Vol. 566 No. 1
57 Caoimhghín Ó Caoláin asked the Minister for Health and Children if his Department is monitoring the effectiveness of the home help scheme, including the impact of cuts in allocations to health boards resulting in reductions of services to people in need. [12298/03]
The policy of the Department of Health and Children in relation to services for older people is to maintain them in dignity and independence at home in accordance with their wishes, as expressed in many research studies; to restore to independence at home those older people who become ill or dependent; to encourage and support the care of older people in their own community by family, neighbours and voluntary bodies; and to provide a high quality of hospital and residential care for older people when they can no longer be maintained in dignity and independence at home. The role of the home help service is vital to this policy.
Following the publication in 1998 of the report entitled The Future Organisation of the Home Help Service in Ireland by the National Council on Ageing and Older People, I am pleased that there has been a major step forward in the implementation of the home help scheme from 1999 onwards, both in terms of the amount of service delivered and treatment of the home helps themselves. On the latter point, the days when home helps worked for a pittance are long gone. I was instrumental in changing that. Upwards of €30 million has been injected into the system to ensure that home helps receive a decent level of pay and other entitlements, such as holidays and sick leave. On the service side, an additional €7 million has been made available to the health boards to increase the level of home help service availability through the employment of more home helps or by increasing the number of hours worked by existing home helps.
I am pleased to inform the House that the total increase in expenditure on the home help service across all health board areas since 2000 is in excess of 114%. The breakdown in each health board area in 2003 compared with 2000 is as follows: 45% in the Eastern Regional Health Authority area; 107% in the North-Eastern Health Board area; 153% in the North-Western Health Board area; 147% in the Midland Health Board area; 131% in the Mid-Western Health Board area; 155% in the South-Eastern Health Board area; 154% in the Southern Health Board area; and 122% in the Western Health Board area.
Additional InformationThe overall economic position in 2003 has had implications for all aspects of public investment and that is reflected in the Estimates and the budget adopted by the Government for 2003. Within this overall framework, however, two thirds of the additional funding available for non-capital investment in services has been allocated to the health services. This funding is being applied largely to maintain existing levels of service across all service programmes, including the home help service.
There are a number of reasons there is an increased demand on the home help service, which included the demographic fact that approximately 6,000 people are coming into the over 65 bracket every year and also there is, proportionately, a bigger percentage increase in the more dependent over 80 category. These factors may necessitate some minor adjustments in the provision of the home help service.
The only health board or authority where 2003 expenditure on the home help service is down on the 2002 figure, to any significant degree, is the North-Eastern Health Board. This is because the board overspent its home help budget in 2002 to the sum of €800,000 and, in accordance with accountability procedures, that amount had to be drawn down against the 2003 allocation. I have been assured by all health boards that the provision of the home help service is organised on the basis that the more vulnerable clients are given priority.
Why does the Minister compare 2003 with 2000? He should go back to 1930. We are talking about the effect of budget cutbacks in 2003 compared with the service provision in 2002. That is the nub of this matter. Is the Minister of State aware – I must ask the question because nothing he said leads me to believe he is aware – of the devastating effect cutbacks in the provision for health boards for home help service throughout the jurisdiction is having on service users and on those who depend on home help care, such as the aged, people with infirmities and those with disabilities? Has the Department done any estimate of the cost in terms of residential or in-patient care which the many thousands of recipients of home help incur in terms of the Exchequer on an annual basis? Is there any appreciation or realisation of the many millions of euro which are saved annually through the provision of care in the home and the community? Nothing in the Minister of State's reply leads me to believe he is aware of that. Some 85,000 hours will be cut this year in the North-Eastern Health Board area.
A question please, Deputy.
Does the Minister of State regard that reduction of 85,000 hours in the North-Eastern Health Board area this year as acceptable? How does the Department monitor the effect of this in terms of the daily lives of those who are dependent on home help, many thousands of whom are now left alone and without the care they received in 2002 and previous years? We are in a backward spiral.
A question, please.
Is the Minister of State aware that there is a cutback of 9% in home help hours in his area? What is he doing to address this issue?
I have a long association with the good work of the home help service. The Deputy referred to my awareness of the service's work and the costs of residential care. I am fully au fait with the good work of the home help service in every health board region.
As I said, the policy of the Department of Health and Children in relation to services for older people is to maintain them in dignity and independence at home in accordance with their wishes. I also said that the role of the home help service is vital to this policy. Let us be clear about that.
I gave figures on the percentage increases in the allocations to health boards to provide home help services. The only health board where expenditure on home help services is down to any significant degree on the 2002 figure is the North-Eastern Health Board. That is because it was the only board which overspent its home help budget in 2002, doing so by €800,000. In accordance with accountability procedures, this had to be drawn down against the 2003 allocation.
