Éamon Ó Cuív warns home care system failing despite new funding

Goona māgat Laas Ciancourle and I would like to thank the Minister for coming in here and I know your personal concern in relation to this matter. Minister, I believe that COVID taught us one thing and that is the value where it is a viable option and the desire of families to care for loved ones at home, particularly in old age. I think that we all resolved after COVID to ensure that this would be a more viable option and that more people who wanted to be cared for at home, both by themselves and by their families, would be given that option. And to do that we need strong state support. It is a very economic way of doing this and we need that in terms of home caring packages and of home carers. However, in reality the opposite is happening. I will give you a few examples. A case of a lady with multiple sclerosis and diabetes who has been awarded 42 hours. So that is approved. The agency who were given this package by the HSE handed it back. So that now there are no carers and they handed it back on the understanding that they did not have the carers. The HSE has said that they also do not have the carers and she is only in receipt of 13 hours weekly provided by the carers. Another case where the carer has not been replaced when she went on annual leave. There were no arrangements put in place to cover the carers leave and everybody is entitled to leave. A case of a constituent who was awarded 16 hours of home care per week and has not been given more than six hours in any given week. And on and on it goes, Minister. I just want to highlight the particular cases because it is a human tragedy that this is happening. And it is, of course, making people reassess the option of caring for people in their own home environment which, as I said, is often the choice. But it is not viable if you do not want the support. Minister, what I am hoping to hear tonight is that the Government has a plan to address the issues. And I think one of the very fundamental issues, by the way, here is that the profession of caring in the home is not a particularly well paid profession. And I think we have argued this for years. There is too big a gap in the top of what the public service is paid and the bottom of the public service is paid. And we need to address this. And this is coming back to haunt us that this issue has been allowed to go on. So, Minister, I hope you will have some answers tonight. I know that you are sympathetic. And if you need support in, you know, looking for the money, I think you would get the support of every member of the House in making a stand that people who are caring and being cared for deserve the best. And that home is the best in many cases. And I am not ruling out the incredible role that nursing homes also play. Goedemnag aigut. Goedemnag aigut. Goedemnag aigut. Deputy O'Cheav, thank you very much for the question. I noticed Deputy Collins is here listening as well. We had a discussion earlier on the back corridor and I know you have raised it as well. Everybody has raised the situation with me. The issue is not funding. If the issue was funding, I would be able to go and look for more funding and I feel I would secure it. My budget for home care for this year is £666 million. It increased by £150 million this year and I have secured the same increase for next year, which is to deliver 24 million hours of home care. And Deputy, you are quite right. Covid has taught us the value of care for people at home. And I want to see the Solange Care model, the right care, at the right time, in the right place, as close to home as possible. By the end of October, almost 17 million hours had been provided to over 54,000 people. So this is about 2.5 million more hours compared to the same period last year. So we have made a lot of improvements this year alone. Significant inroads have been achieved in reducing the waiting list for the funding approval for new and additional services. So in January 2020 there were 7,800 people waiting for funding. It is now down to 400 in September 2021. So I have managed to reduce those waiting for funding for home care by 88%. But therein lies the problem. And the problem has got worse during the year. There are delays between the approval of funding and the delivery of home support hours. And the number of people in this category have increased steadily this year. And it is primarily due to staff capacity issues. So at the end of September this year, there were 4,933 people assessed and waiting for care to become available. But the funding had been provided to provide the package. And that is the most frustrating part for me. The fact that I actually have the funding for the first year ever. I often stood on that side of the house, talking to my predecessor, former Minister Daley. And the funding was not available at the time due to different issues. And now the funding is available. And that is what makes it most frustrating. The HSE is acutely aware that there are increasing capacity issues across both direct and indirect provision. And it continues to advertise on an ongoing basis for health care assistance and recruits. As many suitable candidates where possible. And I will give you an example. Deputy, in your own CHO, CHO4, they are actually recruiting at the moment. No, CHO4 for this Deputy. They are actually recruiting 300 home care assistance. They put it out for advertising last week. So every single HSE area, every single CHO, are trying to recruit as many people as possible. And they are recruiting through a variety of channels, both at local levels and through the shared services office of the health business service. I recently started a round of meetings with the older persons lead in each CHO to discuss these challenges and also to discuss day care, respite and community step down. Because it is so important if we want to keep the throughput through our acute hospitals, the only way we can do that is by having the supports at home. I am also meeting regularly with HCCI, Home Community Care Ireland. They are the private providers. And they are also continuing to recruit home support workers. So just to let you know what I am doing. I have established a cross-departmental strategic workforce advisory group. The role of the group will be to facilitate the views of stakeholders and to examine the workforce challenges in home support and nursing homes. So the areas to be considered include recruitment, retention, training, career development and the sustainable employment of home care workers into the future. I will answer more in the next part. Minister, I take my hat off to you on all that has been done. But how am I meant to go back to a constituent who was awarded 14 hours home help weekly and the hours were meant to be divided between morning and evening. However, the hours will only be given in the morning. And the caries, in other words the person, will be cared for. Wife has to put her husband to bed. But because of the condition he is in, this takes two people. And what she was told is, well, the latest we could come is 6.30 in the evening. Now it is not a viable option putting somebody to bed at 6.30 in the evening. Because if you do that they will be up very, very early in the morning and you will have the same problem in reverse. You know, I hear all the statistics. I know the work you are doing. But that is no good to the person facing the individual dilemma. And yes, I think funding, but not funding in the normal sense. I absolutely accept that you have extra funding. I absolutely accept that it is much quicker to get the hours granted now. So we are used to the problem getting the hours granted. Now we have a problem getting the carers. There is a problem this society has to look at. And I remember the late Frank Prendergast, who was a Labour TD in this House, time and again saying to me that over the years, the gap between the top and the public, how we pay people. And remember, these are front line workers. So it is becoming more and more obvious, and this is right across society, critical service services provided, because we refuse to restructure our society to properly reward those, providing critical care services in our society. And then we wonder why we cannot provide the services. The Prime Minister, to conclude. The Prime Minister of the Cross Departmental Strategic Workforce Advisory Group, I announced a call for submissions since last Friday to further identify key issues in recruitment and retention, and to inform the establishment of the group in early 2022, which is January as far as I am concerned, as soon as possible. We are all aware that terms and conditions do vary from the privates to the HSE. The HSE pay approximately €16 an hour plus travel. Some of the privates pay the minimum wage, some pay more, some pay more. But there are challenges there, and they are losing staff to the HSE. I have also had a lot of talks with the HSE itself, and there are a few recommendations gone to deeper to look at. For example, we have some young people who avail of SUSIE grants, who are allowed to work so many hours per month. We are trying to double that. We are also looking at supporting people who receive a Department of Social Protection payment, that they might be able to work a set amount of hours, like the disability grant, and that you would not lose your support from social protection, it would not affect your medical card. We are hoping we can encourage more people back into the workforce. Deputy, I understand exactly where you are coming from. I get these queries into my constituency office as well. I say there is no one who does not get them. The problem we have is that when you have carers, a lot of them work split shifts. They work in the morning, they work in the evening. 75% of all carers work part-time. Everybody wants their loved one to be put to bed last. But when carers are going out at 5, 6, 7, 8 o'clock in the evening, they go to one house and they move on to the next. So that side of it is very, very difficult. But all I can do is I give my commitment here that I will continue to do everything in my power to try and get more home care workers into the system. We are challenged as you know in relation to, we have more people working now than we ever had before in the history of the state. We are challenged with hospitality, we are challenged with home care and we are challenged with retail as well. And it is quite difficult but all I can say is I am working at this every day. So thank you very much Deputy. Hello. Hi. Thanks so much for joining me. If you Vee Tohoto, the agent on the stage is here. problemas. Dev las we've got. We are back at the stage for the program.