Question 110: To ask the Minister for Health and Children her views on the findings of the National Economic and Social Forum report on the implementation of the home care package scheme which concludes that eligibility differs from area to area resulting in inequalities and inconsistencies for people in need of support and that there is much duplication of work, with double or triple assessment of the care needs of older people; the action she will take in relation to same; and if she will make a statement on the matter.
(Minister of State with special responsibility for Older People and Health Promotion, Department of Health and Children; Kildare North, Fianna Fail)
I propose to take Questions Nos. 106, 110 and 135 together.
The priorities of the Department in recent times, in relation to Services for Older People, have been the introduction of the Nursing Homes Support Scheme, and the bringing into force of new regulations in July last for the long-term residential care sector.
In tandem with these initiatives for the residential care sector, the Department has also been progressing initiatives on the community side and, as part of this, earlier this year commenced an independent Evaluation of Home Care Packages (HCPs). The HCP programme currently undertaken by the HSE involves overall annual funding in the region of €120 million, to provide packages to around 8,700 older people at any one time or approximately, 11,500 over the course of the year. Such packages are intended to enable older people to live at home and in their communities for as long as possible and to facilitate discharge from, or prevent inappropriate admission to, acute hospitals and long-term residential care. The HSE allocates and manages packages on this basis around the country.
The Department’s Evaluation , undertaken by PA Consulting Group, will be formally submitted to Minister, Deputy Harney shortly. The aim of the evaluation was to assess, through quantitative and qualitative research at HSE national and local level, whether the objectives of the HCP Initiative are being met in the best possible way. This evaluation was recommended by the long-term care working g roup, and reinforced by a “Towards 2016” commitment. The Department and the HSE has accepted the need for a more standardised approach to HCP provision generally. In the context of the forthcoming Report by PA Consulting Group, the Department is at present, in conjunction with the HSE, considering various issues in relation to HCP provision, including:
finalising and agreeing standardised access and operational guidelines for delivery of Home Care Packages;
adoption and dissemination by the HSE of a voluntary code of Quality Guidelines for Home Care Support Services for Older People; and
consideration of the Law Reform Commission recommendations in the context of possible changes to legislation and regulation in the area of home care for older persons generally.
I am familiar with the recently launched NESF Report which focused on the implementation of home care packages from a policy implementation point of view. It acknowledges that while the home care package initiative was a well designed policy, improvements are required in a number of areas regarding implementation, including the issues raised by the Deputies. These issues are also being addressed in the report commissioned by the Department.
It is intended that various recommendations of the PA report will be implemented or progressed over the course of 2010, including those relating to governance, operational delivery, performance management and funding.