Dáil Éireann Debate, Wednesday - 8 November 2023
111. Deputy Pauline Tully asked the Minister for Health the actions he is taking to address the current homecare situation; for an update on the progress of the statutory homecare scheme; and if the statutory homecare scheme will cater for disabled people. [48875/23]
View answerThe Programme for Government commits to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care’. The Government is committed to establishing a new statutory scheme for the financing and regulation of home support services, which the Department of Health is currently developing.
Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home support providers; (ii) the examination of future funding options for home support services; (iii) working with the HSE to develop a reformed model of service delivery for home support (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
(i) Regulation of home support providers
Establishing a regulatory framework for home support providers is a significant element of the new scheme and is a priority for government. Regulation will offer protection and quality assurance to service users ensuring they are provided with high quality care. The regulatory framework will comprise: primary legislation for the licensing of home support providers; regulations which will set out the minimum requirements that a home support provider must meet to obtain a licence; and HIQA national standards.
Legislation: The legislation to establish a licensing framework for home support providers is at an advanced stage. The General Scheme and Heads of Bill are currently being finalised by the Department with a view to bringing the Heads of Bill to Government for approval before the end of the year. Primary legislation has been prioritised for drafting in the Autumn Legislative Programme.
Regulations: The draft regulations are at an advanced stage informed by a public consultation, which concluded on 4 August 2022. The analysis of submissions has been carried out by the Institute of Public Health (IPH) which demonstrated strong agreement in relation to regulation of home support service provision. A report on the findings of the public consultation was published in January 2023. Legal advice and engagement with key stakeholders (HIQA, HSE, Private and Voluntary Providers, and service user representative groups) will assist with final revisions to regulations for providers of home support services in 2023.
The Department is working closely with HIQA and the Chief inspector who will have the legal authority to grant, amend or revoke a license. Consultation on HIQA quality standards for home care and home support services will commence early in 2024 when the scope and content of regulations have been finalised.
(ii) The examination of future funding options for home support services
Currently home support services delivered by or on behalf of the State are fully exchequer funded. The Department is examining potential options for a new funding model for home support. The ESRI undertook a programme of work on behalf of the Department on the potential demand for, and cost of, home support which culminated in two reports. The Department is exploring further research and engaging with international experts. As part of this work, the Department commissioned a rapid response from the EU Observatory on Health Systems and Policies which explores the impact of user charges on home care sustainability in Ireland. This report was published in March 2023. This research will form an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.
(iii) The development of a reformed model of service delivery for home support
In 2022 a Pilot for testing a reformed model of service for the delivery for homecare became fully operational in 4 Community Healthcare Organisations (CHOs). A draft evaluation of the pilot, produced by the Centre for Effective Services, has been completed.
The rollout of interRAI as the single assessment tool for care needs in the community will assist with equitable resource allocation. InterRAI standardised outputs will be used to determine prioritisation and levels of care required. The HSE have begun recruitment process for 128 interRAI Care Needs Facilitators. The process for the development of a home support IT system is underway in the HSE. This is a significant project which is vital to deliver reform in the sector. The business case has been submitted to the Digital Government Oversight Unit and is currently going through Peer review.
The HSE is undertaking a recruitment process for a number of key posts to support and enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs including 9 Community Healthcare Organisation home support manager/coordinator posts. Four WTEs have been appointed to date including the head of service, with the remaining posts to be filled as soon as possible. A proposed location in Tullamore for the National Home Support office is being sourced by the HSE.
(iv) Strategic Workforce Advisory Group
Addressing the shortage of care workers in Ireland is an urgent priority for the Government. To this end, the cross departmental Strategic Workforce Advisory Group was established in March 2022 to examine, and formulate recommendations to address, the challenges in frontline carer roles in the home support and long term residential care sectors.
The Group was chaired by the Department of Health and comprised representatives from seven government departments (Children, Equality, Disability, Integration and Youth; Enterprise, Trade and Employment; Health; Higher and Further Education, Research, Innovation and Science; Justice; Public Expenditure and Reform; and Social Protection), the HSE, HIQA and SOLAS.
The Report was published on 15th October 2022. Providing an overview of the work of the Group and its key findings, the report presents a suite of 16 recommendations spanning the areas of areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development and sectoral reform.
Work is underway on all the recommendations overseen by a cross departmental Implementation Group, chaired by the Department of Health. A detailed implementation plan has been published containing timelines and steps involved in delivering each of the recommendations. The Implementation Group meets quarterly and progress reports are published after each meeting. Recommendation 9 has been completed with a further four at an advanced stage.
