Fergus O'Dowd (Louth, Fine Gael)
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741. To ask the Minister for Health the progress made to date on the introduction of a statutory home care scheme as promised in the Programme for Government; the timetable for its introduction; the number and rank of civil servants working full-time on this scheme for each year since 2019; and if he will make a statement on the matter. [4730/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Work is ongoing to progress the development of the new home support scheme within the broader context of the ongoing reform of our health and social care system, as envisaged in the Sláintecare Report. The scheme will provide equitable access to high-quality services based on a person’s assessed care-needs.

Work is ongoing across three workstreams: 

(i) Regulation of home-support providers

The Department is currently developing a regulatory framework for home-support providers with the aim of ensuring that all service-users are provided with high-quality care. This framework will comprise primary legislation for the licensing of providers, secondary legislation in the form of regulations (minimum requirements), and HIQA national standards. 

On 27 April 2021, Government gave approval to the Minister for Health to draft a General Scheme and Heads of Bill to establish a licensing framework for home-support providers. The Heads of a Bill are currently at draft stage. This is being progressed by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity. A Regulatory Impact Analysis is being progressed by the Department to ensure effectiveness and mitigate risks.

Development of regulations and standards are at an advanced stage. The Department has completed a targeted stakeholder consultation on draft regulations (minimum requirements) that will form the criteria against which a provider’s eligibility to hold a license will be determined. Draft regulations for home support providers have been developed by the department and amended following targeted stakeholder consultation. This has been enhanced by regular discussions with HIQA, HSE, Private Providers' representative groups and legal expertise assisting with legal text and interpretation of core issues, such as, capacity legislation, employment laws and health and safety issues. A 6-week public consultation was completed in August 2022 and the analysis of the results by the IPH was recently published:

www.gov.ie/en/publication/56ab1-draft-regulations-for-providers-of-home-support-services-an-overview-of-the-findings-of-the-department-of-healths-public-consultation/

HIQA have conducted an evidence review on home support which was published on May 30^th2022. HIQA have developed standards for home care and home support services which will be the focus of a public consultation early this year. The Department is also represented on the HIQA advisory group. 

(ii)Financing of home-support services  

The Economic and Social Research Institute (ESRI) undertook a programme of work on behalf of the Department on the potential demand for, and cost of, home support which culminated in two reports: 

Demand for the Home Support Statutory Scheme (30 March 2021)

Home Support Services in Ireland: Exchequer and Distributional Impacts of Funding Options (24 February 2022) 

This research will form an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population. 

An internal consultation process on a range of potential funding options is underway. Targeted external consultation is also underway. 

(iii) Reformed model of service delivery 

The Pilot for testing of a reformed model of service for the delivery for home-support is now fully operational. It commenced in November 2021 in CHO 8 and the three other sites CHO2, CHO 4 and CHO 7 became operational in January 2022. The interRAI outputs and pilot site evaluation will be critical to the development of the new home-support scheme.  

Funding has been approved for 128 interRAI care needs facilitators This will help to progress the national rollout of interRAI as the standard assessment tool for care-needs. Recruitment of the Care Needs Facilitator posts will commence with a view to having the posts in place by the end of Q3 2022. 

The HSE is in the process of recruiting key posts to enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs, including 9 home support manager/coordinator posts. The Head of Service of the new National Home support Office has been appointed in November 2022, with the remaining posts to be filled as soon as possible this year. A proposed location in Tullamore for the National Home Support Office is being sourced by the HSE.

In order to examine the significant workforce challenges in the home-support and nursing home sectors in Ireland, Minister Butler established a cross-departmental Strategic Workforce Advisory Group. The group was charged with identifying strategic workforce challenges in publicly and privately provided front-line carer roles in home support and nursing homes and with developing recommendations. The group examined issues such as the recruitment, retention, training, career-development, pay and conditions and barriers to employment for front-line carers in these sectors. Their report was published in October 2022 with 16 recommendations in the areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation. Minister Butler strongly endorses these recommendations and they will be progressed through a dedicated implementation group. The report is available here:

www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/

Recommendation no 9 has been implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home-care workers was signed on 16th December 2022. Information about the next steps that employers need to take (i.e. satisfying the Labour Market Needs Test) is available online at Labour Market Needs Test - DETE (enterprise.gov.ie).

There are 10 staff in the Department working on the Statutory Home Support Scheme across the grades of EO to Assistant Secretary.