Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Senator very much for raising this issue. It is not the first time I have heard about it. I was in Bessborough on Saturday and two councillors raised it with me. I was in Bessborough in Cork city for the opening of the first ever dementia lodge for people with early onset dementia to support them and their families. I was spoken to by two councillors and have also heard about the issue from two other people. I have been looking into it to find out what the situation is.

As the Senator will know, there is no bigger advocate for home care than me. There is a triangle of supports to support older people to age in their own homes. This consists of home care, day care and meals on wheels. Today, some 56,000 people the length and breadth of the country are receiving home care. In 2024, the overall home care budget has risen to approximately €730 million. This represents an additional €235 million put in place since budget 2021. Last year, we broke all records and delivered 22.1 million hours, an increase from 17.9 million within the lifetime of this Government. That is an increase of 4.2 million hours. It is the right thing to do, as I know the Senator will wholeheartedly agree.

The HSE reports that there were 7,599 people receiving home support services in the CHO 4 area at the end of March. There were 506 clients on a waiting list for additional hours and 842 were waiting for a new service to commence. It is important to note that those services had been funded. It is not a funding issue. The HSE has advised that priority is given to those in the community who have acute needs and to those assessed and waiting in acute hospitals who are unable to return home without supports.

I am committed to improving the way in which the HSE delivers its services across the country and there are a number of important initiatives in place to ensure this. The HSE is examining how it delivers home support and how technology can best be used to support it. The HSE is in the process of procuring a new ICT system that will improve its ability to ensure that services are allocated fairly and efficiently.

The HSE is also in the process of rolling out a rostering system across the country. I do not want anybody on a waiting list. We are trying to use the best people available to deliver home care in their own areas. I know that concerns have been raised in the CHO 4 area, where people have experienced changes in how their home support is being delivered as a result of this system being implemented. The aim of the home support service is to deliver support that enables the HSE's clients to live safely and independently at home. The HSE will always endeavour to facilitate a client’s wishes and personal preferences, where possible. However, the contract of employment contains a requirement for staff to be rostered.We have to roster staff. We have to have people working seven days over seven. We just cannot have people working five days over seven. This has been agreed nationally following engagement between staff representative groups and the HSE. Healthcare assistants now operate in teams working to set roster arrangement over a four-week period.

In the delivery of service and the implementation of rostering, the HSE recognises the care needs of its clients and endeavours to minimise disruption to service and undue stress while these new arrangements are introduced. The HSE has kept these teams, where possible, to a cohort of four staff members. Therefore, if a person is receiving home care seven days per week, it is not possible for the same person to deliver that morning and evening seven days per week. That person needs time off as well. With a cohort of four people, the client should only be seeing those people over the course of the whole week. I am really disappointed to hear that the Senator has experience of people who had two calls previously reduced down to one call. That was never the purpose of this. I am disappointed to hear about a 102-year-old lady living who is at home on her own beside her son. I could not support people who had two calls previously now only getting one call. I will come back in the next piece.