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Dáil Éireann díospóireacht -
Thursday, 20 Nov 1997

Vol. 483 No. 2

Adjournment Debate. - Home Help Service.

I thank the Chair for selecting this matter and the Minister of State for coming into the House to reply to it. I welcome this opportunity to raise this matter. The question of home help might not seem very important to many people as they go about their daily business, but there are those in our urban and rural communities who depend and rely heavily on the small input and short visit of a home help on a regular basis.

Home helps are usually women who may be long-term unemployed and because of their circumstances they may be unable to qualify for a permanent allowance or work and decide to devote a few hours a week to support and care at a high level for their neighbours, friends and relations who are usually frail, old and have a significant disability. Home helps care for people in their homes. It is important to realise the valuable work done by home helps in caring for others in their home surroundings.

That small intervention, while most important to the recipient, is inadequate. The average rate of pay or allowance, if it could be called either of those terms, of £2 per hour for part-time work is a disgrace. We hear much criticism of abuse in the areas of child labour and part-time workers. However, the rates paid to young people and part-time workers who work in the evenings or at weekends in supermarkets, pubs and petrol stations are reasonable compared to what is on offer to home helps.

This group of workers can do little to improve their pay or conditions. They will not withdraw their service from dependent older people because their social consciousness, commitment and the recognition of the great need to help old people will not allow them to do so. They have no rights within the workforce. I see it as an abuse of a committed group of volunteers.

Has the Minister or the Department ever realised the cost savings as a result of maintaining old people at home rather than in a nursing home where the average rate demanded to maintain them is from £200 to £300 per week? Living in their own homes in familiar social surroundings is best for aged people.

The Minister of State should urgently review the rates of pay and allowances for this important group of workers. He should recognise and acknowledge their important contribution in maintaining a vulnerable and dependent section of our society within its own community and surroundings. I ask him to provide funding to health boards to enable payment at a rate of at least £4 per hour so they can continue their work and be recognised as workers. Their work combines that of a nurse, social worker and housewife in helping elderly people. I do not know why it is only in the last 12 months that the rate has been increased from £1 to £2 per hour. All too often health boards will say, when they are only a short time into their budgetary year, that the funds for this service have been allocated.

As budget time approaches, we should recognise the important work that home helps have provided down the years. We should recognise them and substantially raise their allowances so they can continue without interruption the magnificent work they have been doing. It could even be extended so that greater demands on State resources could be diverted from institutions to allow people have comfort in their own homes.

I thank Deputy Burke for raising this important issue on the Adjournment. For many years the main focus of the care of older people has been to enable them to continue living in their own homes for as long as they wish to do so. It is recognised that the home help service contributes enormously to the maintenance and dignity of frail and dependent older people at home. There are approximately 20,000 beneficiaries of this service at an annual cost of some £17 million.

Under section 61 of the Health Act, 1970, health boards may make arrangements to assist in the maintenance at home of persons who, but for the provision of such a service, would require to be maintained otherwise than at home. This section empowers, without obliging, health boards to provide or support services such as home help, laundry and meals.

Health boards are not limited in the categories of persons they can assist at home and may charge for the service. The services are, however, usually provided free or at a nominal charge. The health boards consider individual cases on the basis of need and in the light of resources available to the scheme. In practice, about half the home helps are provided by voluntary organisations with funding from health boards. The remaining home helps are employed directly by health boards. The balance between voluntary and health board input to the home help service varies from health board to health board. Home helps are predominantly part-time, though a number of full-time home helps and home help co-ordinators are employed by some boards. Voluntary involvement also strengthens the sense of neighbourly obligation towards the elderly and encourages the self-development of the home help.

The underlying philosophy governing the operation of the home help scheme is that it is a community based good neighbour scheme which attracts people primarily motivated by the desire to engage in community service. Accordingly, the remuneration of volunteers does not come within the realm of conventional employment. Volunteers who work as part-time home helps are paid a stipend or gratuity for the service they provide. As operated in many areas, this is meant only as a contribution and is not intended to compensate fully for the task undertaken.

The service is essentially a local client-based service. The rate paid to part-time home helps employed varies from place to place and is related to the particular requirements and type of task undertaken in each case. It is a matter for each health board to decide on the level of home help services required and the level of payment to be made in respect of these services.

The issue of funding for the home help service has been raised on a number of occasions in the recent past. My Department, in consultation with the chief executive officers of the health boards, has under consideration a number of aspects of the home help scheme, including the overall organisation of the service and the diversity of arrangements which exist within health boards for the provision of this service.

Following these discussions it was decided to have an examination of the operation of the home help service carried out by independent consultants, under the supervision of the National Council on Ageing and Older People, which will advise on how the services can be developed in a cost effective manner with the other community-based services. Work has commenced on this project and will be completed as quickly as possible.

When the results of this examination are made available to me, I will be in a better position to consider how best improvements may be brought about in an overall organisation and development of the home help service. Related issues, such as rates of payment for home helps, will be considered as part of this process. My Department has allocated additional funding to three boards in 1997 for the purpose of increasing pay rates to home helps. It is my intention to facilitate the improvement of the provision of the home help service, including pay rates, on a phased basis as resources permit.

The Dáil adjourned at 5.20 p.m. until 2.30 p.m. on Tuesday, 25 November 1997.

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