Colm Burke (Fine Gael)
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I welcome the Minister of State. I very much appreciate him dealing with this matter, which relates to the increase in demand there will be for home care now that we have an increasing number of older people in the country. That number will continue to increase at a dramatic pace in the next ten to 12 years. The figures, as I understand them, indicate that 637,000 citizens are over 65. Within 12 years, that will be 1 million. While there has been an increase in the number of people who are being provided with home care, we also need to plan for the long term. In particular, we need to plan to upskill people who will be able and available to provide home care.

The other challenge we face relates to the fact that because of the increase in employment, people will not be attracted into providing home care because there are more permanent jobs available. We will have to look, therefore, at what kind of mechanism we should put in place to ensure that people have job security. That is becoming more of a challenge for those who want to provide home care. It is in that context that I am raising this issue. I would like to know what action the Government and the Department of Health are taking to deal with this issue?

Jim Daly (Cork South West, Fine Gael)
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In common with other developed counties, Ireland is experiencing the ageing of its population. As the Senator rightly pointed out, this is giving rise to some significant challenges for us. The proportion of the population aged 85 and over increased by more than 20,000 between 2006 and 2016 and is projected to increase by a further 36,000 by 2026. This effectively means that this age group is expected to more than double over a 20-year period. Based on current CSO population projections, it is expected that population ageing will continue in the forthcoming decades. This, of course, has direct implications for health and social care services because demand is highest among those in these age groups.

The HSE, working within its available resources, has sought to maintain and, where possible, expand the range and volume of services available. These services include supporting people to remain in their own homes and preventing early admission to long-term residential care, as well as supporting people to return home following an acute hospital admission. Home support services were a particular area of focus in budget 2018, with an additional €18.25 million allocated. The additional resources made available in 2018 bring the total budget for the direct provision of home support services to €408 million.The HSE's national service plan provides for a target of just over 17 million home support hours to be provided to 50,500 people. Turning now to the steps that have been taken, I can advise that at the end of last year the Minister for Health, Deputy Harris, launched the national strategic framework for health and social care workforce planning. The framework aims to support the recruitment and retention of the right mix of workers across the health and social care system to meet planned and projected service needs. The framework proposes a consistent approach to strategic workforce planning together with the establishment of structures and governance arrangements that support and enable the application of this approach in the health sector and cross-sectorally where appropriate. One of the early actions identified as necessary to implement the framework is the development of a more formal and structured arrangement for engagement between our health and education systems to ensure the development and retention of the appropriate competencies and skills in the system. As with all health and social care workers we must ensure that the competencies and behaviours being developed by those who wish to become home care providers take account of developments in health and social care delivery. It is essential that educational and training courses are provided to these individuals with the core competencies which are required for their future profession. Ensuring closer engagement between health and education and training systems is vital to achieving this goal. The development of a protocol for engagement between the two sectors is a high-level objective of the framework's implementation plan. I am fully aware that home care providers play a vital role in improving the health and well-being of our older population by supporting and looking after them at home, which is usually their preferred environment. In terms of the provision of training, the HSE provides training to its home support workers. The current programme in health service skills leads to an award at level 5 recognised in the national framework of qualifications or equivalent. This skills programme is available to staff working in the HSE and section 38 agencies. This ensures that they have the necessary competencies required for their role meeting all the quality standards required for effective patient and client care.

Paul Coghlan (Fine Gael)
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Does the Senator have a supplementary question?

Colm Burke (Fine Gael)
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I thank the Minister of State. He has acknowledged that there will be a substantial increase in the demand for home care. In the context of the national strategy framework for health and social workforce planning, do we have a five-year or ten-year plan to develop this service or are we merely going from year to year? My concern is that it is the latter.

Jim Daly (Cork South West, Fine Gael)
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I can appreciate the Senator's concerns because the demographic trends are frightening to say the least. It is staggering to think we will have 1.2 million people over the age of 65 years living in this country in the next 20 years or so. There is a huge challenge and that is why, early in my tenure in this role, the Minister for Health, Deputy Harris, and I launched a consultation on a new statutory home care scheme that would mirror the fair deal scheme. It would be underpinned by statute, would be guaranteed funding and would be a demand-led scheme. Part of that is looking at our workforce planning and the issues surrounding ensuring that we have availability. It is a challenge in many different regions and it contributes to the ad hocnature of delivery today. The upskilling and recruitment, as well as the maintaining and keeping in the system of home care workers, is part of that statutory scheme and is part of the planning process that is being undertaken at the moment. I assure the Senator that we are aware of that challenge and that is to the fore in our development of the new statutory scheme, which we hope to have up and running within the next two to three years.