The policy of the Department of Health and Children on 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, there has been a major step forward in the implementation of the home help scheme from 1999 onwards, in terms of the amount of service delivered and treatment of the home helps — the days when home helps worked for a pittance are long gone. Upwards of €50 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. Considerable additional funding 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.
There are several reasons for an increased demand on the home help service, which include 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 health boards provide the home help service on the basis that the more vulnerable clients are given priority. The tables demonstrate the extent of the additional funding which has been applied to the home help service over the past three or four years and the resultant increase in the number of hours provided. While there are still gaps in the service there has been significant development in the service in recent years.
Expenditure
Health Board
|
Home Help Budget
|
|
2000
|
2001
|
2002
|
2003
|
2004
|
|
€
|
€
|
€
|
€
|
€
|
ERHA
|
14,854,841
|
22,304,785
|
21,673,347
|
21,650,641
|
26,846,000
|
NEHB
|
3,943,666
|
7,940,449
|
8,788,108
|
9,290,000
|
9,301,469
|
NWHB
|
3,297,528
|
6,883,268
|
7,987,268
|
8,347,268
|
10,654,000
|
MHB
|
3,499,000
|
7,008,000
|
7,970,000
|
8,671,000
|
8,866,000
|
MWHB
|
4,133,456
|
9,741,212
|
9,459,248
|
9,574,315
|
10,739,198
|
SEHB
|
3,605,456
|
8,477,244
|
8,891,659
|
9,196,719
|
11,481,379
|
SHB
|
12,300,000
|
27,900,000
|
28,000,000
|
31,300,000
|
32,000,000
|
WHB
|
6,060,536
|
12,004,280
|
12,344,989
|
13,513,791
|
16,747,397
|
TOTAL
|
51,694,483
|
102,259,238
|
€105,114,619
|
111,543,734
|
126,635,443
|
Hours
Health Board
|
2001
|
2003
|
2004
|
ERHA (NAHB)
|
Not available
|
538,600
|
538,600
|
ERHA (SWAHB)
|
Not available
|
930,000
|
900,000
|
ERHA (ECAHB)
|
282,642
|
313,793
|
313,793
|
NEHB
|
783,078
|
732,183
|
815,000
|
NWHB
|
606,300
|
676,034
|
676,034
|
MHB
|
Not available
|
516,716
|
516,716
|
MWHB
|
610,189
|
696,935
|
696,935
|
SEHB
|
650,555
|
878,694
|
878,694
|
SHB
|
2,454,484
|
2,600,000
|
2,652,000
|
WHB
|
824,409
|
945,944
|
975,611
|
TOTAL
|
|
8,828,899
|
8,963,383
|
These figures show an increase in hours in 2004 as against 2003. This is in line with overall funding to this Department in 2004, on the basis of continuation of existing level of service. Since my appointment as Minister of State, I have encouraged the Eastern Regional Health Authority and the health boards to introduce personal care packages for older people as an alternative to long-stay residential care. Personal care packages are designed for the individual concerned and could possibly include the provision of a home help service, home subvention payments, arrangements for attendance at a day centre or day hospital and other services such as twilight nursing. Personal care packages allow older persons the option of remaining living in their own homes rather than going into long-stay residential care. Additional funding of €1.25 million was made available to the authority and health boards this year for the introduction of personal care packages. This is on top of the significant expenditure currently being incurred on home help and other services aimed at supporting people at home.