Galway, 325 in Mayo and 114 in Roscommon. The challenges we have are not financial; they concern securing the staff. There are only 1,400 people waiting for funding. By the end of next month, there will be only 500, but the challenge is to recruit the staff. I will touch on that in addressing supplementary questions.