I must now deal with a postponed division relating to the motion on home care workers and home support scheme. On Wednesday, 8 November 2023, on the question, "That the amendment to the motion be agreed to", a division was claimed and in accordance with Standing Order 80(2), that division must be taken now.
Home Care Workers and Home Support Scheme: Motion (Resumed) [Private Members]
The following motion was moved by Deputy Duncan Smith on Wednesday, 8 November 2023:
That Dáil Éireann:
acknowledges that:
— there is still no statutory right to home help or legislative underpinning for the home support scheme despite long standing commitments to act;
— the delayed referendum to replace Article 41.2 of Bunreacht na hÉireann, if passed, will finally insert language that recognises and values care within the home and the wider community; and
— the Commission on Care for Older Persons is due to finally get underway in January 2024, and while Ireland has a growing population, it also has an ageing demographic profile requiring increased resourcing of elder care;
recognises that:
— the State has a central role in providing care for people in the community and in their home, but there is growing healthcare privatisation through the outsourcing of more and more care, diagnostics, treatments, employment and services instead of investing in the permanent capacity of our public health service;
— over 60 per cent of State-funded home care is provided by private and voluntary providers, but there is no requirement for these contractors to engage in collective bargaining, despite a long-standing recruitment crisis in the sector; and
— home carers directly employed by the Health Service Executive (HSE) as Health Care Support Assistants (HCSAs) have better pay, and stronger terms and conditions compared to those working for private providers, creating a two-tier workforce and pay disparity for people doing the same job;
notes that:
— the health budget for 2023 originally funded over 23.9 million hours of home support in the HSE National Service Plan 2023, with a total budget of €723 million, but this was cut to 22 million hours in July in order to fund an increased rate of €31 per hour for providers, a so-called "living wage" floor of €13.10 per hour for workers and payment for travel time;
— Budget 2024 provides again for only 22 million home support hours, and allocated just an extra €2.8 million in funding for inflationary pressures, a 0.4 per cent increase;
— as of the end of June 2023, 10.55 million home support hours were delivered nationally to 53,579 people with a further 6,020 people assessed and waiting for a carer to be assigned, but no data is collected on how long people must wait;
— before the new tender 40,000 people over the previous year received care through private providers charged to the HSE at a rate of €26.50 per hour, while workers still had no predictable income;
— under the new HSE Home Support Authorisation Scheme 2023, the day rate for providers is now €31 per hour, but payments to workers are not indexed to increases in the Living Wage, which is now at €14.80 per hour;
— in the public service a HCSA can start on more than €16 per hour rising to over €20 on their salary scale, while privately employed home carers are paid €13.10 per hour, with providers funded at a rate more than twice that;
— the HSE, in October, abandoned a cost saving plan that would have cut 15 minutes from an hour of private home help, reducing it to just 45 minutes; and
— it is a year since the publication of the Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants and while some recommendations have been partially acted on, there is no fully resourced implementation plan;
further notes that:
— the failure to fully resource the home support service and waiting lists for homecare packages leads to discharge delays in acute hospitals, and at the end of June there were nearly 500 delayed transfer of care patients;
— there is a postcode lottery when it comes to home care waiting lists, and evidence that those in rural areas wait longer due to a lack of mileage and travel costs for carers;
— social welfare rules create disincentives for part time work by home carers, reducing the hours they can work;
— the lack of progress on employment terms and conditions, including travel expenses, a competency framework, recognition of training, and a pension scheme, are further barriers to recruitment; and
— there has been a shocking inconsistency in the payment of the Covid-19 Pandemic Special Recognition Payment to home carers and other healthcare workers; and
calls for:
— the adequate funding of our health service, the immediate reversal of the recruitment embargo on health workers, and a commitment not to block the hiring of public service HCSAs;
— restoration of the 1.9 million hours of home help support cut in July 2023, and no cuts to the duration of home support hours;
— a guarantee that home carers are paid, at a minimum, the new Living Wage rate of €14.80, and payment to be provided for mileage expenses and travel time between care locations, along with guaranteed hours and continuity of income for HCSAs;
— a commitment in outsourced State contracts that private home care providers engage in collective bargaining with recognised trade unions, and the introduction of a Joint Labour Committee for workers in the private care sector to set employment standards;
— a published and resourced implementation plan for the recommendations of the Strategic Workforce Advisory Group report, to deliver on the recruitment needed to clear the current waiting list for home care and support before Christmas, and sufficient resources to be put in place to address the winter health crisis;
— annual targets to increase the proportion of home support hours provided directly by the HSE, in order to achieve a publicly provided service;
— the collection of data by the HSE on how long people are waiting for home care and the adequacy of the hours granted;
— the payment of the Covid-19 Pandemic Special Recognition Payment to those home and family carers, and all those other health workers in Health Information and Quality Authority registered settings excluded to date;
— an end to the payment disparity between home support for older people, and those with disabilities; and
— a commitment to the referendum to recognise care work in 2024.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Eireann" and substitute the following:
"recognises and notes:
— the invaluable work carried out by Home Care Support Assistants;
— that the Home Support Service is a core service for older people and is highly valued by service users;
— improving access to home support is a priority for the Government, with €723 million allocated in Budget 2023, up €228 million since 2021;
— delivery of home support hours in communities is increasing, in line with enhanced investment;
— almost 20.8 million hours of home support was provided across the country in 2022, and this is 3 million more hours than were delivered in 2020;
— as of 31st August, 2023, over 14.3 million hours have been provided this year to date, and this is almost 600,000 hours more compared to the same period last year;
— addressing the shortage of care workers in Ireland is an urgent priority for the Government, with an implementation group established to implement the report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants, in areas including pay and conditions of employment;
— a new tender for Home Support Services has been in place since August 2023, and this provides for a revised, increased rate to ensure that home support workers are paid appropriately, and to help address some of the key issues impacting the waiting lists and recruitment and retention;
— the Programme for Government: Our Shared Future 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 heads of Bill are currently being drafted by the Department of Health, with a view to bringing the heads of Bill to Government for approval before the end of the year, and primary legislation has been prioritised for drafting in the Autumn Legislative Programme and the Department is engaging with key stakeholders;
— the draft regulations are at an advanced stage, informed by a public consultation, and legal advice and engagement with key stakeholders will assist with final revisions to regulations for providers of Home Support Services in 2023;
— the Health Information and Quality Authority is in the process of developing standards for home care and Home Support Services, which are in the early stages of development; and
— the new system of regulation for home support will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice.".
To delete all words after "Dáil Eireann" and substitute the following:
"recognises and notes:
— the invaluable work carried out by Home Care Support Assistants;
— that the Home Support Service is a core service for older people and is highly valued by service users;
— improving access to home support is a priority for the Government, with €723 million allocated in Budget 2023, up €228 million since 2021;
— delivery of home support hours in communities is increasing, in line with enhanced investment;
— almost 20.8 million hours of home support was provided across the country in 2022, and this is 3 million more hours than were delivered in 2020;
— as of 31st August, 2023, over 14.3 million hours have been provided this year to date, and this is almost 600,000 hours more compared to the same period last year;
— addressing the shortage of care workers in Ireland is an urgent priority for the Government, with an implementation group established to implement the report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants, in areas including pay and conditions of employment;
— a new tender for Home Support Services has been in place since August 2023, and this provides for a revised, increased rate to ensure that home support workers are paid appropriately, and to help address some of the key issues impacting the waiting lists and recruitment and retention;
— the Programme for Government: Our Shared Future 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 heads of Bill are currently being drafted by the Department of Health, with a view to bringing the heads of Bill to Government for approval before the end of the year, and primary legislation has been prioritised for drafting in the Autumn Legislative Programme and the Department is engaging with key stakeholders;
— the draft regulations are at an advanced stage, informed by a public consultation, and legal advice and engagement with key stakeholders will assist with final revisions to regulations for providers of Home Support Services in 2023;
— the Health Information and Quality Authority is in the process of developing standards for home care and Home Support Services, which are in the early stages of development; and
— the new system of regulation for home support will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice.".
-(Minister of State at the Department of Health, Deputy Mary Butler)
Amendment put:
The Dáil divided: Tá, 66; Níl, 54; Staon, 0.
Tá
- Brophy, Colm.
- Browne, James.
- Bruton, Richard.
- Burke, Colm.
- Butler, Mary.
- Cahill, Jackie.
- Cannon, Ciarán.
- Chambers, Jack.
- Collins, Niall.
- Costello, Patrick.
- Cowen, Barry.
- Creed, Michael.
- Crowe, Cathal.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- Farrell, Alan.
- Feighan, Frankie.
- Flaherty, Joe.
- Flanagan, Charles.
- Fleming, Sean.
- Foley, Norma.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Higgins, Emer.
- Humphreys, Heather.
- Kehoe, Paul.
- Lahart, John.
- Leddin, Brian.
- Madigan, Josepha.
- Martin, Catherine.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McGuinness, John.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Naughton, Hildegarde.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Phelan, John Paul.
- Rabbitte, Anne.
- Richmond, Neale.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Stanton, David.
Níl
- Andrews, Chris.
- Bacik, Ivana.
- Barry, Mick.
- Berry, Cathal.
- Boyd Barrett, Richard.
- Brady, John.
- Browne, Martin.
- Buckley, Pat.
- Carthy, Matt.
- Clarke, Sorca.
- Collins, Joan.
- Conway-Walsh, Rose.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Funchion, Kathleen.
- Gannon, Gary.
- Guirke, Johnny.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Howlin, Brendan.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Mac Lochlainn, Pádraig.
- McGrath, Mattie.
- McNamara, Michael.
- Munster, Imelda.
- Murphy, Catherine.
- Murphy, Paul.
- Mythen, Johnny.
- Nash, Ged.
- Nolan, Carol.
- O'Callaghan, Cian.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Shanahan, Matt.
- Shortall, Róisín.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Tully, Pauline.
- Whitmore, Jennifer.
- Wynne, Violet-Anne.
Staon
Tellers: Tá, Deputies Hildegarde Naughton and Cormac Devlin; Níl, Deputies Duncan Smith and Ged Nash.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to".
The Dáil divided: Tá, 67; Níl, 53; Staon, 0.
Tá
- Brophy, Colm.
- Browne, James.
- Bruton, Richard.
- Burke, Colm.
- Butler, Mary.
- Cahill, Jackie.
- Cannon, Ciarán.
- Chambers, Jack.
- Collins, Niall.
- Costello, Patrick.
- Cowen, Barry.
- Creed, Michael.
- Crowe, Cathal.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- English, Damien.
- Farrell, Alan.
- Feighan, Frankie.
- Flaherty, Joe.
- Flanagan, Charles.
- Fleming, Sean.
- Foley, Norma.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Higgins, Emer.
- Humphreys, Heather.
- Kehoe, Paul.
- Lahart, John.
- Leddin, Brian.
- Madigan, Josepha.
- Martin, Catherine.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McGuinness, John.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Naughton, Hildegarde.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Phelan, John Paul.
- Rabbitte, Anne.
- Richmond, Neale.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Stanton, David.
Níl
- Andrews, Chris.
- Bacik, Ivana.
- Barry, Mick.
- Berry, Cathal.
- Boyd Barrett, Richard.
- Brady, John.
- Browne, Martin.
- Buckley, Pat.
- Carthy, Matt.
- Clarke, Sorca.
- Collins, Joan.
- Conway-Walsh, Rose.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Funchion, Kathleen.
- Gannon, Gary.
- Guirke, Johnny.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Howlin, Brendan.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Mac Lochlainn, Pádraig.
- McGrath, Mattie.
- McNamara, Michael.
- Munster, Imelda.
- Murphy, Paul.
- Mythen, Johnny.
- Nash, Ged.
- Nolan, Carol.
- O'Callaghan, Cian.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Shanahan, Matt.
- Shortall, Róisín.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Tully, Pauline.
- Whitmore, Jennifer.
- Wynne, Violet-Anne.
Staon
Tellers: Tá, Deputies Hildegarde Naughton and Cormac Devlin; Níl, Deputies Duncan Smith and Ged Nash.
Question declared carried.
Cuireadh an Dáil ar athló ar 7.30 p.m. go dtí 9 a.m., Déardaoin, an 9 Samhain 2023.
The Dáil adjourned at 7.30 p.m. until 9 a.m. on Thursday, 9 November 2023.