Lack of oversight means homecare is 'based mainly on trust', committee hears

Alone chief executive Sean Moynihan told the committee: 'Despite multiple reports by the Department of Health, there has been no progress relating to identifying a suitable funding mechanism for home support.' Picture: Arthur Carron

Homecare services are “based mainly on trust” with no independent oversight or regulations even as waiting lists grow rapidly, the Oireachtas Health Committee has heard.

The committee heard about growing pressures from Alone, an organisation which supports older people who wish to stay at home instead of moving to a nursing home or other centre.

Many older people rely on carers provided by the HSE or by private companies under contract to the State. They might need help getting up in the morning or with showering, for example.

Alone chief executive Sean Moynihan said it continues to witness growing waiting lists”, adding: "We are behind in delivering a statutory home support scheme." Based on its experiences, he warned: 

Currently our home support services operate based mainly on trust. There are no regulations, no standards, no independent oversight, and very little data. 

The discussion centred on the general scheme of the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024.

This is part of several measures which will make up a new model for homecare. Mr Moynihan told TDs and senators:

"Despite multiple reports by the Department of Health, there has been no progress relating to identifying a suitable funding mechanism for home support.

“We are concerned by reports of a ‘Fair Deal’ scheme for home support, given the extensive bureaucratic process of Fair Deal.” 

He called on the committee “to support the design of services with the needs and rights of the older person at the centre of the process".

He told Senator Martin Conway that meetings with the Department of Health on this have gone on for “around five years” to date. 

He added while they welcome progress made so far, Alone would like to see critical elements such as training for workers be further developed.

Alone senior policy and advocacy officer Gráinne Loughran agreed limits to the legislation are disappointing, in response to questions from Social Democrats health spokeswoman Roisin Shortall.

Mr Moynihan said older people have other needs too which should be taken into account.

For example, one in three people who contact ALONE with questions about healthcare in the community needed help connecting with a public health nurse. The next most common problem was lack of access to occupational therapists.

Describing staff shortages as “pinch points”, he asked for a review of staffing levels for both these roles.

Last year two thirds of all people we assessed experienced loneliness or social isolation some or all the time. The EU commission’s research says Ireland is the loneliest place in Europe. 

"Alone has over 7,000 engaged volunteers who give their time to support and befriending isolated people in their communities. 

"Yet commitments to develop an action plan to combat loneliness have not been realised.” 

• Alone is a national organisation that last year provided support to over 36,000 people.