Dáil Éireann Debate, Wednesday - 24 April 2024
185. Deputy Róisín Shortall asked the Minister for Health to provide an update on the Programme for Government commitment to introduce a statutory right to homecare; the timeline he is working towards in publishing the legislation; and if he will make a statement on the matter. [18326/24]
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".
In 2024, the Department of Health is focused on developing the regulatory framework for providers of home support services. It aims to ensure that all service users are provided with regulated care. 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
In 2024, the Department of Health is focused on developing the regulatory framework for providers of home support services. It aims to ensure that all service users are provided with regulated care. It will consist of primary legislation, regulations and Health Information and Quality Authority (HIQA) national standards. This work is at an advanced stage, with ongoing engagement with key stakeholders and legal advisors.
The primary legislation provides for the licensing of home support providers. Transitional timelines are being finalised for the registration of home support providers under this framework. The General Scheme is currently being finalised and is expected to be published shortly.
The regulations will set out the minimum requirements that a home support provider must meet to obtain a license. Final revisions are being made to the draft regulations, informed by a public consultation.
Finally, the draft HIQA standards for home support will go out for public consultation in 2024.
(ii) the examination of future funding options for home support services.
Currently, home support services are fully Exchequer funded. How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department of Health is researching different funding models. The Economic and Social Research Institute (ESRI) also undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports:
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme/.
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding/.
A rapid response from the European Observatory on Health Systems was commissioned and published in March 2023:
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
This research will form an important part of the evidence base for the development of a sustainable funding model for home care services. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.
(iii) working with the HSE to develop a reformed model of service delivery for home support
The Department of Health is collaborating with the HSE to develop a reformed model of service delivery. The national roll-out of interRAI as a single assessment tool is a priority for equitable allocation of home support services. The testing of interRAI use was evaluated in 4 pilot sites and recommendations (2023) have informed design and operational aspects of the service.
A National Home Support Office will be operational in 2024 and the Head of Service and other posts have been appointed. The HSE has established a Home Support Reform and Statutory Home Support Scheme (SHSS) Programme to support planning for the regulation of Home Support Providers and the establishment of a SHSS. One of the key programme priorities for 2024 is the procurement, design, development and implementation of the Home Support Services Case Management and eRostering System (CMeRS) and the National Nursing Homes Support Scheme and Statutory Home Support Scheme Information System (NHSS-SHSS).
(iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
Addressing the shortage of care workers in Ireland is an urgent priority. In March 2022, I established the cross-departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in frontline carer roles in the home support and long-term residential care sectors.
The report was published on 15 October 2022:
www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/I
Implementation of the 16 recommendations is underway by a cross-departmental group, chaired by the Department of Health. The group meets quarterly and publishes progress reports thereafter. The implementation group met most recently on 1 February 2024 and a progress update has been published which can be found here:
www.gov.ie/en/publication/66dd1-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-healthcare-assistants/#:~:text=Providing%20an%20overview%20of%20the,recruitment%2C%20pay%20and%20conditions%20of /.
