Holly Cairns
Ceist:827. Deputy Holly Cairns asked the Minister for Health her plans for implementing the European Care Strategy with regard to unpaid carers. [7193/25]
Amharc ar fhreagraTuesday, 25 February 2025
Ceisteanna (827)
Freagraí scríofa
Family carers are key enablers for Government policy to support people to live with dignity and independence in homes and communities of their choosing for as long as possible by providing vital care to some of our most vulnerable citizens. The care they provide is unpaid.
In September 2022, the European Commission published the European Care Strategy to help ensure quality, affordable and accessible care services across the European Union and improve the situation for both care receivers and the people caring for them, professionally or informally.
The European Care Strategy includes the following recommendation in respect of family carers:
“Supporting informal carers, who are often women and relatives of care receivers, through training, counselling, psychological and financial support.”
Government policy on family carers is set out in the National Carer’s Strategy which provides the strategic direction for future policies, services and supports provided by Government departments and agencies for carers. The Strategy is designed around a core vision which recognises and respects carers as key care partners who are supported to maintain their own health and well-being, care with confidence and participate as fully as possible in economic and social life. Oversight of the Strategy is led by my Department, with individual Government departments leading on action areas that fall within their remit.
In the area of health, for which I am responsible, a number of actions have been taken to directly support family carers, in particular women family carers, in line with the recommendation of the European Care Strategy.
Carer’s Guarantee
Since Budget 2021, recurring funding of €2m has been provided towards the Carer’s Guarantee, to provide a core basket of services to carers across the country, regardless of where they live. €0.6m in additional funding has been provided in Budget 2025, bringing total funding for the Scheme to €2.6m.
This funding helps to provide a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. From 2025, €2.44 million of this funding will be provided to Family Carers Ireland (FCI) to deliver a mix of community and individual supports across five areas of activity: community carer supports; intensive and emergency supports; education and training; FCI’s freephone careline; and psychosocial supports. €160,000 is supporting the development and delivery of online supports for over 8,000 family carers through Care Alliance Ireland by means of an online support group.
Under the Carer’s Guarantee, the Department of Health funds training and mentoring programmes to help family carers acquire new understanding and relevant skills to their evolving caring role while also raising awareness of the importance of self-care. A range of training programmes from e-learning programmes to short workshops and courses extending over several weeks are offered.
The Alzheimer Society of Ireland also provides in-person and online training for family carers covering a variety of topics including communication, responsive behaviours, personal care and nutrition, and self-care. There is a separate training course for carers of people with late-stage dementia. Online carer support groups also allow carers to share information, ideas, tips and individual experiences of caring for a person with dementia.
GP Visit Cards for Carers in receipt of Carer’s Allowance
Since September 2018, individuals in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. On foot of this measure, as of January 2025, 7,614 people in receipt of either full or half-rate Carer's Allowance or Carer's Benefit have gained GP Visit Card eligibility. It should be noted that many carers may have already held a medical card or GP visit card prior to this welcome policy change.
A range of other measures have been introduced in recent years to expand access to GP Care including the automatic awarding of a GP visit card to all persons over 70 in 2015 and increase to GP Visit Card income thresholds in 2019. In addition, under the GP Agreement 2023, GP visit card means-tested eligibility was fully expanded, as per that Agreement, to all those who earn up to the median household income from November 2023 (having commenced in September 2023). Approximately 430,000 people under the means-tested expansion were estimated to be eligible under this expansion.” Altogether, as at 1 January 2025, more than 2 million people or over 42% of the population currently have access to free GP care through either a medical or GP visit card.
Women’s Health Fund Project on Midlife and Older Women Family Carers
Funding of €250,000 has been approved under the Women’s Health Fund for a project to support midlife and older women family carers. The project aims to research the impact of the gendered nature of family caring on midlife and older women’s health and wellbeing and to develop effective responses to support women carers. The project will be undertaken by Family Carers Ireland with oversight by the Department of Health.
This project will deliver an evidence base for women’s health issues associated with caring into middle and older age by assessing the effectiveness of available supports and a report will be produced on the effectiveness of available supports for sustaining caring into later life.
Family Carer Needs Assessment Pilot
From 2021-2023, a Family Carers Needs Assessment was piloted in Community Healthcare West to test the implementation of the interRAI Family Carer Needs Assessment (FCNA). The pilot examined the role of the family carer, how caring affects them, and how much care they can realistically provide while still allowing for involvement in other activities. The FCNA identified the types of support family carers need to support them in their caring role and how these can be met. It also identified barriers to providing support including family carers not self-identifying as a family carer and a focus of health and social care professional on the person in receipt of care to the detriment of the family carer.
This pilot is part of a larger ongoing international study of the interRAI FCNA. The project’s final evaluation report was published in March 2024. While awaiting the final results of the international study, the HSE and the Department of Health are considering what next steps may be required to further support family carers.
Inter-departmental Working Group on Family Carer Supports
In March 2024, an inter-departmental working group (IDWG) examining supports for family carers was established. The IDWG is chaired by the Department of Social Protection with membership of the group including my Department and the Department of Children, Disability and Equality
The work of the Inter-departmental Working Group will be informed by a broader review of means testing underway in the Department of Social Protection, the National Carer's Strategy, led by my Department and work being carried out by the Department of Children, Disability and Equality under the Action Plan for Disability Services 2024-2026 to increase family resilience and provide extra support for families and carers.
The inter-departmental working group will report its findings to me and the Ministers for Social Protection and Children, Disability and Equality.
Department of Social Protection Income Supports for Carers
In addition to the supports provided by my Department outlined above, the Department of Social Protection provides a range of income supports for family carers who cannot work because of the level of care that they are providing. The main income supports are Carer's Allowance, Carer's Benefit, the Carer's Support Grant and Domiciliary Care Allowance. It is estimated that the total value of payments on these schemes will amount to over €1.9 billion in 2025.
Carer’s Allowance
The Carer’s Allowance scheme is the main scheme by which the Department provides income support to carers in the community. It is a means-tested income support for people living in Ireland who are looking after someone who needs full time care and attention.
The means test is used to target the support to those most in need. Like other income supports the payment is intended to provide an income support for people who cannot earn income through employment or other means due to a specified contingency.
The provision of full-time care and attention requirement is moderated somewhat by allowing a carer to work or engage in education or training for up to 18.5 hours per week.
Carer’s Allowance has the highest income disregards in the social welfare system. The amount of weekly income disregarded is €450 per for a single person and €900 for carers with a spouse/partner. These disregards will increase to €900 and €1,250 respectively from July.
Carer’s Benefit
Carer’s Benefit is a payment made to insured people who may be required to leave the workforce or reduce their working hours to care for a person(s) in need of full-time care. It is payable for a period of up to 2 years (104 weeks) for each care recipient and may be claimed over separate periods up to a total of 2 years (104 weeks).
Carer’s Benefit is income-tested. Income cannot exceed €450 per week after tax. As part of Budget 2025 and from July the earnings limit will increase to €625. From January, the payment has been made available to the self-employed.
Carer's Support Grant
The Carer's Support Grant is not means-tested or subject to social insurance conditions. It is automatically paid to people in receipt of Carer's Allowance, Carer’s Benefit and Domiciliary Care allowance in June of each year. Other carers not in receipt of a carer’s payment may also be eligible for the Grant. The objective of the Carer’s Support Grant is to support carers in their caring role and carers may use the grant in a manner that is appropriate to their needs. The grant is paid in respect of each person being cared for to take account of the additional costs of providing care and to recognise the particular challenges faced by these carers.
As part of Budget 2025 the rate of the grant has increased by €150, bringing the total grant to €2,000.
Domiciliary Care Allowance
Domiciliary Care Allowance is not means tested. It is payable to a parent/ guardian in respect of a child aged under 16 who has a severe disability and requires continual or continuous care and attention substantially over and above the care and attention usually required by a child of the same age. This level of care and attention must be required to allow the child to deal with the routine activities of daily living. The child must be likely to require this level of care and attention for at least 12 consecutive months.
As part of Budget 2025 and with effect from January 2025, the payment rate increased by €20.00 to €360 per month.