Dáil Éireann Debate, Friday - 3 December 2021
112. Deputy Ruairí Ó Murchú asked the Minister for Health the details of engagements regarding the need to increase the number of staff delivering home supports; the steps that can be taken to remedy the shortage of staff in the home support sector; and if he will make a statement on the matter. [53104/21]
Amharc ar fhreagraI have had a number of engagements, both public and private, with the Minister of State on this issue. All of us in this House understand the difficulties that exist regarding families who are looking for home care packages that will ensure their family members can stay at home as opposed to needing to go into long-term nursing care. We need to deliver that, while accepting there are difficulties because of pay scales and other issues. The Minister of State's task force has met a couple of times and is considering incentivising people who work in this sector and ensuring that we get more people into it. I would appreciate it if she will go into a little detail on that.
I acknowledge the Deputy has raised this issue with me on several occasions.
Work is ongoing in the Department of Health to progress the development of a new statutory scheme to support people to live in their own homes. Recruitment for 130 posts to support the national roll-out of international resident assessment instrument, interRAI, as a standard assessment tool for care needs is scheduled to commence this quarter. A national home support office is in the process of being established and a home support pilot commenced this month in one site, with the other pilot sites to be fully operational by January 2022. I was disappointed that the four sites did not commence operation in October. The only reason was the recruitment of staff. It was not due to lack of funding. We have started in one site and the other three sites will commence. This is to test the statutory home care model in four sites to provide us with information as we go forward.
On home care specifically, last year, I secured an additional €150 million for home support, which provides for an additional 5 million hours. My budget for home support this year is €666 million, which is a vast amount. The HSE target is to deliver 24 million hours of home support this year. It is estimated that, by the end of September, 15 million hours had been provided to more than 53,000 people. Notwithstanding the challenges we have, this is approximately 2.2 million more home hours compared to the same period last year. The funding secured in budget 2021 to provide these additional 5 million hours has been maintained for next year.
Significant progress has been made overall on reducing waiting lists for people awaiting funding approval for home support from 7,800 in January 2020 to just under 400 in September. I will conclude in the next part of my reply.
I appreciate that. I accept the added difficulties with the pilots the Department was looking to put in place in the context of the wider issue we have that an insufficient number of people are working in this sector. I know that a lot of things are being considered. We have to look at pay scales and any incentivisation we can provide. We know of the difficulties of people, some of whom were contracted staff, who would state that they were not going to get paid expenses for travel. Every obstacle possible was being put in their way. I think the Minister of State told me that the task force has met, or at least had met when we spoke last, three times and that it is examining every avenue to deal with this problem. Could she go into a little detail in that regard? We all know that the big issue is weekend support. Could she provide a general timeline for getting those pilots up and running? Where is the pilot that is under way operating? Where are the other three? Will the Minister of State provide a timeline, with all the caveats necessary?
To go back to the point, the funding of home care is not the issue. We are all aware of the €666 million available. Delays are occurring at the moment because we have delays in providing home care workers into specific areas. As the Deputy said, weekends and rural areas, especially, can be very problematic. Notwithstanding that, the number has come down significantly over recent years. Home care in Ireland is delivered with a 50:50 split, that is, 50% public and 50% private, but it depends where someone lives. Up in County Donegal, for example, only 19% of home care is delivered on a private basis, with 81% of care provided publicly. In CHO 5, which includes Waterford, where the Acting Chairman and I come from, it is a 26:74 split, whereas in the Dublin area, for example, all home care is provided both voluntarily and privately. That has been going on for many years.
I have put in place a cross-departmental strategic workforce advisory committee. It has met informally on a couple of occasions, but the inaugural meeting will be held very soon. We want to look at the challenges of private providers.
The Deputy referred to the difference in the rates of pay. I will come back to that in a moment.
Obviously, we need to look at the issue of the rates of pay. Again, I accept the difficulties in providing a timeline, but we need that task force to have its inaugural meeting. I accept that considerable work has probably been done, but we need the task force to put the priorities that are required in place and on the agenda, to be enacted by the Government as quickly as possible. We are all dealing with families coming to us who just do not have sufficient care. Could the Minister of State detail, as I said, the pilot schemes and a general timeline as to when they will be up and running? I have referred to the proposals on the agenda regarding improving the numbers of people in the sector.
The pilot scheme in the Galway area is operational. The pilot schemes in west Cork, Mullingar and the Dublin area are not. I will get the Deputy a note on that because it will outline exactly the areas being covered.
That would be brilliant.
The role of the cross-departmental strategic workforce advisory group will be to facilitate the views of stakeholders and to examine workforce challenges in home support and nursing homes. Potential areas will be recruitment and retention, training and the career development of home supports. I was updated by the chief officer yesterday on CHO 4, which comprises counties Cork and Kerry. They are strategically looking to hire 300 healthcare workers in the next three months. They have gone out on a very strong recruitment campaign, which is happening all over the country. The challenge we have, however, is that many people have left the home care sector and gone into nine-to-five jobs and into retail. Some have gone to work in factories, where the terms and conditions for some are more favourable.
They are family-friendly.
We are, therefore, challenged but we are working with the Department of Public Expenditure and Reform to look at different things to see that people on social welfare, for example, might be able to work a certain number of hours and students in receipt of the SUSI grant might be able to work enhanced hours. We are trying to throw the kitchen sink at this to resolve it.
