Colm Burke (Cork North Central, Fine Gael)
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As this refers to a service matter, I have sent this PQ to the HSE for direct response. As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.

Mary Butler (Waterford, Fianna Fail)
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The Programme for Government commitment to “introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care” requires focused effort across several different workstreams that are all contributing towards strengthening the statutory framework and improving the experiences of those receiving home support.

The first element that is being legislated for relates to the licensing and registration of home support providers. The General Scheme to establish a licensing framework for professional home support services delivered in the State - the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024 General Scheme - was approved by Government on 14 May 2024 and is published on the Department of Health’s website. It was referred to the Joint Oireachtas Committee on Health for pre-legislative scrutiny and Department officials met with the Committee on 19 June 2024.

This Bill will provide for the regulation of the sector by HIQA. Final amendments have been made to draft regulations for home support providers following a public consultation and engagement with stakeholder groups. The Department has been working closely with HIQA, which has prepared draft quality standards that are expected to go out for public consultation Q3 2024.

As well as delivering on the legislative elements of this commitment, the Department is working to address the future financing of homecare, the reform of the model of service delivery and the breadth of issues relating to recruitment and retention in this sector; all in the context of unprecedented expansion of the State-funded home support service, nationally.

Over the last two years, extensive work has taken place within the Department of Health to progress the Programme of Government commitment, including but not limited to:

• Development of draft regulations, which were informed by a 6-week public consultation completed in August 2022. The consultation results were analysed and published, and have been incorporated in revisions to the draft regulations.

• Oversight of the pilot for testing of a reformed model of service for the delivery for homecare, which became fully operational in 4 Community Healthcare Organisations in this period. Evaluation of the pilot has been completed and reviewed.

• Ongoing engagement with the HSE on the continuing reform of the model of service delivery for home support. Funding has been provided for establishment of a National Home Support Office and the Head of Service, and a number of other posts have been recruited. The national roll-out of interRAI as the new standard assessment tool for care-needs in the community is underway.

• Addressing the shortage of care workers in Ireland through establishing, in March 2022, a cross departmental Strategic Workforce Advisory Group. After extensive engagement and consultation, in September 2022, the group published a report containing 16 recommendations to address workforce challenges. Implementation is being overseen by a cross-departmental Implementation Group, chaired by the Department of Health.

• Extensive engagement with the HSE and DPENDR on the establishment of the HSE home support tender in 2023, ensuring that it delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding.

• Liaising with the DETE on bringing forward a statutory instrument authorising the issuance of 1,000 employment permits for home support workers.

• Commissioning multiple reports on potential demand, costs and charging models for home support, from the ESRI and the European Observatory on Health Systems. This research is being examined, as it forms an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population.

• Expanding access to home support services through securing significant increases in funding through annual Estimates processes.