I propose to take Questions Nos. 84, 88 and 91 together.
The HSE provides a range of assisted living services including Personal Assistant (PA) and Home Support Services (HSS) to support individuals to maximise their capacity to live full and independent lives.
PA and Home Support Services are provided either directly by the HSE or indirectly through a range of voluntary and private service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.
Home support services are provided to both children and adults with a wide range of disabilities from physical and sensory disabilities to intellectual disabilities and autism. The home support service for children with disabilities assists the child with various activities and supports the parent/family. Over 3 million home support hours are delivered to almost 7,200 people annually.
PA services provides one-to-one support to people with physical disabilities in their homes and communities by trained, professional Personal Assistants. The PA service facilitates a person’s independence, improves their quality of life, and supports them to participate in their local community. A PA support can range from a few hours a week to daily assistance. A vital element of this personalised support is the full involvement of the individual in planning and agreeing the type, times when support is provided to them and choosing the best way to use their allocated PA hours, to enable them to achieve maximum control over their life by tailoring their service to meet their unique support requirements. In 2024, approx. 1.77m PA hours will be delivered to over 2,600 adults across the country.
The following figures for Home Support and Personal Assistance are up to end of Quarter 2 2023. The Deputies will appreciate that, due to Forsa industrial action, the collation of end of year figures for 2023 has been delayed.
CHO 5 encompasses South Tipperary, Carlow/Kilkenny, Waterford and Wexford. Up to end Q2 2023, 744 persons with a disability received home support hours, with 176,323 hours provided. A total of 334 persons with disabilities received personal assistance hours, with 78,430 hours provided.
CHO 6 covers Wicklow, Dun Laoghaire and Dublin South East. Up to Q2 2023, 459 people with a disability received home support hours, totalling 165,089 hours. For personal assistance, 116 people received a total of 36,713 hours.
CHO 8 includes Laois/Offaly, Longford/Westmeath, and Louth/Meath. Up to Q2 2023, 881 persons with a disability received home support hours, with 335,145 hours provided. A total of 381 persons with a disability received personal assistance hours, with 111,229 hours provided.
Currently, each CHO has a process to manage applications and referrals for PA Services. Individual’s needs are assessed against the criteria for prioritisation. The needs of the individual, compliance with prioritisation criteria, and the level of resources available determine resource allocation. As with every service, there is not a limitless resource available for the provision of home support services and while the resources available are substantial, they are finite. In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.
While many individuals are adequately provided for by their current level of support, it is also the case that many would benefit from more support hours if they were available.
Acknowledging this unmet need, the Action Plan for Disability Services 2024-2026, published by my Department in December, commits to the delivery of 110,000 additional Home Support hours between 2024 and 2026 to address shortfalls in services and to support people with disabilities live at home, in line with Article 19 UNCRPD.
The Action Plan also commits to 800,000 additional Personal Assistance hours in the same period, with the delivery of 80,000 additional hours in 2024. A policy review of PA services in the light of the UNCRPD is already underway, with a working group involving key stakeholders and disabled people's organisations, to develop formal policy and service description, develop eligibility and prioritisation criteria, and consider the best form of governance and regulation.
