Home Care Packages Funding

Dáil Éireann Debate, Tuesday - 18 October 2016

Tuesday, 18 October 2016

Ceisteanna (20)

Catherine Connolly

Ceist:

20. Deputy Catherine Connolly asked the Minister for Health the funding made available for County Galway and south Mayo for home help packages in 2016; if his attention has been drawn to the fact that as a result of going over budget early in the year to relieve the pressure on the hospital, the service has now been severely curtailed with the result that there are both delayed discharges and delayed admissions to the hospital; the steps that have or will be taken to make sufficient funds available to rectify the situation; and if he will make a statement on the matter. [30393/16]

Freagraí ó Béal (6 píosaí cainte)

Deputy Catherine Connolly

Has the Minister of State's attention been drawn to the crisis in home care packages in Galway and the fact that the budget was overspent? There is now a severe crisis with delayed discharges and admissions in the hospital. Will the Minister of State address whether her attention has been brought to that and, if so, what she will do about it?

Deputy Helen McEntee

I thank the Deputy for raising this issue. It has been brought to my attention. The original allocation for home care packages and home help hours in 2016 for counties Galway and Mayo is in the region of €27.3 million.

Home care services across the country are being stretched by demands from more people and for more hours in the evenings and at weekends, all of which cost more. Activity in the first quarter of 2016 was ahead of the same period in 2015 as efforts continue to alleviate pressure on the acute hospital system. Without additional funding, this could not have been sustained and the allocations for the rest of the year would have been reduced. The Government has been able to respond to this situation by providing an extra €40 million for home care in 2016, of which community health care organisation area 2, which includes Galway and Mayo received almost €5.5 million.

According to the HSE delayed discharges report, as of 27 September 2016 there were 30 delayed discharges in Galway University Hospital. Of these, five people had submitted applications for home care. On 11 October 2016, the HSE reported that this had reduced to 21 cases with two applications being processed for home care.

As part of the winter initiative €1.8 million funding has been made available to provide six new home care packages each week from October to February at Galway University Hospital. This will provide for 114 new home care packages over the winter period. The hospital is also being provided with an average of 16 transitional care bed approvals per week throughout the course of the year.

I am pleased to say that overall funding for services for older people has increased to €765 million in 2017, which is an increase of €82 million. In a situation where demand continues to grow, as the Deputy rightly pointed out, challenges remain in managing home care budgets. However, the increased resources provide additional flexibility to managers who are responsible for meeting these challenges in the different geographic areas within the resources available.

Deputy Catherine Connolly

I did not catch whether the matter has been drawn to the attention of the Minister of State. Has she spoken with the hospital in Galway and with Galway Primary Care? That is a specific question.

As a result of the cutbacks in Galway city, there are patients in the hospital who cannot be discharged and, as a result, patients cannot get in. I refer to one particular case where the patient had to stay in bed and breakfast accommodation. Meetings are taking place on a weekly basis and the role of the public health nurse has been extended in order to reduce the number of home care packages and home help hours patients are getting. I have an urgent message on my phone about a patient in the hospital. I will not go into it because we are in the Dáil Chamber. The patient's recommended package is 21 hours, which gives an indication of the seriousness of the medical condition. The public health nurse's role is to reduce that number. They are now at eight hours and they are negotiating in a situation where 21 hours is recommended.

Deputy Helen McEntee

I thank the Deputy again. It is something that has been brought to my attention. I have not been at the hospital yet but I hope to be in Galway in the coming weeks. It is something I can address at that stage. I am aware there have been exceptionally high patient numbers recorded, particularly in Galway - 224 on 27 September and 233 on 10 October were recorded. Similarly there has been a high number of patients who have required acute admissions. There are about 40 emergency department admissions each day. Many of the patients are elderly and have a variety of conditions, some of which the Deputy has outlined.

I reiterate that €1.8 million has been allocated to Galway University Hospital in the winter initiative to provide the six new home care packages and 114 home care packages over the winter period. In last year's allocation, we spent approximately €330 million, including €20 million in time related savings which accounted for 15,450 home care packages and 10.4 million home help hours. I cannot tell how many hours and home help packages the additional funding for this year will result in. When the service plan is drawn up, each area, including the CHO we are discussing, will receive additional home care packages and home help.

Deputy Catherine Connolly

It is difficult to digest the figures the Minister of State has given. Presumably I will get a copy of all those figures. I will bring those figures down to a personal level. I do not like bringing stories into the Dáil Chamber but I have to do it to illustrate. The Minister of State is talking in general figures and increases. Currently in Galway there is a patient who is not unique - I will not say whether the person is male or female - who cannot be discharged because the recommended number of hours cannot be given. How can the Minister of State stand over that, given the cost of keeping someone in hospital, at a conservative estimate, is €1,300 and in a nursing home is €800 to €1,200? Home care is the cheapest, most effective and best way on a human level. How can the Minister of State stand over a situation where somebody cannot be discharged and the public health nurse has been given the terrible role of reducing the number of hours? Is the Minister of State standing over that type of system?

Deputy Helen McEntee

This is a situation we have all found ourselves in throughout the year. The number of people seeking home help hours and care packages at the beginning of this year reached an unprecedented high and without the €40 million in additional funding this year we would possibly see even more cuts than we see across the board now. We will be spending €68.4 million more on home care packages and home help next year than we are this year. I do not like to put it into figures because we are talking about somebody's mother, grandmother, brother or sister. Without that additional funding, we will not be able to provide the additional support. I cannot give the Deputy the exact figures of how much will go to CHO area 2, which covers the hospital the Deputy has asked about. It will be decided in the coming weeks. I will provide the Deputy with the figures I have discussed here on the increases this year and next year.