Dáil Éireann Debate, Monday - 9 September 2024
1920. Deputy Richard Bruton asked the Minister for Health the number of persons reached and care hours provided per person by the pilot home care support scheme, in tabular form; whether he has estimated the likely additional cost and additional man-hour capacity that would be needed to extend the scheme beyond the present pilot areas; and if he will outline the Department’s plans to gradually move to make this a universal statutory scheme. [35848/24]
View answerThe Programme for Government commits to a statutory scheme based on high-quality, regulated home care. It is clear, therefore, that the first step towards any scheme is to ensure that home care is regulated and that there are quality standards in place that services can be inspected against. It is essential that no matter where or how care is provided, everyone can be assured that their provider meets minimum standards of quality, safeguarding and governance.
My Department is progressing the development of a regulatory framework for home support providers. This will consist of primary legislation for the licensing of providers, secondary legislation in the form of regulation, which set out minimum requirements, and HIQA national quality standards.
The Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024 General Scheme was approved by Government in May and has been published on the Department of Health website along with the Regulatory Impact Analysis. The Joint Committee for Health began pre-legislative scrutiny (PLS) of the general scheme in June 2024 and my officials attended. The Department looks forward to reviewing any recommendations included in the Committee’s PLS report. The General Scheme has now been referred to the Office of Parliamentary Counsel for final drafting.
In the meantime, the Department has developed draft Regulations in anticipation of the enactment of this legislation. There has been extensive consultation on these Regulations, including public consultation. HIQA has also begun work on drafting standards for home support providers, which will go out for public consultation in 2024.
The point has been made that the delivery of regulated home care is not the same as the delivery of a statutory scheme. I agree with this, however we cannot have a statutory scheme without a regulated system of care. Fair Deal took many years to develop, and this was in the context of improving the fairness of existing systems that related to a sector that was well-known at the time. The home support sector is very different; it has never been subject to any kind of scheme or to the kind of oversight and regulation we are looking at now.
Strategic Workforce Advisory Group
Addressing the shortage of care workers in Ireland is an urgent priority. There can be no significant reform of the home support if we do not have the carers to deliver it. In March 2022, I established a cross-departmental Strategic Workforce Advisory Group. It set out to examine the challenges in frontline carer roles in the home support and long-term residential care sectors and its report contained 16 recommendations to address the challenges.
A cross departmental group is charged with implementation of the 16 recommendations, chaired by the Department of Health. Significant reform has been delivered. A new HSE home support tender has been in place since August ‘23. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding. Recommendation number 9 is fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for homecare workers was signed on 16 December 2022. 917 permits have been issued to June 2024.
The implementation group meets quarterly and publishes progress reports thereafter. The implementation group met for the fifth time in July 2024 and a progress update will be published shortly.
The examination of future funding options for home support services
How home support will be funded in the future will be an essential factor of the new Statutory Scheme. Currently, home support services are fully exchequer funded. The Department is researching different funding models which will form an important part of the evidence base for the development of a sustainable funding model for home care services and has commissioned several reports from the ESRI and the European Observatory on Health Systems. This research is being examined, as it forms 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. It is important to note that no decision on future funding options has been made and further research is underway. I am on record as saying that I am not minded to charge for home support and that remains my position.
I have asked my officials to examine and report to me on options in relation to a statutory scheme, including consideration of how any such scheme might be financed, which might include equity release among other approaches.
I have asked the HSE to reply to the Deputy regarding the number of persons reached and care hours provided per person by the pilot homecare support scheme, in tabular form; and the likely additional cost and additional man hour capacity which would be needed to extend the scheme beyond the present pilot areas.
