Gino Kenny warns private home care risks 'race to the bottom'

Thank all our witnesses in relation to a very, very important matter. Just in relation to the previous discussion in relation to home care, it's shaping up that, you know, well, the fact that 50% of home care hours now are publicly provided and probably more than 40% is from the private sector. And in CIP2's open statement, they said that obviously this is, this trend is, you know, moving towards a model of, you know, private care relation to home care. Now, obviously, there's a huge downside to that in relation to paying conditions. And I've just worked it out that the average, the mean hourly pay from the, from HSE, HCA hours would be the mean, the mean would be probably by 16.50. And then in the private sector, it's 12.50. And then in the private sector, it's 12.50. So that's a considerable amount of money per hour. So it's probably four euros extra, if not more, in relation to public sector. Now, obviously, home care providers and private sector are getting an enormous amount of money from the HSE. They're getting a huge amount of money from the HSE to provide this home care. So obviously, they're for profit. They make, you know, they make, you know, they make, obviously, profit from that, while at the same time, they're putting pressure on paying conditions for their workers. Now, there's no, there is no reason why workers are leaving that sector, particularly in the private sector, because of them paying conditions. And there is a retention issue. There's no getting away from that. And that spills over also the public sector as well. So my kind of main question is, you know, if that's the case, but there's obviously a worry that what we've seen in the kind of the nursing home sector in Ireland, that, you know, 15, 20 years ago, it was 80% provided by the state. Now it's 20% and the roles are reversed. Could this happen in the same way that, you know, it's happened to the nursing home sector in relation to private sector essentially taking over, which I would argue that it's a service for public good rather than profit. And obviously what happens then that it brings a downward pressure on workers' wages, which is a really bad thing. Thank you. Good morning. Your comments, I'd fully share 100% in relation to your observations. Not alone is the hourly rate significantly lesser in the private for profit providers on our members. They don't have access to guaranteed hours. They don't have sick pay. They have no superannuation scheme, no maternity pay in a lot of cases, etc. So it is, in our view, a race to the bottom in relation to terms and conditions of employment. So we would be anxious that where we now have established terms and conditions, which recognise the role and responsibility and the efforts of our workers in providing home care, which is important. We all have family members involved and have seen the benefits of it. That it should not be a race to the bottom and it shouldn't be about secured in hours based on how little you pay the worker. Our aim is that, you know, the HSE, Department of Health and Government have now established these rates with ourselves through the third-party machinery. And it's to maximise those hours available to avoid the scenario you alluded to there. Could I just add to that, Deputy Kenny, a very quick comment. The question you referenced about could what happened in the nursing home sector happen in this? Well, it could, but it wouldn't if we all got on board the Solange Care Bus. Simple as, because it would be treated as a different type of citizen's right and it would be delivered in that way. And I don't think, whereas the nursing home sector kind of, it happened by degree almost, almost death by a thousand cuts, because the for-profit organisations were kind of lurking around looking for that type of business. And I don't mean this to be, you know, disrespectful, but they are a profit-making industry. And I don't think we should allow that to happen. Thank you. Just to add one more point just to finish that off and to round it out. There is a very real threat to the service I see at the moment. And it is the fact that the HSE is already unable to fulfil the needs of the citizens and is already giving 10 million hours a year to the private for-profit sector. And they, as everyone has said, have to build in the difference between wages is the profit that the private sector has to make. And if the HSE does not resource it properly with the willingness of government and Solange Care and the Department of Health and all those people, we will see that happening. And one thing that just worries me with nursing homes, you know, there was some obvious tax incentives around nursing homes that made it a very lucrative area to invest in for a long time. And I think this is why this conversation is so important that it is happening now and that we get the sector resourced properly through direct labour, that there is not that opportunity for the private sector to say, oh, you are on a statutory footing. There is now every person in this country over 18 has a right to statutory home care. We will provide it. Don't worry about that. So I think it is vital. And that is why we are so delighted to be here today to raise these issues. It is vital that we move now and, you know, I am going to echo Eamon again. Solange Care is the way forward. That is our view. One final supplement. You are going to be silent again. Do you know that you are having a problem with your microphone? Can you hear me? Can you hear me? Yes, yes. My final supplemental question in relation to the private sector in relation to home care. How profitable is the home care industry at the moment in the opinion of, say, Zip2 or Forza? It is probably hard to put an accurate answer on that. But all I can probably say is that the number of providers is growing and the competition is increasing. So there is obviously something of benefit to the providers in that. And from our understanding, the cost of providing that service to the state, be it in the home care provision, works out similar to the cost of providing it directly. So the question then is asked, where is the difference going from the point of view of the hourly rates, etc.? We would add that if you allow what happened in the nursing home sector to happen here, the profit margins would increase. So it is not being done by for profit making organisations out of pure benevolence. It is a combination of we provide a service out of benevolence, but ultimately we are here to make a profit. And the results would be inevitable.