Colm Burke (Fine Gael)
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I welcome the Minister to the House. My question concerns the Law Reform Commission report of December 2011, which set out recommendations on the legal aspects of professional home care. This followed a report in 2010 in the media that people providing professional home care were monitored. In a similar manner to what happened in Áras Attracta, we saw people who were paid to provide home care for one hour stayed for only 15 minutes. The Law Reform Commission report also recommended that there be amending legislation. I have taken the time to have a Private Members' Bill published on the matter.

I want to know if the Minister and the Department intend to deal with the recommendations in the Law Reform Commission report. I know the HSE brought in clear guidelines about how people would be employed in the area of home care but those guidelines are not within a proper regulatory framework. Because I believe there is a need for amending legislation, I introduced the Health (Professional Home Care) Bill 2014 last week and I am anxious. I do not want there to be a scenario in 12 months' time whereby we will have another TV broadcast going back over same ground as 2010 and saying the Department and the HSE are powerless to take any action in the matter. It is in that context that I tabled an Adjournment motion.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I am taking this Adjournment matter on behalf of the Minister for Health, Deputy Leo Varadkar.
Government policy recognises that most older people would prefer to stay at home. We seek to facilitate this through various community-based supports aimed at ensuring older people receive timely, safe and appropriate care and treatment at the lowest level of complexity. Services can be provided by the HSE, voluntary agencies or private operators. Government for National Recovery 2011-2016commits to developing and implementing national standards for home support services, which will be subject to inspection by HIQA. Nursing homes have been registered and inspected by HIQA since 2009, as the Senator knows.
During the course of this Government HIQA's function has extended to residential services for those with disabilities and child protection services. However, primary legislation and resources will be required for the introduction of a statutory regulation system for home care services. This will be progressed, but in the context of overall legislative and resource priorities and will take into account the points the Senator has made about the recommendations of the Law Reform Commission. Many of the commission's recommendations have informed current standards and will continue to inform our deliberations on the regulation of home support services. I would like to emphasise, however, that statutory regulation or licensing is only one way of improving quality and safety. Earlier this month the national policy and procedures for safeguarding vulnerable adultswas launched. This builds on the existing elder abuse policy. It applies to all statutory and publicly-funded non-statutory service providers who are providing health and social care services to vulnerable persons. It is underpinned by a number of principles including respect for human rights, person-centredness, culture, advocacy, confidentiality, empowerment and collaboration.
Staff training and awareness will be vital aspects of the implementation of this policy and since 2007, about 39,000 people have received training on elder abuse. The HSE has progressed a range of measures - with which the Senator is familiar - to improve home care provision overall, to standardise services nationally and to promote quality and safety. The home help service is monitored on an ongoing basis mainly through the public health nursing service and the home help co-ordinators in each area. Monitoring involves an assessment of the needs of clients on application for the service as well as an ongoing evaluation of the time allocated and the care provided to each client. Staff receive training in areas with which the Senator will be familiar.
In 2012 the HSE as part of a procurement process introduced standards of care for all external providers of enhanced home care. They are monitored through service level agreements with the HSE to ensure that standards are being met. They have to provide a prescribed range of information and they are supervised through regular local operational meetings and care plan reviews. Audits are completed and quarterly reports are requested and reviewed. However, the HSE is currently undertaking a full review of home care services with a view to improving services generally and the executive has developed national quality guidelinesfor home help services for older people which will apply to all home support services. The guidelines will set out what a quality safe service should be with underlying criteria showing how the service can be judged. One has to take all of these measures together because they are aimed at ensuring that a safe and high-quality service is delivered nationally across the home support service.

Colm Burke (Fine Gael)
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I thank the Minister. It is, in fairness, a very comprehensive reply, but I think it is important when the Law Reform Commission produces a report that we take on board the recommendations. This is going back to December 2011 which is three years ago at this stage. Part of that was the legislative process.

Everyone is well aware of the need for long-term planning. We are going to go from having 585,000 people over 65 at the moment to over 990,000 by 2030. The provision of home care is going to be even more important because it will no longer be physically possible to provide the current level of support in nursing homes. The draft Bill provides that each person who requires home care provision would have a clear home care plan in place. We need to make sure it is not just about what is happening today but what is going to be happening in the next ten to 15 years. It is in that light that I have tabled this Adjournment matter and drafted the legislation. I thank the Minister for the very comprehensive reply and ask that my views on this matter would be taken on board as regards future legislation.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I believe it is a very important point that Senator Burke has raised about the future needs of our elderly population and the benefits of having a legislative, statutory base to the home care provisions that are made. As he says, this was recommended by the Law Reform Commission and I have no doubt it will guide the Ministers in their approach to this area. As I said in the reply, it will be progressed in the context of the overall legislative and resource priorities. I congratulate Senator Burke on introducing the Bill and I will make sure that it is brought to the attention of the Minister for Health.