Brian Ó Domhnaill (Fianna Fail)
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I thank the Chair for selecting this matter. I welcome the Minister of State at the Department of Health, Deputy Catherine Byrne. Many people are affected by the issue I am raising, namely, the delay in providing home help or support services. It has been raised in the Dáil by various Deputies, including during a debate last night. If one looks at the backlog for the home support service, one will discover that 6,423 people are on the waiting list for increased or new hours. That is according to the information the HSE supplied to me last week. Included in that are 228 people on the waiting list in my county, Donegal. This is an excellent, cost-effective service and the delays are causing numerous difficulties for the families and individuals concerned, with domino effects for the Department and the HSE in the context of late discharges from acute hospitals because no home care is being provided. That has been highlighted by the National Health Service, NHS, in the UK, which commissioned a report on this issue and found that late discharges were giving rise to additional costs in the context of its acute hospital budget. The NHS implemented the recommendations in the report to which I refer and has saved €60 million in the past 12 months alone by allowing people to go home sooner because the relevant care was in place. The NHS's calculations were based on a £313 charge per day for acute hospitals. The same is evident here if we can allow people to go home and avail of home help care or home support.

I am aware that additional resources are being provided to this service. Over the past four to five years, additional resources have been provided. Clearly, however, these are not sufficient to meet demand. If this is such a cost-effective way of dealing with the health needs of elderly people over the age of 65, then the shortfall in resources needs to be addressed as a matter of urgency. I have been informed by the HSE that it would cost €40 million this year to clear the backlog of 6,423 cases. I call on the Minister of State to make that money available to the HSE in order that it might clear the backlog before it increases. In County Donegal, the backlog has increased by 27% since May. That could increase again during the winter months and the situation could be much graver by February or March. I call on the Minister of State to provide the resources to reduce the backlog immediately and to put a better system in place to support home carers and those who provide care independently on behalf of the Department. I hope the matter relating to this excellent, cost-efficient service will be addressed as a matter of urgency.

Catherine Byrne (Dublin South Central, Fine Gael)
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I am taking this matter on behalf of the Minister of State, Deputy Jim Daly, who cannot be here this morning. I acknowledge and welcome the debate in the Dáil last night. I was there for some of it. I know there was support from every corner of the Dáil. I do not know if the statement I am about to read will provide the Senator with additional information. I will read it in any event.

We all share the common objectives of improving quality of life for our older citizens. This Government continues to strive to ensure that initiatives are put in place to provide older people with the type of care they need and that such care is delivered in the right place and in a timely manner. The home support service is a core service for older people and is highly valued by service users, their families and the HSE. The service provides supports which assist older people to live independently in their own homes for longer. It enables large numbers of people to return home following acute hospital admission who otherwise would remain in hospital or would be admitted to long-stay residential care. This allows care to be provided in the community, which is a key principle of the vision of and implementation of Sláintecare. There has been sustained significant investment in these services in recent years. As a result, the home support budget has increased from a base of €306 million in 2015 to almost €420 million in 2018. Continued investment in home support is be a key consideration of the service planning process. Overall, the 2018 HSE national service plan provided over 17 million home support hours to be delivered to 50,500 people at any time. In addition, a further 156,000 hours, relating to adverse weather funding, were provided from spring 2018. Intensive home care packages will be delivered to approximately 235 people at any time and will deliver approximately a further 360,000 hours in the full year.

Despite this significant level of service provision, demand continues to rise. All those waiting are assessed and provided with a service, if appropriate, as soon as possible and having regard to their assessed needs. People being discharged from acute hospitals who are in a position to return home with supports are prioritised. At the end of September, preliminary figures indicate that there were 6,423 people approved for either new or additional home care supports who were waiting for funding to be available. The Minister of State, Deputy Jim Daly, has overseen investment in other areas of community supports such as in the availability of transitional beds aimed at reducing the need for older people to stay in hospital while awaiting long-term care packages such as home support or fair deal funding to be finalised. Transitional care also facilitates a cohort of patients who require further convalescence care but do not need to remain in acute hospitals. The number of approved transitional care beds has increased year on year and the availability of these beds is an important community-based support year-round, particularly during the winter. Following the recent budget announcement, the HSE and officials from the Department of Health are in the process of developing and agreeing the HSE national service plan 2019, which will set out, in detail, the type and quantum of services to be delivered in 2019 including services for older people.

The Senator's concerns included the 228 people in Donegal waiting to be assessed for or provided with a home care package. I will raise that with the Minister in question. We all want to make sure that older people and not-so-old people who would like to live in their communities get the care to be able to. The Minister is doing everything possible. With the continued development and agreement of the HSE national service plan for 2019, we hope that more funding will be made available. I will come back to the Senator after his next contribution.

Brian Ó Domhnaill (Fianna Fail)
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I thank the Minister of State. The HSE has provided the cost to me. Some €40 million would clear the backlog. It is unfair that there is no backlog if one lives in Kerry, north Cork, south Cork, Carlow, Kilkenny, south Dublin or County Louth. If one lives in Donegal, Sligo, Mayo, Galway or Cavan, there is a substantial waiting list. That is wrong. The HSE is a national organisation and should provide the same service to all. Investing in transitional care and other hospital facilities is much more costly. This is more cost-efficient and I would appreciate the Minister of State raising it. I know there are many competing demands but it makes economic and social care sense to deal with this.

Denis O'Donovan (Fianna Fail)
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The Minister of State has already committed to bring this back to the Minister of State, Deputy Jim Daly.

Catherine Byrne (Dublin South Central, Fine Gael)
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I welcome this debate, which I am taking on behalf of the Minister of State, Deputy Jim Daly. Like Deputies in the Lower House last night, I welcome the provision of 550 additional home care support packages. These are really needed at this time and, in particular, as we come into the winter months. All of us with older parents or people who have certain requirements and need to be at home want to make sure that they get the best care, particularly in the communities in which they live. I am of the view that people want to stay in their communities. The Minister of State is very conscious of this. After I took last night's debate in the Dáil on his behalf, the Minister of State spoke to me about a vision for the future whereby people who cannot live at home will be able to stay in a managed environment - and have their own hall doors - or in retirement homes where their loved ones can visit and where there could be services nearby. The Minister of State is pursuing that option.