Alison Comyn (Fianna Fail)
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I welcome the Minister of State, Deputy Kieran O'Donnell, to the House and invite him to deliver his opening statement.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the Acting Chairperson. I am pleased to introduce the Bill following its recent passage through Dáil Éireann. I look forward to hearing the views of the Seanadóirí and working with them to progress this important legislation through the House.

Home support is a vital service that is delivered to thousands of people nationwide every day. This highly valuable service has users of every age and their families. It enables people to maintain independence and dignity while living at home. In line with Sláintecare, this Government is committing to ensuring we take concrete actions that will support and empower people to stay in their own homes and communities. I must acknowledge carers and service providers who provide formal home support. In recent years especially, they have demonstrated extraordinary dedication and diligence. As a result, our most vulnerable citizens have received professional and compassionate care.

I also acknowledge that it is not only State-funded services that help keep people at home and well in their communities. While increasing the provision of home support hours is a key priority for the Government, we must recognise that family carers have an essential role in helping people to live with dignity and independence in homes and communities of their choosing. The Bill will provide families with peace of mind that the care their loved ones receive is regulated, monitored and of the highest standards. I acknowledge the fantastic work of family carers. The programme for Government commits to designing a statutory homecare scheme to allow people to stay in their own homes for as long as possible. The first essential step towards the scheme is to ensure that homecare is regulated and there are quality standards in place that services can be inspected against.

This legislation will therefore ensure that for the first time in Ireland, home support providers, whether public, private or voluntary, will be required to operate in a regulated environment. There are inherent risks for service users in the provision of health and social care services by an unregulated sector. In vital areas such as infection prevention and control, staff training and clinical governance, there are no standards or regulations that all home support providers must comply with.There are standards of service that can be expected of the HSE through HSE-funded services or through the terms of private contracts. However, there are currently no consistent minimum standards of care applied universally to home support providers. There is also no independent oversight of the provision of services. Therefore, there is no independent mechanism to ensure that standards that exist, such as HIQA's National Standards for Safer Better Healthcare 2012, are complied with. The regulations that will be made on foot of this legislation will, therefore, offer quality assurance to service users that their service meets the same minimum standards wherever and by whom it is provided. The introduction of a statutory framework to provide independent oversight of home support providers will ensure increased compliance with regulations and quality standards, which will increase public confidence in home support services.

The Health Act 2007 established the Health Information and Quality Authority, HIQA, and Office of the Chief Inspector of Social Services. It also provides the regulatory framework for residential services for older persons, persons with disabilities and children in need of care and protection. The Chief Inspector of Social Services monitors compliance with this regulatory framework. The Bill before the House is modelled after the regulatory framework for the designated centres as set out under the Health Act. It amends the Act, establishing a regulatory framework for home support providers, which will be required to meet minimum requirements set out under ministerial regulations to provide a home support service. This framework will be further supported by HIQA's national standards for home support services. These amendments will act to safeguard service users and raise the quality and consistency of care nationally and will be a first step in meeting the programme for Government commitment to design a statutory homecare scheme. The framework will extend to all service users regardless of age who, by reason of illness, frailty or disability, require a home support service. As such, it applies to home support provision funded by both the Department of Health and the Department of Children, Disability and Equality.

The Bill will introduce for the first time the registration and regulation by HIQA and the Chief Inspector of Social Services of all home support providers in Ireland. Among other measures, it will provide the chief inspector with a range of powers and make it an offence to provide a home support service without being registered. The chief inspector will also be responsible for monitoring and assessing compliance of registered home support providers against regulations and HIQA standards. The new system of regulation for home support will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice.

I will take the House through the Bill to briefly outline the content of each section. The Bill has two Parts consisting of 22 sections.

Part 1 relates to preliminary and general matters and contains sections 1 to 4, inclusive. Section 1 provides for the Short Title, collective citation and for the commencement of the Bill's provisions.

Section 2 provides definitions of key terms used in the Bill.

Section 3 provides that the operation of the Act must be reviewed within five years of its enactment after which a report on the findings is to be laid before the Houses of the Oireachtas.

Section 4 repeals a section of the Human Tissues (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Act 2024.

Part 2 sets out amendments to the Health Act 2007 and consists of 18 sections. Section 5 amends the principal Act to provide for the definition of key terms relating to the regulatory framework for home support providers.

Section 6 amends section 8 of the principal Act to provide for new functions for HIQA to set standards on safety and quality in relation to home support services.

Section 7 provides for HIQA to conduct investigations of registered home support providers.

Section 8 expands the functions of the chief inspector to establish and maintain a register of home support providers, collect key data in relation to home support providers, inspect premises where he or she suspects the business of a home support service is being carried out, and register and inspect home support providers against both ministerial regulations and HIQA standards.

Section 9 inserts a new Part, Part 8A, to the principal Act to provide for the registration of home support providers through the insertion of 29 new sections, 69B to 69ZD, inclusive. Section 69B provides for the definition of key terms used in Part 8A and provides for exemptions to the requirement to register as a home support provider. Section 69C provides for a prohibition on carrying out the business of a home support service without being registered. Section 69D provides for a prohibition on making false or misleading statements in a material respect when applying for registration or renewal of registration. Section 69E provides for the application process for a person seeking to register or renew the registration of a home support provider. Section 69F provides for the establishment of a register of home support providers. Section 69G provides for the grant or refusal of the registration of a home support provider.I will not be able to finish in the required time. I ask the Acting Chair for another minute to conclude.

Section 69H provides for grounds under which the chief inspector can cancel, vary or remove a condition, or attach an additional condition to a registration of a home support provider.

Section 69I provides that the chief inspector may remove a condition attached to a registered home support provider's registration where they deem it is appropriate and will not adversely affect a service user receiving support from that provider.

Section 69J provides that a registered home support may apply to the chief inspector for the variation or removal of any condition that has been placed on their registration.

Section 69K provides for notices to be issued by the chief inspector to an applicant or a registered home support provider, as appropriate, in respect of a proposed decisions to an application submitted under sections 69E and 69J.

Section 69L provides that an applicant or registered home support provider, as appropriate, has 14 days after a notice is given of a proposed decision of the chief inspector under section 69J to make a written representation to the chief inspector concerning the proposal.

Section 69M provides that the chief inspector is to give written notice to an applicant or registered provider of a decision to refuse or grant an application, to cancel a registration, to remove or vary a condition or to attach an additional condition or to remove a condition of a registration.

Section 69N provides for when the chief inspector proposes to make certain decisions where the home support service is provided or proposed to be provided by an applicant or a registered home support providers from more than one business premises and a single application has been made for registration.

Section 69O provides for required and prohibited conduct for registered home support providers.

Section 69P provides for the appeals process from a decision of the chief inspector regarding an application for registration.

Section 69Q provides for the chief inspector to seek a District Court order enforcing certain decisions under sections 69G, 69J, and 69H.

Section 69R provides for the chief inspector to seek a District Court order where they believe there is a serious risk to a service user due to the actions of a registered home support provider or person acting on their behalf.

Section 69S provides for the chief inspector to make an application under section 69R as an ex parteinterim order.

Section 69T provides for a final determination of matters dealt with in an ex parteinterim order under section 69R.

Section 69U provides that an appeal of a District Court decision under section 69N lies in the Circuit Court.

Section 69V provides that the chief inspector is a party to any court proceedings taken under this Part of the Principal Act and is entitled to appear, be heard, adduce or give evidence.

Section 69W provides for the submission of information to the chief inspector by registered home support providers.

Section 69X provides for the collection of key data from registered home support providers, the sharing of information with the Minister and public bodies, such as HIQA and the HSE, and the publication of this data in aggregate form by the chief inspector.

Section 69Y provides that a registered home support provider shall not submit false or misleading information to the chief inspector under sections 69W or 69X.

Section 69Z provides that where a registered home support provider decides to cease to carry on the business of a home support service, they are to notify the chief inspector of the date in which they are to cease operating in accordance with the timeline set out under regulations.

Section 69ZA provides that where a registered home support provider ceases to carry on its business, the chief inspector will make a note in the appropriate register and cancel the registration of the provider.

Section 69ZB provides that where a person is appointed by or under law to take charge of the business of a registered home support provider, that person is to notify the chief inspector as soon as practicable and no later than 48 hours after the appointment.

Section 69ZC provides for the notifications by the chief inspector relating to certain home support providers.

Section 69ZD provides for transitional arrangements for persons providing a home support service immediately before this Bill comes into operation.

Section 10 provides for the HSE to appoint persons to examine business premises of a home support provider that is providing service on behalf of the HSE. A person appointed under this section will be authorised to enter any business premises of the home support provider and examine any records relating to the service and interview any employees of the provider.

Section 11 provides the right of entry and inspection by the chief inspector to the business premises used or proposed to be used by a home support provider or the private dwelling of a service user where a home support service is provided with the consent of the service user concerned.

Section 12 provides that if the chief inspector has reasonable grounds to believe that the business of a home support provider is being carried out on a premises which is not registered, the chief inspector may enter the premises to inspect it.

Section 13 provides for the District Court to issue a warrant to authorise the chief inspector entry to premises where the chief inspector suspects the business of a home support provider is being carried out, if required.

Section 14 provides for the inclusion in the definition of “dwelling” of any part of the business premises of a registered home support provider that is occupied as a private residence by that person or a member of staff of the provider.Section 15 provides for the inclusion of a reference to home support providers in relation to the further circumstances in which the District Court may issue a warrant.

Section 16 provides that HIQA may prepare and publish reports relating to the monitoring of compliance and standards by registered home support providers, and the manner in which those reports should be prepared.

Section 17 provides for the serving of compliance notices on registered home support providers. Under this amendment, where the chief inspector is satisfied that a registered home support provider has contravened a relevant provision of legislation, he or she may issue a compliance notice. A registered home support provider who fails to comply with the compliance notice by the date specified in the notice shall be guilty of an offence and liable to prosecution. Registered home support providers will have the right to make an appeal to the District Court within 14 days.

Section 18 requires the chief inspector to maintain a non-compliance list of providers on whom a fine or penalty has been imposed.

Section 19 amends section 79 of the principal Act providing for offences for home support providers.

Section 20 amends section 99 of the principal Act providing the Minister for Health, in consultation with the Minister for Children, Disability and Equality as appropriate, to make regulations relating to the registration of home support providers under the Act.

Section 21 provides the Minister for Health, in consultation with the Minister for Children, Disability, and Equality, as appropriate, to make regulations for home support providers to ensure proper standards in relation to the home support services they provide.

Section 22 inserts a new section 101C into the principal Act providing the Minister for Health with regulation-making powers to prescribe the collection, sharing and publication of data with regard to registered home support providers. Regulations will determine the type of data to be collected, shared and published and the frequency of the submission and sharing of information.

During Committee Stage as the Bill progressed through the Dail, I brought forward 31 amendments to the Bill on behalf of the Government. These amendments were technical in nature and sought to improve the clarity and readability of the legislation.

This legislation is a major step forward towards designing a statutory home care scheme, which is in the programme for Government. It is something I am very committed to as Minister of State, as are the Minister, Deputy Carroll MacNeill, and the Government in its entirety. The establishment of a regulatory framework for home support providers will act to provide new protections for service users and will raise the quality and consistency of care nationally.

I thank the Acting Chairperson and all the Members for their patience. I look forward to their contributions.

Alison Comyn (Fianna Fail)
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It was a tall ask in the time allotted. Gabhaim buíochas leis an Aire Stáit.

Maria Byrne (Fine Gael)
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I thank the Minister of State and his officials for coming here today to discuss this all-important topic. Quality of care and assurance is something all families look for, especially when they want to keep their loved ones at home. Longevity is something we have here in Ireland. For a long time, people did not live as long. More and more people desire to try to stay at home as long as possible and that cannot happen without carers. Whether they are public carers, sourced through a private company or funded through the HSE, it is really important that a standard be set. I compliment the Minister of State and his officials on their dedication to setting that standard and bringing forward proposals that will create safeguards around accountability and the fact that people will be properly trained. There will be set standards. Up to now, there were different standards and some people may not have had formal training. The fact that the Minister of State is looking at all those and regulating the fact that the service provider has to make sure everybody is at the same standard means there will be continuity of care.

It is also an assurance piece for the family of the person who is being cared for. When we speak to people who are living at home and living independently, they tell us that the carers coming in and doing this job or that job gives them the competence to live longer and also to live at home. It gives them greater confidence in being able to achieve things. As long as we can keep people at home, they are more comfortable in their own surroundings. It is consistent care in a lot of cases. Sometimes, people have different carers coming in but in many of the companies it is the same carer. I attended an information day with one of the care companies with the Minister of State and they had an award ceremony for some of their carers. The patients who people were working with were asked to vote for different carers and talk about their qualities. Some of the issues they raised were so complimentary because so many people are so caring.

We always have people who might have slipped through that loop, but this legislation will set down the foundation for making sure everybody receives the same level of care with that accountability piece. That the sector is answerable to HIQA is also important because it sets such high standards in terms of its inspections and that whole quality piece. I compliment the Minister of State and his officials. I look forward to working with him on bringing this Bill through the Houses.

Victor Boyhan (Independent)
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I thank the Minister of State for coming here today. He will appreciate the constraints of time. He had to go way over the time that was agreed for the Minister of State under the Order of Business. That is no disrespect to him, but it indicates that 75 minutes for important legislation like this is not enough. I make one ask of him. I ask him to go back to the Leader of the Seanad and make a case, as Minister of State, that he deserves to have his time. He has difficulty here today and that is no fault of his own. This is an important piece of legislation. We have only got five minutes to engage with the Minister of State on this important legislation before Committee Stage and he has time to come back. Clearly, it is not enough time. Next week, we are going to be busy and right up to the recess. I ask him to talk to his Government colleagues and say that the Seanad and its Members need the respect they deserve. We are a revising Chamber of this Parliament and we need the time. That is in no way a reflection on the Minister of State. I thank him, as always, for coming to the House. I have made that point and I will leave it with him.

Family carers across Ireland are being pushed deeper into financial hardship, social isolation and poor health as they shoulder ever-increasing caring responsibilities with insufficient State support, according to a new report forwarded to me by Councillor Richie Molloy from Tipperary, who is a strong advocate for Family Carers Ireland. The report is titled, The State of Caring 2026, and I will circulate it to all Members later this afternoon. This report, published by Family Carers Ireland, paints a stark picture of life for thousands of people providing unpaid care for loved ones with disabilities, chronic illness and complex support needs.

The Minister of State will be aware that elder abuse remains widely under-recognised and under-reported and can take many forms. Many of us will also have heard of complaints about hospitals and nursing homes, but we know elder abuse and the abuse of those in care takes place in family homes too. Safeguarding begins with noticing and listening to older people and responding when something does not seem quite right. Having access to nutritious food, adequate hydration and choice and support at mealtimes are fundamental to health and quality of life. Older adults must be supported for and cared for in a way that respects their preference, independence and dignity. I call on the Department of Health to work on the long-delayed adult safeguarding Bill. That needs to be done and the Minister of State might perhaps address that at some stage.

As we prepare a statutory home support scheme and a new regulatory framework, we have an opportunity and an obligation to create a system that prioritises dignity, flexibility and client choice. The statutory home support scheme, committed to by successive Governments, should provide and protect access to care in people’s homes, enabling them to stay at home for as long as possible. The Minister of State is seeking to do that here and I acknowledge that. Central to this legislation must be the client choice model. Critical to the success of this legislation will be building on the client direct home support that empowers clients to choose their provider and agrees flexible times, improving alignment between needs and skills but also making better use of capacity.

Waiting lists for home care services have surged. Data released by the HSE, which is on the Oireachtas site because I tuned into the Minister of State's debate in relation to this business, show that waiting lists for home care stood at 5,300 for the first three months of 2026. The HSE heads of service for older people, and for accessibility and integration, said that nobody is waiting for funding to be allocated for home support, which is an important point, but they are waiting for carers to be assigned to them, due to shortagesThe shortage of carers is presenting problems for many hospital patients who are unable to be discharged because they are waiting for a carer to be found. The shortage of home care support is particularly challenging in rural areas and is totally unacceptable for people around the country seeking support.

This is important legislation but what is critical is the need to deliver a statutory home care scheme. I know the Minister of State is committed to that. The recruitment of staff is an issue that is causing difficulties for many people. Remuneration is also an issue. The Minister of State will be familiar with the strategic workforce advisory group, SWAG, and its recommendations. Some of those have been implemented but others have not. That is also a critically important piece.

I wish the Minister of State well with this important legislation. Clearly, it will warrant some amendments but given the committee that looked into this matter and the way it addressed the limited number of amendments in the Dáil, the Minister of State is certainly moving in the right direction. I genuinely wish him every success with this really important legislation that I know is dear to him and his vision for care in people's homes.

Teresa Costello (Fianna Fail)
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I welcome and support this Bill. It is simple in that it is just making sure that people who receive care in their own homes can be confident that the care they receive is safe, of high quality and properly regulated. Every day across Ireland thousands of older people and people with disabilities rely on their home care support services. These services help people with everyday tasks such as getting dressed, preparing meals and personal care, enabling them to remain independent in their own homes. For so many families home support is an essential service that allows their loved ones to remain in familiar surroundings and maintain their independence.

My dad had dementia prior to passing and we availed of home care supports. The carers were just amazing. It was not always easy for them. Their job is difficult and what the carers who come into family homes go through is not highlighted enough. A patient can be having a really bad day and they can be abusive to their carers. They can be difficult and decide they do not like the carer for no reason but the carers just continue to show up. The carers who came to our family home, Ashley and Fernanda, were so good to my mam as well and that made my dad's last time on earth so much easier. The respect I have for carers is enormous.

Regulation is so important. We struck gold with our carers but regulation will ensure that all people have a similar experience. Nursing homes and other health services are regulated and inspected but home support services have not had that same level of oversight, so standards can vary from one provider to another. Regulation means that the providers must meet national standards and be accountable for the quality of care they provide. The Bill makes it an offence for a provider to operate without registration, which is very important. It gives HIQA and the chief inspector of social services the power to inspect services, which is critical. They will be monitoring compliance, which is important. This is about protecting vulnerable people. People who are in need of care are vulnerable and it is important that a high standard of care is being delivered and being monitored.

I welcome the fact that the Bill applies to all home support service providers, whether public, private, voluntary or not-for-profit. Everybody should be working to the same standards and every person receiving care should have the same protections. I also welcome the inclusion of services provided to children and young people. Families should have the confidence that quality and safety standards apply regardless of age.

This Bill is an important step towards the Government's wider goal of developing a statutory home care scheme, as Senator Boyhan said. We know that people, for the most part, want to remain in their own homes for as long as possible. We also know that Ireland's population is ageing and that the demand for home support services will continue to grow in the years ahead. The Government has shown its commitment through significant investment in home support services. Funding has been increasing year after year but investment alone is not enough. We have to ensure that the services being funded are safe and accountable and of the highest quality. This legislation will protect service users, support families and improve consistency across the country. It will also go some way towards strengthening public confidence in these services.

Pauline Tully (Sinn Fein)
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Curaim fáilte roimh an Aire Stáit. I will be supporting this Bill. Who would not agree that the private home support sector should be regulated? It actually makes me shudder to think that it has not been to date and that we have no minimum standards of care when it comes to home care services. Home support workers are going into the homes of very vulnerable people, including older people living on their own, people with a disability and people who have suffered a stroke and cannot articulate or advocate for themselves. We need this legislation. Up to this point, the HSE was not even in a position to provide a list of private providers who go into the homes of vulnerable people.

The legislation is long overdue and is extremely welcome. It is urgent and needs to be moved on as quickly as possible. Families and individuals deserve assurances of safety standards and accountability. The Bill allows for both the inspection of homes and enforcement, where necessary, to be carried out by the chief inspector and HIQA. Increased resources will be needed and I presume that has been factored in. We do not want to hear that HIQA and the chief inspector do not have the people on the ground to do the work that is necessary.

Unfortunately, this is not the statutory home care scheme that has been identified in a number of programmes for Government. We still need to move towards such a scheme. This legislation is not about delivering entitlements for patients either and it embeds the privatisation of care. We really need to build a genuinely public health and social care system. I have spoken to the HSE in my locality because I know of lots of people who are waiting for home care. I have asked the HSE if there is a moratorium on recruitment but it tells me that there is not. There are many people working for private companies who are excellent workers and who would love to work for the HSE because the pay and conditions are much better but the HSE does not seem to be recruiting. I just do not understand it, particularly when there is a shortage of home carers. Why is the HSE not recruiting?

There are over 5,000 people waiting for home care hours. Some are waiting for additional hours to the package they have because their needs have increased while for others, it is a new service. This Bill is not going to guarantee those people the hours they need. It will not guarantee them continuity of carers. Nor will it guarantee that they will be able to remain safely in their own home or be able to leave hospital or a nursing home to go home. Yesterday, I had a phone call from a woman whose mother is 97. She is living in her own home and there are carers coming in but frequently one carer cannot come. Carers are entitled to time off at weekends, for holidays or if they become ill, but there is no additional cover provided. This lady will help as much as she can and she has brothers who are brilliant and who help out, but neither the mother nor they themselves are comfortable with the personal care element. The woman and her sons have their dignity, and that has to be respected.

I was talking to another woman whose husband's carer was not able to come to the house. She was asked if she had neighbours who could help. Why on earth would she do that? Her husband deserves respect. He does not want neighbours coming in to help him to shower. Another lady I spoke to is a wheelchair user. She has been a very independent lady for all of her life. She requires surgery so, for the moment, she is unable to manage. She has waited for months and finally has got some level of care but she said she is still juggling family members with the care. However, the carers are coming to her home in the evening to put her to bed at 7 p.m. This is an active lady. She is 70 years of age but she is really active and involved in lots of committees and so on. She said to the person in the HSE - because it is not the carer's fault - that she does not want to go to bed at 7 p.m.She was told that she was lucky that she was not going at 5 p.m. That is no way to treat people. That is a total lack of dignity.

She inquired about a personalised package and was told that it was not available. She told them that she knew it was available to people. They asked her what age she was, and when she said she was 70, she was told that it is not available to old people. It was available to her as a disabled woman should she have needed it - which she did not but she knew of other disabled people who had accessed it - but not to her because she had aged out of the service. It was like her disability had disappeared. That is ageism. This woman is well able to manage her own affairs and would be happy to do so. Her carers are a mixture of HSE and private carers. She says there is one company from which she has not seen the same carer in the time they have been coming in. For people with dementia, that is very confusing. They need a continuity of care. Older people and vulnerable people need to get to know people as well and not feel like that they are a burden on society.

While everything in this Bill is needed and needed as quickly as possible, a lot more is needed around how home care is actually provided.

Tom Clonan (Independent)
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The Minister of State is very welcome, as are the Department's officials. I hope they will be able to address my concerns in the time provided.

I echo what Senator Stephenson said. I have a concern about section 69B(2)(a) which states, "the person provides a home support service to fewer than 4 persons". Senator Stephenson quite correctly pointed out a concern about whether an unscrupulous operator could get a pile of smaller care providers, limit them to three clients and in that way try to evade regulation. That is a concern. The suggestion in that amendment is that an operator is deemed exempt from the regulator if they only provide care to that number of people.

I do not know if the Minister of State or the Department's officials can answer this for me, but I am very worried about this clause for a different reason. I will give the House some context. My family has been receiving a number of care hours from the HSE for a very long time now, maybe ten or 12 years, and to echo what Senator Tully said, the experience is mixed. I also echo what Senator Costello said that without exception, the people who come into our home from all over the world are the most wonderful people, but it is the model of the provision that can sometimes lead to inconsistencies. For example, we had one service provider where we never knew from one day to the other whether somebody would turn up, and it was rarely the same person. The carers then would not understand my son's care needs and I would have to come down. It was just very stressful. That is one thing.

For-profit care providers - I am not going to name them because I do not want there to be a suggested or implied criticism of them - can be hit and miss. Also, because they keep a certain amount of the money they take from the HSE for themselves, those carers tend to be paid very little. What happens all the time with our son is that he gets a wonderful carer and they really gel, but because they are only getting paid €12 or €13 an hour, they inevitably get a better offer of work and they say, "I am really sorry, but I have to move on" and so that continuity is denied.

In all of those years, there has been a very unequal power relationship between families and the HSE. I am not talking about the carers, but the HSE itself and the people who open the funding gates. Across all of the regional health areas, they are all different. They are all capricious. They all have their own little kingdoms and their own little rules. I have had people say to me, "You are not getting that funding". When I ask why they say, "Because I say so", and because we do not have a legal right to any of these things, it is very hard to push past that.

Under the brokerage model of care provision, with a company like Home Instead, a client gets to pick and choose their carers who then come in and provide a service. However, they would not come under the definition of the Bill because they would likely be dealing with just two or three clients. Would this legislation give the HSE-----

Kieran O'Donnell (Limerick City, Fine Gael)
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Will the Senator make that point again?

Tom Clonan (Independent)
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The brokerage model-----

Kieran O'Donnell (Limerick City, Fine Gael)
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No, beyond that.

Tom Clonan (Independent)
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Would the HSE be able to say that it is not giving funding for that service provider because they are not amenable to regulation, and that it would be irresponsible of it to release public funds to a carer in that situation? That is something that I really need to get an answer on because if that were the case, that would then confine all of us to using a model we do not want. For example, most recently when funding was cleared for supports for my adult son, his preference was to go with the care provider that had been given to him through the higher education thing for going to university.In our CHO the HSE just said that we could not do that. We had to take the company it suggested or nothing. For fear of losing the funding, we just had to accept it. The company has been fine but it is not the service of his choosing. Will the Minister of State clarify that for me? I understand that people providing fewer than four are exempt from the regulations, but will the Minister of State guarantee that they will, notwithstanding that, be allowed to receive State funding to provide the very valuable services they do? I thank the Minister of State for his patience on that.

Alison Comyn (Fianna Fail)
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Before we move to our next speaker, I welcome to the Visitors Gallery, Mr. Matthew Wagner, who is a guest of Deputy Mary Lou McDonald. I hope you enjoy the rest of your day. It is quite timely then that we are moving to our next speaker, an Seanadóir Joanne Collins.

Joanne Collins (Sinn Fein)
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I welcome the opportunity to speak on the Bill. As my colleague Senator Tully said, we will support this on Second Stage because the private home care sector must be regulated and families deserve basic assurances of safety, standards and accountability. Supporting a Bill is not the same as applauding the Government's record on this. The legislation is necessary but it is also a stark admission of how little has been delivered and how low the Government's ambition has been and has fallen when it comes to home care. In plain language, this Bill is about regulating providers; it is not about delivering entitlements for patients. We support it because families currently rely on a patchwork system. Some receive HSE-approved and HSE-provided support, which is often rationed and insufficient. Others depend on a growing private market where standards and oversight have not always matched the vulnerability of those receiving the care. Registration, inspections, enforceable standards and accountability are the minimum that people should expect. Regulation is overdue and it is an essential part of any future statutory home care scheme. However, the problem is that the Government will undoubtedly present this as progress towards that scheme. The reality of this is very different. The current and previous programmes for Government promised a statutory home care scheme and after five years what has been delivered is a register for providers. People were led to expect something completely different and something comparable to the nursing home support scheme, namely, a pathway to universal home care that is planned, funded and delivered as part of a properly resourced public health and social care system.

Instead, this Bill says nothing about access, affordability or entitlement. It risks embedding a model that is designed around private provision rather than building a genuine public capacity. Regulation is not the same thing as a statutory scheme. Regulation can help prevent poor practice and protect vulnerable people, but it does not guarantee someone will receive the hours of support they need. It does not guarantee continuity of care. It does not guarantee that an older person or a person with disability can remain safely and independently in their own home. The Bill contains no answers for the families that every day ask questions like who qualifies for support, how quickly will the support be provided, what is the maximum waiting time, how are different levels of need assessed and what happens when a family cannot afford additional care. If the Government is serious about shifting care into the community, home support cannot remain as a discretionary service. It must become a right and it must be delivered to a high standard, with a defined timeframe and supported by transparent reporting and accountability.

What is needed now is the clear roadmap that we have been promised to the statutory home care scheme, with timelines, phased implementation and dedicated funding. We need a genuinely needs-based system that recognises the difference between basic home help and high-dependency care and the guarantee of access based on needs rather than availability. While we support the Bill because regulation is necessary, the Government should not confuse a regulatory register with a statutory home care scheme. Families need rights, access, affordability, and most of all, they need a Government that will listen to the actual issues rather than another promise deferred.

I am from County Limerick and I will give my own example. I know how important home care is, but I also know how detrimental it is when you cannot get home care. My mother has late stage dementia. My dad minded her at home every day because he made a promise to her that he would not put her into care. He was awarded home care hours but there was nobody there to give them so now she is living long term in a respite centre. She cannot get a place in a nursing home because she walks too much with her dementia, so they will not take her in a nursing home. It is very unfair. My father is nearly 80 and he drives for an hour and 20 minutes every day just to get to see his wife for an hour. That is wrong. There is a breakdown of the system. It is just not right and it is breaking families.

Sarah O'Reilly (Aontú)
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I thank the Minister of State for coming in on this very important issue. I too welcome this long-overdue Bill. Introducing regulation and independent oversight for private, home support providers is absolutely necessary to protect vulnerable adults, who are essentially inviting strangers into their home to care for them. That is why I would like greater clarity on how inspections will work in practice. Unlike residential settings, these services are delivered in private homes. How will HIQA ensure standards are maintained, while respecting the privacy of individuals and families? How will consistency be monitored when care is taking place in thousands of different homes across the country? It is a very positive step and I welcome it. However, home care needs to be radically transformed in this country. We have an ageing population, yet we know that for the first three months of this year over 5,000 people were waiting for a home support service to commence.

Last year, I spoke to carers who were available and ready to work but the HSE had not released funded packages or hours because it had gone over budget. The staff were there for the people who desperately needed care and yet the service was not being delivered. What I was hearing was that the HSE had run over budget, care packages had been approved, and that was giving a false reading of the situation because even though the packages had been approved, the HSE had not released them. There is that extra step. They were not released to the home care providers because of budgetary constraints. The Government increasingly relies on private providers to deliver home care while simultaneously failing to provide a public care structure that is fit for purpose. I ask the Minister of State to explain how many approved home care hours are currently going unfilled and what concrete steps are being taken to ensure that support is actually being provided.

Kieran O'Donnell (Limerick City, Fine Gael)
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How much time do I have?

Shane Curley (Fianna Fail)
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Five minutes.

Victor Boyhan (Independent)
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On a point of order, can we clarify what was agreed on the Order of Business? I think it was 75 minutes for this debate, so the Minister of State has more than five minutes if he wishes.

Kieran O'Donnell (Limerick City, Fine Gael)
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Do Members wish to come back in?

Victor Boyhan (Independent)
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Yes.

Kieran O'Donnell (Limerick City, Fine Gael)
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I am quite open to it if Members wish to come back in.

Shane Curley (Fianna Fail)
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What was agreed was eight minutes for the Minister of State's opening statement, five minutes per Member, and then the Minister of State to respond.

Victor Boyhan (Independent)
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Can I suggest that within the 75 minutes if the Minister of State needs a bit of time he takes it. Is that okay with the House?

Shane Curley (Fianna Fail)
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Is that agreed? Agreed.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the members for their very constructive and heartfelt contributions. Virtually everyone spoke about a family member. There is probably no one out there who has not been in some way involved with family members, friends or relations of any form, in dealing with home support. To give context to my role, I have responsibility for older people in two Departments. The programme for Government outlines a commitment to design a statutory home care scheme, which I am utterly committed to doing, but I want to do it in a structured way. The first key element of that is to regulate the sector, which is unregulated at the moment.I acknowledge and compliment the officials here with me on the serious body of work they have done on it. In many cases, a lot of the work is hidden but it is a huge amount of serious work and I wanted to acknowledge that. I have no doubt but that we will discuss it in a lot more depth on Committee Stage. It is something I very much value.

I wish to acknowledge again what everyone else has done here. I will perhaps do it in reverse order. I want to acknowledge the family carers; the people in their homes. All Senators spoke but in particular, Senator Collins spoke about her mother and what her dad is doing. If there is something I can do, we can maybe talk. That is complete dedication from the Senator's dad. He is giving her that commitment and that is to be admired but it has an impact on the carers as well. I want to acknowledge the professional home carers across the public, private and voluntary sectors. They are all doing great work and that is hugely important.

What we are doing here is regulating the sector. It is the first step in designing a statutory home care scheme. We have to have a scheme that is based around need. We have to look at assessing that need. We need to put in place a service that serves people and is sustainable. It is something that, in my role, I am working on with the officials.

What I would like to do now is address, as well as I can, the particular issues raised by Senators. Senator Byrne made reference to demographics. We have an ageing population and we want to give more and more people the option of remaining at home. It is choice and for me, it is all about choice. As people get older, we want people to be in better health condition now than they may have been a couple of years ago. Home care is a huge element to that; meals on wheels is another element. It is across the spectrum, including nursing homes and acute hospitals. That is what we are looking to build into it.

Senator Boyhan raised a number of points. As for where safeguarding overall is, it was something I felt very strongly about when I came into the role because it is a key element in regard to older people in particular. The first thing I wanted was a commitment in the programme for Government to bring forward the first ever adult safeguarding national policy. We published that last December and the Government approved that policy. It equally approved us to proceed to bring forward legislation. We are working actively on it at the moment. I want us to bring that legislation forward towards the end of the year in regard to a general scheme. Once again, we must get it right.

The next issue Senator Boyhan rose came up everywhere. I am doing a body of work with the HSE at the moment around home support delivered by the HSE. I want to bring down the waiting lists. They are coming down but not at the rate I would like. The HSE has been given funding and, in regard to a reference Senator Tully made, there is no embargo on recruitment. The HSE has been given funding to recruit 257 additional home support and HSE home care workers, along with recruiting a number of people for vacancies. That is actively under way. It is something I want to see. I meet the HSE regularly on this and I very much want to see a structured approach.

Senator Costello made reference to it being an essential service. She referred to her own parents and the issues around protecting vulnerable people. There is a number of components. Regulating home support is hugely important because it will give that certainty.

I covered the points Senator Tully raised in sequence including, once again, the home support.

While I think Senator Stephenson has gone, that dovetails into the key points Senator Clonan raised. When I came in, I wanted to look at what the background was. It is effectively less than four but it is three or less. It was looked at as a proportionate measure. I happened to be in Wales for St. Patrick's Day and I met with the Minister in that area, along with her officials. At the time it was the Minister for Children and Social Care, Dawn Bowden. I went through, in depth, what they have done. In Wales, they have had it up and running for a long number of years. In their case, it is four or less. In our case, it would be three or less. The main reason that was done was proportionality. It is in this Bill as well. We are not including personal assistance, PA, services. The Department of children wished that PA services would not be included so we are not including them. If it wishes, we will but for the moment, that is its decision. PA services, in many cases, will be delivered by that lower number. We want a standard of care and it is something we will be looking at. The proportionate model was done in a way to ensure that it worked in practice.

Senator Collins made reference to the human aspect. It is something I am working on with the HSE. I want to see the HSE recruiting more staff. Senator Collins made reference to rural areas in many cases, and these are the areas I want to tackle with regard to bringing down the numbers. There are many areas of the country where there are not waiting lists. There are other areas where there are and I want to do a concentrated body of work. It is not just about putting the legislation in place. It is also about doing the day-to-day work, along with the officials.

Senator O'Reilly has gone. On the legislation itself, we are now proceeding to Committee Stage with Members and I really look forward to the contributions. There will then be regulations put in place in regard to how it works in practice. There will be a lead-in period. We have gone through this legislation in great depth and I think it will add to the quality, consistency and regulation of home support for people living at home, particularly for the service users themselves but also for their families and to give that level of assurance. What we want to do is progress it. It is the first step in designing a statutory home care scheme, which we are actively working on. It is something I am looking to bring forward as quickly as possible but I want to do it in a way where we have a structured approach, so that we get that something that is very much sustainable and is based around need in particular.

I hope that covers all the aspects. We can obviously go through the various sections of the Bill in great depth when we have Committee Stage, which will be next week. I thank the Seanad for facilitating it. This is about independent regulation of a sector that up to now has not been regulated. I think it is something that everybody can collectively agree on. I look forward to further engagement on Committee Stage and I thank Senators for their contributions.

Shane Curley (Fianna Fail)
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When is it proposed to take Committee Stage?

Maria Byrne (Fine Gael)
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Next Tuesday.