Shane Cassells
Ceist:7. Deputy Shane Cassells asked the Minister for Health the reason Meath local health office experienced a reduction of 36,253 home help hours in 2017; and if he will make a statement on the matter. [17042/18]
Amharc ar fhreagraThursday, 19 April 2018
Ceisteanna (7)
Freagraí ó Béal (7 píosaí cainte)
Why did the Meath local health office experience a reduction of 36,200 home help hours in 2017? The fact the drop in home help hours in Meath is many times the national average is shown in the daily calls and visits to my constituency office from people whose loved ones receive half an hour or 40 minutes of care in the morning but do not see anyone else for the rest of the day. I would appreciate a statement on the matter.
I thank the Deputy for the question. Home help has been a priority for me since taking on this position in the middle of last year, and this is evidenced by the consultation process the Minister and I launched shortly after my appointment to review how we do home help. I have accepted in various fora that the current system is not delivering as it should be. I am a believer that if we always do what we always did, we will always get what we always got, and it is not good enough. The consultation has been completed and we are reviewing it. I hope in the next week or two to publish its results.
The overall macro picture with regard to home help is that this year we increased the budget for home help by €18.25 million and home help hours now have a budget of €408 million per annum. This is a significant budget by any standards but clearly it is not enough. I appreciate this does not, as somebody said before, butter any parsnips for those waiting to get home help hours or waiting to get a service delivered to their house.
The Deputy mentioned Meath and the reduction of 36,000 hours. There are two issues at play. One is that recruitment is a challenge in a number of areas, which is leading to a reduction. We cannot get the staff. It is not a financial issue. It is that we cannot get enough staff to deliver for the demand that is there. We are also seeing a fairly significant increase in the number of intensive home care packages. Last year in Meath we delivered 440 home care packages and this year we have delivered 496 packages, which is an increase of 56 intensive home care packages. The Deputy is aware these packages provide thousands of home help hours when they are added up and this makes up for the shortfall. The issue is the HSE's reporting structure, and it is now working to combine home care packages and home help hours to make it more transparent and create a more straightforward and easier to follow system for counting the hours.
I thank the Minister of State and I appreciate his reply and the information on the details on the review. In the three years since I have been elected, the biggest issue in my constituency office, after housing, is health, in particular the issue of home help hours. In a county with a population of 200,000 people, it is natural that the elderly population is increasing and the care required for the elderly should be paramount. Last year in particular, we were inundated with cases and pleas for help with securing home help hours, which had been reduced from 500,000 to 464,000, which was a drop of 7%. This was far in excess of the nationwide drop of 1.5%. I appreciate what the Minister of State has touched on in terms of the difficulties with staffing. It is something we are seeing as having an impact in the northern part of the county. Across the border in adjoining counties such as Cavan and Westmeath, staff are available but because of the county boundaries they cannot work in Meath. I ask the Minister of State to look at this as part of the review because the staffing issue is key. The system is under a lot of pressure and I appreciate the Trojan work done by the home support co-ordinators, but as part of the review I ask the Minister of State to look at this aspect also because the drop is significant. It is 7.2% as opposed to the national drop of 1.5%.
The issue is the increase in intensive home care packages of 13% in County Meath, which more than balances out the drop in individual hours being delivered to which the Deputy referred. They are being delivered through packages for people as opposed to individually. Notwithstanding this, I accept what the Deputy has said and I accept his acknowledgement of the challenge in recruitment. It is something we also experience in my constituency of Cork South-West. It is particularly challenging to get staff. This will be one of the key areas of focus for me when I review the scheme, to try to deliver a home help scheme along the lines of the fair deal scheme, whereby people will be able to get the care they need by statute and that it will be there on demand and delivered to them, as opposed to what some might describe as a postcode lottery in the current system, whereby how lucky a person is depends on where he or she lives. I accept the spirit in which the Deputy has put the question and I hope I have clarified it as best I can.
I thank the Minister of State. The drop is symbolic of resourcing issues in County Meath, which has one of the largest populations in the country but ranks the lowest when it comes to funding across a range of Departments, whether it is with regard to health, policing or housing. I have just come from a meeting of the Committee of Public Accounts where a departmental Secretary General has told us we have the lowest spend per capita in local government with just €522 per person as opposed to €1,400 per person in the city of Dublin.
The Minister of State and the Minister are aware of the campaign to save Navan hospital, and the promise made in 2011 of a regional hospital in Meath, which has disappeared off the books. Cabinet members have now admitted it is a dead duck. Last week, my local newspaper, the Meath Chronicle, had an article stating GP practices in my home town of Navan are turning away people because they have no space. In a town of 36,000 people, GP practices are turning people away from their doors. There is a real issue when it comes to centres such as Meath and commuter counties which have big populations but are not keeping track with the type of services that people in larger counties require. This particular reduction in home help hours is symbolic of a wider problem in a county such as Meath.
At the risk of repeating myself, if we add up the increase of 56 intensive home care packages and the number of home help hours included in them, there is no decrease. Nationally, the number of home help hours has increased from 16.36 million last year to 17.1 million this year. This is a significant increase in the delivery of home help hours but I appreciate it is not enough. If we are trying to move away from acute services and towards supporting more people in their homes, we need to invest further in home care delivery, home care packages and home help hours, but we can only do this incrementally, as the Deputy will appreciate, because of the demands on the acute side. It is a gradual move and shift away, in line with what is set out in the Sláintecare report, which is to deliver services at the nearest point possible to the person.
The Deputy mentioned the local authority, GP practices and Navan hospital. Unfortunately, many of these issues are above my pay grade to comment on.
To use a phrase used recently.