This question is in the name of Deputy Emer Higgins but will be put by Deputy Richard Bruton.
Thursday, 8 December 2022
Questions (6)
Oral answers (10 contributions)
Emer Higgins
Question:6. Deputy Emer Higgins asked the Minister for Health the steps his Department is taking to address the long wait times for home care packages in CHO 7; and if he will make a statement on the matter. [61343/22]
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How far are we from achieving consistency in the delivery of home care packages? CHO 7 is highlighted in the question, but I would also like to hear what progress is being made in developing the statutory home care system, which I understand is being piloted? I believe this would achieve the sort of consistency we have not been able to deliver to date.
In 2023, the overall budget for home support will exceed €700 million. Over the last three budgets, I have secured more than €200 million in additional funding for home care support, a 42% increase since 2020. I thank the Minister for Health, Deputy Stephen Donnelly, for his support, and that of the whole Government and Cabinet, in ensuring this particular funding has been provided.
I am in the unique position that I have the full provision of funding I need to deliver home care to 56,500 people every day. The problem, unfortunately, is that as of today, we still have 6,200 people on a waiting list. Their care is funded - I cannot be clear enough about that - but we do not have the staff to provide the services at the moment.
Last year, we delivered 20.9 million hours of home care. Already, we are 6% ahead of target this year. We are seeing more people being referred for home care supports. The three main provisions to protect people and support people to age well at home are home care, day care centres and meals on wheels. We are doing a huge amount of work in this area. I am very concerned about the lack of staff, especially at weekends and in rural areas, when it comes to delivering home care. This year, I put in place strategic workforce advisory group. This is a very important committee that works across Departments. It also includes representatives of those who provide supports from the private, public and voluntary sectors. The group made 16 key recommendations and I have endorsed every one of them. The Deputy may have heard that last week, the Minister of State, Deputy Damien English, and I announced the provision of 1,000 permits for home care workers from outside of the EU who will be able to apply from January. We know this initiative has been successful because to date more than 2,540 people have come into the nursing home sector on these permits.
I commend the Minister of State on her efforts. I am interested to know how close she is to getting some sort of consistency across the country. The intent of the statutory home care scheme being piloted is to achieve consistency in standards and access.
Are we in a position to plan for the delivery of that statutory scheme? That would give staff more confidence in the long-term prospects of a career in this sector. Will the Minister of State update us on whether we can move to that type of design? That would deliver across the country.
We have been working very hard on the statutory home care scheme over recent years. We lost time during Covid. I would be the first to admit that.
The Deputy is right that we need the same standards in respect of home care the length and breadth of the country. The interRAI, which is the single assessment tool, is what will provide that.
I secured funding in my very first budget to hire 128 assessors, and they are being recruited at the moment. We have four pilot sites operational. The pilot sites started early last year. We had challenges in respect of staff. I have asked that the pilot be allowed to run longer because we need to get the relevant data in respect of the four pilot schemes. They are under way in Cork, Galway, Dublin and the midlands. I look forward to receiving those data.
We want to make home care a really attractive career proposition for people who enter the home care market. The recommendations, which I will address in a moment, will help.
I need not remind the Minister of State of what the Minister said recently when answering questions about Beaumont hospital. The big problem is that we have a very expensive resource but delayed discharges because we do not have this service. I remind the Minister of State, although I do not think she needs reminding, that this is key to the efficient working of the entire health service.
There are a great many home care workers the length and breadth of the country. To be fair, 56,500 people will receive home care today. Many will receive more than one visit during the day. However, we are seeing many more complex cases as a result of Covid and more referrals from GPs and public health nurses for people to avail of this service. The Deputy is right that if there are blockages in the community system, there will be blockages in the acute system. Two of the main recommendations were that when people are paid for providing home care, the minimum they be paid is the living wage, which is currently €12.90, and that they should receive mileage if they have to travel. I hope all these changes will make a significant difference.
I am aware of cases in which the patient is in hospital and has been deemed eligible for a home care package but has not been able to get it, and then the hospital charges the patient for the extended stay. The hospital charges the patient because the other end of the HSE service cannot provide the home care that is necessary. Will the Minister of State make it clear today that hospitals should not charge for extended stays where, through absolutely no fault of their own, patients cannot go home for health and safety reasons because home care is not in place? Will the Minister of State instruct the hospitals not to charge those patients? Where bills have been issued, can they credit those bills? It is not the patients' fault that they cannot get the care for which they are eligible and which is necessary for their health and safety.
I thank the Deputy for raising this matter. I was not aware of it. I know that in my area, for example, there is huge provision of community and step-down beds and transitional beds for up to 11 weeks for people who it is deemed no longer need to be in an acute hospital and whose consultant has said they need only community or step-down care. As the Deputy will know, we are abolishing all inpatient charges in hospital settings next year. If she wishes to forward me any of the details of those cases, I will certainly have them looked at.
I will do so. I thank the Minister of State.
Question No. 7 taken after Question No. 8.