Dáil Éireann Debate, Wednesday - 4 July 2018
278. Deputy Robert Troy asked the Minister for Health the improvements he plans in the home care system; his views on whether substantial investment in the system is required to supply the level of home care necessary; and if he will make a statement on the matter. [29505/18]
View answerIn advancement of the Government’s commitment to promote community-care so that people can continue to live independently in their own homes for as long as possible, the Department of Health is currently engaged in the development of a new, stand-alone statutory scheme and system of regulation for home-care services.
The new home-care scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to service-allocation. It will therefore be an important step in ensuring that the system operates in a consistent and fair manner and will help to improve access to home-care services on an affordable and sustainable basis. The introduction of a system of regulation for home-care will help to ensure public confidence in the services provided. The new scheme will also be designed to support family/unpaid carers and will complement and integrate effectively with other health and social-care services such as long-term residential care (including the Nursing Homes Support Scheme), primary and community services and hospital services.
The development of a statutory scheme for home-care is a complex process. A significant amount of preparatory work remains to be undertaken before decisions are reached on the form of the scheme and the system of regulation. This is required if reforms are to be successful, affordable and sustainable. Every effort is being made to advance this work as quickly as possible.
While the new home-care scheme is under development, the Department of Health and Health Service Executive are continuing efforts to improve existing home-care services. In 2018 the HSE brought the funding for Home Help and Home Care Packages together into a single Home Support Service for older people. As well as simplifying the application-process for home-care, the new service will be more responsive to service-users' changing needs. More broadly the HSE will continue to encourage local integration of services and to build appropriate care-pathways, in particular for people with complex needs. A consumer-directed approach to home-support provision will be introduced, giving service-users greater choice in relation to when they receive services and their selection of a service-provider.
In line with the commitment in A Programme for a Partnership Government (2016) to increase funding for home-care annually, funding for Older Persons’ Services rose from €763m in 2017 to €811m in 2018, including approximately €417m for the provision of home-support services. The HSE’s National Service Plan 2018 provides for a target of 17.094m home-support hours to be provided to 50,500 people, which compares with 16.34m hours delivered to 50,000 people in 2017. A further 156,000 hours, relating to adverse weather funding, will be provided in 2018. A target of 360,000 home-support hours for people with complex needs will be provided through 235 Intensive HCPs.
Despite this significant level of service-provision, the demand for home-support continues to grow. It is important to note that, although the funding for home-support across the system is significant, it is finite, restricting service-supply. At end of March 6,458 people were waiting for new or additional supports following assessment. All those waiting are provided with a service as soon as possible on the basis of their assessed needs, with priority given to those awaiting discharge from acute hospitals.
The Health Service Capacity Review 2018 outlines projections of demand and capacity requirements for a range of health services to 2031. Accordingly, it forecasts that a 120% increase in home-care services will be required by 2031 if key reforms and productivity measures are implemented.
