The provision of home help services is, in the first instance, the responsibility of the health boards and Eastern Regional Health Authority. The aim of the home help service is to enable people to remain living at home, where appropriate, who would otherwise need to be cared for in long-stay residential care and that this service is an essential support to families and informal carers. The home help service by its nature is a flexible service, which is designed to respond to clients' needs. The service is targeted at high and medium dependency clients in accordance with their assessed need. As a result, therefore, the service required in individual cases will fluctuate from time to time. Assessments are undertaken at local sector level and are carried out by public health nursing services to ensure effective prioritisation of the service.
There are a number of reasons demand for the home help service has been increasing, such as demographic factors. Approximately 6,000 additional people come into the over 65 bracket every year and there has been a proportionately higher percentage increase in the more dependent over 80 category. These factors have necessitated minor adjustments in the provision of the home help service at health board level. Although a small percentage of clients may have had their hours reduced, this has been counter-balanced by others receiving the service for the first time. I have been assured by all health boards that the provision of the home help service is organised on the basis that the most vulnerable clients are given priority.
The following table outlines the funding allocated to the home help service by health board area in 2003 and the percentage increase in funding for this service compared with 2000:
Authority/Health Board
|
Expenditure in 2003 on Home Help Service
|
Percentage Increase in Expenditure since 2000
|
|
€
|
%
|
Eastern Regional Health Authority
|
21,650,641
|
45.74
|
Midland Health Board
|
8,671,000
|
147.81
|
Mid-Western Health Board
|
9,574,315
|
136.62
|
North Eastern Health Board
|
8,165,391
|
107.05
|
North Western Health Board
|
8,347,268
|
131.62
|
South Eastern Health Board
|
9,196,719
|
155.07
|
Southern Health Board
|
31,300,000
|
154.47
|
Western Health Board
|
13,513,791
|
122.98
|
Total
|
110,419,125
|
|
The total increase in expenditure on the home help service across all health board areas since 2000 is 113.59%. An additional €3.748 million has been allocated by my Department to this service in 2004. The North Eastern Health Board overspent on its home help budget in 2002 to the sum of €800,000 and, in accordance with accountability legislation, that amount had to be drawn down against the 2003 allocation. Accordingly, the number of home help hours delivered by the board to clients in 2003 was down on the 2002 figure.
The information requested by the Deputy regarding the administration of the home help services at local level is not routinely collated by my Department. I have, therefore, requested the health boards and the authority to provide this information as a matter of urgency and I will be in contact with the Deputy again when this information is to hand.