Róisín Shortall (Dublin North West, Social Democrats)
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408. To ask the Minister for Health the status of his Department’s work in respect of establishing a funding model for a statutory right to home care; the options being considered; the timeline he is working towards; and if he will make a statement on the matter. [30800/24]

Mary Butler (Waterford, Fianna Fail)
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Home Support aims to enable people to continue to live in their own homes with confidence, security and dignity. It is a non-statutory service and access to the current service is based on assessment of the person’s needs by the HSE; having regard to available resources and the competing demands for the services. Demand for Home Support, and its importance as an alternative service to long stay care, has grown considerably over the past number of years.

Extensive work is ongoing within the Department across four broad areas to make progress on the Programme of Government commitment to “introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care”.

The proposed regulatory framework will confer on HIQA, the authority to grant, amend and ultimately revoke a license if home support providers fail to meet minimum requirements set out in draft regulations and supported by quality standards. On 14 May 2024, the General Scheme was approved by Government and has been published on the Department of Health website www.gov.ie/en/publication/a3ef4-general-scheme-of-the-health-amendment-licensing-of-professional-home-support-providers-bill-2024/ along with the Regulatory Impact Analysis.

The Department is engaging with the HSE on the development of a reformed model of home support service delivery. The Department is committed to a single assessment process and the HSE are developing standardised operational policies, integrated care pathways, robust governance and accountability structures. A key enabler will be a bespoke ICT system which is currently being progressed through procurement.

Implementation of the 16 recommendations of the strategic workforce advisory group is being addressed by a cross-departmental group, chaired by the Department of Health. The minutes and progress reports can be found here: www.gov.ie/en/publication/66dd1-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-healthcare-assistants/. A new HSE home support tender has been in place since August ‘23. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding.

Currently, home support services are fully exchequer funded. The Department is researching different funding models which will form an important part of the evidence base for the development of a sustainable funding model for home care services and has commissioned several reports from the ESRI and the European Observatory on Health Systems. This research is being examined, as it forms 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.

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

Data from the ESRI ‘Demand for Statutory Home Support Scheme’ Report 2021 indicate that up to 8 million additional hours of home support may be required in less than 10-years to meet the increased demand from people with Activities of Daily Living (ADL) difficulties who may have previously relied on unpaid and family care. (ESRI, 2021).

A rapid response from the European Observatory on Health Systems was commissioned and published in March 2023 setting out a number of funding options:

eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option

No final decision on future funding has been made and further research is currently underway to enhance the evidence base.