Pauline Tully (Sinn Fein)

I wish to raise the issue of boarding-out regulations, that is, the service for older people. Not everyone is familiar with boarding-out services. This is a service for older people who are mobile and generally in good health and who do not require nursing home care but who cannot live on their own because they might not quite manage or they do not want to because of loneliness and so forth. Instead, they can live in a house in the community, which is arranged by the HSE. A family can take up to six residents to live with them in their home. The HSE pays a certain amount for each resident and then each resident also pays a percentage of his or her pension, determined by the HSE.

This was a common enough practice the Cavan. There were eight boarding-out houses at one time. We are now down to one. That one has given notice to the HSE that it is going to finish up at the end of July. The reason it is finishing up and many of the others have stopped operating, not just in Cavan, but in other counties as well, is that the regulations introduced in 1993 have not been updated since. There was a review carried out about 15 years ago, but it was a very basic review and little changed. The statutory instrument - SI 225 of 1993 - and its regulations need to be updated. Providers need to see an increase in the amount that the HSE pays. They need to see that standardised across CHO areas because different areas were paying different amounts. They also need to see an increase in the amount that the resident pays. They would like to see the number of residents per household be increased from six to nine. They have also asked that tax exemptions, similar to the rent-a-room exemption, be introduced to make the scheme more attractive.

I have been raising this issue since 2020. I have raised it with the former Minister for Health, Stephen Donnelly, and then with the Minister of State, Deputy Butler. I had many interactions with the latter about this. I submitted parliamentary questions, raised the matter on the floor of the Dáil and written to the Minister of State. At the time, she assured me that she was having her officials update the regulations, but nothing happened. I raised the matter with the current Minister of State, Kieran O'Donnell, and I have been hearing since March that he is going to do something about it, but nothing has happened.

It has come to crunch point now because the last provider is finishing up in just over a month. The residents living with her were in tears when they heard this because they have nowhere to go other than into a nursing home, which they do not want to go to. In terms of the cost to the State, the difference between putting them in a nursing home and keeping them boarded out is about €30,000 per year on average. It is huge. The HSE pays between €8,000 to €9,000 at the moment. In a nursing home, it would be paying a lot more than that. It could be anything up to €50,000 a year.

This scheme needs to be updated, revised, made more attractive and expanded because it is a very good scheme. I was talking to the residents living in the house the other day. Basically, they get their food and their board there, but they can come and go as they please. They can get a bus into Cavan town or Longford town. They can go to bingo. They can go to the pub for a drink. It is an independent life with just a little bit of support and so they are not living on their own. They are going to lose all of that now because successive Ministers have failed to update these regulations. The HSE has also failed to promote this scheme. It is a very good scheme that would suit a lot of people and keep them in their communities and out of nursing homes, able to live a supported but more or less independent life. That is what we need. It is something that is supported strongly by the charity ALONE as well.