Call for overhaul of how HSE awards home help contracts

The head of the organisation that represents private home care providers has called for an overhaul of the way the HSE awards care package contracts to companies that look after the elderly in their homes.

Joseph Musgrave, chief executive of Home and Community Care Ireland (HCCI), said the current system is “Fastest Finger First” - where companies who respond the fastest get the work.

“There is a rush to reply. A provider has a very short time to respond to say they can provide a package. While the HSE does not set official time limits, if providers take more than five minutes to respond, they tend to find the packages are gone,” Mr Musgrave said.

He said the time given to providers to respond “seems to have decreased” since last September, when a new tender document governing outsourced work, known as Tender 2018, was introduced.

I think people would be concerned to know that the care their elderly parent is receiving is based on who says ‘yes’ the quickest, rather than saying ‘yes’ in a meaningful way.

He was also critical of the HSE’s “discretionary” approach to paying mileage to outsourced providers.

Moreover, unlike HSE-employed home care support assistants (HCSAs) who are now paid “travel time” for the time spent travelling to clients’ homes, the 12,000 HCSAs employed by the 80 companies HCCI represents are not.

Mr Musgrave said if providers were given more time to respond to the HSE’s commissioning model, it could help reduce travel time because providers would have more time to plan service delivery.

Either they have to pay travel time to people in the outsource sector or change their commissioning model, which I think is totally broken.

Currently, travel time only applies to the HSE's own 6,000 or so directly employed HCSAs, on foot of a recently negotiated deal.

In a statement, the HSE said: "The current Home Support Service tender is the second such tender and has enabled the HSE to provide services to thousands of vulnerable people. We are continuing to work with providers to ensure that the third iteration of the tender process is closely aligned with clients’ needs."

Today, the Irish Examiner revealed the HSE has introduced restrictions in its home support service, with little scope for awarding new or additional hours up to next November as it strives to stay within budget.

While home support services did receive additional funding in 2019, this will have to offset the costs of the travel time deal.

With more than 6,000 people on waiting lists for home support, Labour Party health spokesperson Alan Kelly called on Health Minister Simon Harris to “find the resources to increase the number of home help assistance hours”.

“Minster Harris must see this for what it is: a ban on new entrants to the scheme and a failure to cover the full costs of delivering home care,” Mr Kelly said.

This year, the HSE will provide 17.9 million home support hours to 53,000 people.

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