Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This is achieved through a range of community-based services such as mainstream home help, meals-on-wheels, and respite or day care. In more complex cases, enhanced home care packages may be provided. The reductions recently introduced in respect of home help hours relate directly to the critical financial position facing the Health Service Executive towards year end and the statutory responsibility of the executive to live within the budget Voted for it by the Oireachtas.
The target in the HSE service plan for 2012 was to deliver some 10.7 million home help hours to 50,000 people. In addition, just over 15,700 people were targeted to receive a home care package in 2012. As I have indicated on several occasions throughout the year, a key challenge facing the health service is how best to utilise a reduced level of resources in addressing the increasing needs of older people for health and personal social services. This means prioritising those in greatest need and accelerating reform of services overall to maximise such provision in the future.
Most of the measures recently agreed with the HSE to address immediate funding pressures focus on areas that do not have a direct patient impact. It is a priority of the executive to minimise the impact on patients and clients of any spending reductions. The reduction envisaged for the mainstream home help service is €8 million, and approximately €1.2 million for enhanced home care packages. Allocation of home help hours will continue to be based on a review of individual needs and no current recipient of the service, who has an assessed need, will be without a service. The HSE has indicated that it will ensure that any alterations to supports or services will be undertaken in the context of a review of the client's assessed need, documented on client records. While the Government fully appreciates the difference high-quality home care makes to supporting vulnerable older people and their families and the impact the recent reductions will inevitably have in some cases, we must deal with the reality of funding services overall for this and subsequent years.
Additional information not given on the floor of the House
Notwithstanding the recently announced reduction in HSE home support provision for the remainder of 2012, investment in these services remains significant, with provision in the region of €320 million expected for home help and home care packages this year. In addition, in the context of prioritising what was always a limited resource, the HSE has been developing various operational initiatives to improve its approach to all relevant aspects of its home supports services. These include various new guidelines for home care and a new procurement framework for approved agencies providing services on its behalf. While ongoing developments have been designed to standardise and maximise the use of limited resources in the face of increasing demand, they are also intended to enhance quality, safety and other relevant aspects of service for providers and care recipients alike.
Services for older people are monitored on a regular basis by the Department of Health and the HSE to meet evolving circumstances in line with available resources. The executive has been asked to furnish weekly reports to the Minister for Health on home care provision between now and year end, in the light of recently announced measures. The position in respect of 2013 and beyond is subject to the annual Estimates process in the light of evolving resources and services priorities for the overall health sector.