Pearse Doherty (Sinn Fein)
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Cuirim fáilte roimh an Aire Stáit. Ba mhaith liom an tacaíocht atá ar fáil ina dtithe féin do seandaoine agus daoine tinn a phlé. Is cúis imní í an cheist seo do mór-chuid daoine i Chontae Dhún na nGall. Tá ganntanas uaireanna home help ar fáil faoi láthair. Níl an tseirbhís sin ag leathnú amach mar a bhí sé san am atá thart. Tá daoine ag cailleadh uaireanna, pá agus postanna de bharr sin.

The issue I wish to raise is the reduction and withdrawal of some of home help services in County Donegal. We have heard many times from the Government that it protects the old and vulnerable but the truth from what I am hearing on the ground in County Donegal is that this is not the case. I have heard this from different individuals, from people who provide home help services, from those who are losing the service and from the daughters and sons of parents who are old and frail and need the support and the type of care that has been provided in the past.

Home help hours are being reduced or services are being discontinued. In a case of an elderly person who cannot get out of bed the hour and half of personal care that person was being given has been reduced to 20 minutes. In other cases the home help service has been discontinued at the weekend. The laundry service provided the HSE in the Manorcunningham area of County Donegal, an example of other services provided, has not been in operation since November last year and the HSE has cited that it cannot find a replacement for the person who used to provide the service.

The unions are fearful that the home help service is being run down by the Government and the HSE and that this service is in the process of being privatised. The unions in the county cannot arrange a meeting with the HSE for a number of months yet. There is serious concern about the continued provision of this service. All those issues are important in terms of meetings and how they will be resolved, but behind all of that are people who need the support and help of those who provide this service.

In the case of some people nobody calls to them except the woman or the man who provides the home help service. Many of these carers continue to provide the service in a voluntary capacity. We have debated in this Chamber the importance of volunteerism. However, we cannot ignore the fact that people need to be paid and a proper service needs to be put in place, namely the home help service, and home help hours need to be retained.

When the unfortunate situation arises that a person passes away, even though there are people waiting for and deserving of the home help service, the people who provide that service are not being given new clients. There is a fear this service is being whittled away and downgraded and that it will be discontinued and the service will be privatised in the future.

I ask the Minister of State to clarify the position of the Minister for Health and Children on the provision of this service. I am sure what I said is not unique to County Donegal but I can only speak about the real life experiences relayed to me by the elderly people concerned, their carers and families.

John Moloney (Laois-Offaly, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister, Deputy Harney, who cannot be here.

I thank the Senator for raising this issue as it give me the opportunity to re-affirm the Government's continued commitment to services for older people generally and, in particular, to the important area of the home help service.

Government policy in regard to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where this is appropriate. This policy approach is renewed and developed in the partnership agreement, Towards 2016.

The development of these services nationally reflects the prioritisation and significant investment by the Government in recent years with, for example, just more than €200 million additional funding provided to develop or expand such services over the period 2006 to 2008. This additional funding related, for example, to home care packages, home help, meals-on-wheels and day respite care. Home care services are delivered either directly by the Health Service Executive or on behalf of the executive in partnership as appropriate with the voluntary sector or through private providers.

Specifically, the position in regard to the home help service shows, for example, expected expenditure this year of €211 million by the HSE, including more than €55 million development funding provided since 2006; an increase from 10.8 million home help hours in 2006 to nearly 12 million hours this year; and numbers benefiting increasing from 41,400 in 2006 to around 54,500 this year.

The home care packages are a relatively new initiative, introduced in 2006, and developed in the meantime across the country through a phased investment of €120 million new funding made available by the Government. A package comprises a variety of community based services and supports, including a significant home help element in many cases, to meet the needs of an older person. Clients may have significant medical, nursing and-or therapy requirements and may be recently discharged from hospital, or at risk of admission to hospital, if such needs are not met in a planned way. The HSE service plan envisages around 8,700 people benefiting from packages at any one time, or more than 11,000 people benefiting over the course of the full year.

It is important to stress that, notwithstanding current financial pressures generally, the Government has made every effort to protect home care services for older people. This year, the HSE aims to deliver the same quantity and quality of home help and home care packages nationally as delivered in 2008.

I understand that, in the first quarter of 2009, the HSE in Donegal provided 54,246 home support hours per month. This is in excess of budgeted hours, which is set at 52,000 hours per month for 2009. Since 2003, there has been a 60% increase in home help hours delivered to older people in Donegal. In addition, 191 people in Donegal benefit directly from home care packages. The local health office provides the third highest number of home help hours per capita to those over 65 years of age out of 32 local health offices nationwide.

The HSE has indicated it is intended to achieve efficiencies in service delivery, by reviewing the scale of provision on Sunday and bank holidays in particular where premium pay rates apply. The aim is to meet patient needs through a variety of supports, including public health nursing, day hospitals, day centres, home care packages etc. Any person who is dissatisfied with the level of home support can appeal the decision to the HSE appeals officer in the north west.

It is clear the Government has made considerable improvements in recent years to enhance home care provision generally across the country, including in Donegal. There is no doubt that demand can at times exceed service resources. I am satisfied, however, that the HSE will continue to deliver the home help service in the best manner possible, taking account of evolving financial circumstances at national and local level.

Pearse Doherty (Sinn Fein)
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I thank the Minister of State for his response. I note he has referred to old figures. He mentioned the HSE in Donegal is providing 54,246 home support hours per month, which is 2,246 hours in excess of those budgeted for. I have outlined the position for the Minister of State. The truth of what is happening on the ground is that home help hours are being cut across the board in County Donegal. Is it the position that the HSE has to remain within its budget and therefore 2,246 home help hours are been removed from people in County Donegal? Can we be assured that the number of home help hours provided in the county will not drop below 52,000 per month?

John Moloney (Laois-Offaly, Fianna Fail)
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I reiterate my response that the aim of the HSE is to deliver the same level of service as it delivered last year. However, I must add the caveat that it is reviewing the premium rates paid at weekends. That is possibly what the Senator has been hearing on the ground. The HSE intends to deliver the same level of service in terms of home support hours.