Tuesday, 26 November 2019

Ceisteanna (44)

Michael Moynihan


44. Deputy Michael Moynihan asked the Minister for Health the number of the additional 1 million home help hours promised in budget 2020 that will be allocated to the north Cork area; and if he will make a statement on the matter. [48876/19]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte) (Ceist ar Health)

I ask the Minister, in light of the additional home help hours promised in budget 2020, what amount will be allocated to the north Cork area, which is starved of resources for home help hours at present. How many extra hours can we expect in the north Cork region in 2020?

Home supports enable older people, as the Deputy is aware, to remain in their own homes and communities, as well as facilitating timely discharge from hospital. The latest preliminary information available to me indicates that at the end of October, 1,424 people were in receipt of home support and Cork Kerry community healthcare had provided 352,902 home help hours in the north Cork area in the year to date. In addition, 5,014 hours have been provided through intensive home care packages. At a national level, additional supports are being put in place as part of this year's winter plan, which will assist timely discharge from hospital, as well as improved access to home support in the community.

In line with programme for Government commitments, we have made improved access to home support services a priority. We have committed to an additional investment of €52 million in budget 2020 for home supports and next year, the HSE will deliver more than 19.2 million hours of home support. This represents a substantial increase of 1 million hours more than this year's target.

This investment is focused on enabling older people to remain at home, where they want to be, and reducing the current waiting lists for the service being experienced in almost all areas. As appropriate, provision of hours will also be targeted at times of peak demand in winter 2019 to 2020, at the beginning and end of the year, to ensure more timely egress from hospital for our older citizens. The HSE national service plan for 2020 has been submitted and is under consideration in my Department. The allocation of hours and targets to community healthcare organisations is currently under way and I have been advised that this will be finalised in the coming weeks.

I thank the Minister of State for the reply. He mentioned 2019 to 2020. I understand that the additional hours in the budget are for 2020. If he is true to his reply, no extra home help hours are becoming available. We are into the last five weeks of this year and there is a crisis as people wait for home help hours. Families are waiting for home help packages and are making decisions about loved ones coming home. As I have told the Minister for Health on a number of occasions in recent weeks, a constituent of mine is in Dún Laoghaire, awaiting discharge. The HSE has met all the relevant bodies over the past few days but the family is still waiting for sanction of home help hours. The difficulty, which has been clearly described to me in writing, is that it is a question of funding. If we are to be serious about it and about getting the best possible bang for our buck in the health budget, if we can take people out of long-stay, very specialised beds and into a home setting, it would be by far the best way to utilise resources. I cannot see why we cannot look at individual cases as a priority, even at this late stage in 2019.

I thank the Deputy again and acknowledge the Deputy's commitment and consistency on this issue, having raised it a number of times in this forum. The Minister, Deputy Harris, is aware of the specific case because Deputy Moynihan has brought it to his attention. The Minister has addressed it with the HSE and asked it to prioritise and look at the case. He has also been in contact with the HSE about the wider question of availability. The Deputy asked about the end of this year. There is €26 million for the winter plan, which is to assist with both home help hours and respite and transitional care, to improve movement through the hospital system. In answer to the question of whether there is anything towards the end of this year, additional money has gone into the system to support it. I have a number of these cases in my own constituency. These cases can be complicated, where one is trying to start a service and get the necessary personnel available. I am not speaking about the Deputy's specific case but not all cases are resource-dependent. Some are resource-dependent, and more important than the money is whether a person is there to deliver the service, which is a complication in my area and other areas.

I acknowledge what the Minister and Minister of State have said on the particular case. I will continue to raise this in any forum that I can to try to get a result for that particular person and the family. The wider issue is that it is almost as if we are working in silos. The home help budget and acute hospital care budget are there. If we were able to manage it better to try to make sure that people are discharged from hospital to their home settings faster, it would alleviate many difficulties. If any assessment is done, it will be seen that the home care package has delivered considerable results for the State, along with the carer's allowance. Keeping people in their own homes for a small amount of money each week has delivered very well. We should prioritise home care packages and try to have people in their own home settings as much as possible. Back that up with respite but have people in their homes as much as possible. Last Thursday, the Minister of State, Deputy Finian McGrath, responded in a Topical Issue debate. It was a case of three high-dependency beds being tied up. They would all be freed up by a home care package. Many State resources were being tied up by not applying home care packages properly. The Minister of State and the HSE should look at this and continue to keep an eye on the specific case that I raised.

The Deputy makes a very fair point about the difference between the budget for community care and acute care. That is why the Minister has overseen the change from that system to what we call the regional integrated care organisation, which takes both together. Those organisations which have been established, as the Deputy is aware, have a single budget to address the issue. We are aware of and have addressed the issue. Home care is being addressed with the introduction of a statutory home care scheme in 2021, which is committed to under Sláintecare. We have funding in the budget for next year to bring in some pilots to test the scheme. I will bring proposals for that scheme to Cabinet in the next weeks and we will unveil more detail of it in late January. That will assist as well because there is an issue there. The Government accepts the benefit of home care and that is why the budget has increased from €300 million or so to almost €500 million in the last number of years. We cannot keep up with the pace of its success and trying to meet the demand for it, but we are determined to do so under a statutory scheme.