The director general of the HSE said he “accepts” that they do not have a big enough budget to meet the demand for home support services.
Paul Reid was responding to questions from Independent TD Catherine Connolly who asked if she should tell people on waiting lists for home support that they are “simply collateral damage”.
Mr Reid had told Fianna Fáil TD Marc McSharry that he accepted that demand on home support services “is above and beyond the budget we can provide”.
“You are saying there’s a limited budget, that you are trying to work within that, anything other than that is collateral damage,” Ms Connolly said.
She asked if that was the message she should pass on to the 208 people on a waiting list for home support in Galway, of whom 176 are waiting more than 12 months.
“I would disagree,” Mr Reid said. The opposite of a limit on the budget would be that “we just continue to spend”, he said.
“That is not a mandate that I have. It’s not a bad thing to say deliver within your budget.”
The HSE recently introduced restrictions to its home support services, which will remain in place until November. They include reducing the number of new hours in the system compared to last year, a reduction in the amount of “recycling” or reallocating of hours, and a reduction in the amount of new hours provided to hospital discharges. More than 6,000 people are currently on waiting lists for home support.
Ms Connolly asked if it was “effective use of public money” not to support people in their homes, when acute care was so much more expensive.
Mr Reid acknowledged that the manner in which the HSE is currently investing in home support “has to change because it is not meeting the needs of service users”.
Labour Party TD Alan Kelly said home support should be “a demand-led” scheme “for one simple reason - it will save money and keep people out of acute care”.
Department of Health secretary general Jim Breslin said what Mr Kelly was suggesting was a statutory entitlement to home support, which the government is currently looking at.
“That’s an absolute priority,” Mr Breslin said.
Mr Reid was also asked about a report in yesterday’s Irish Times which said the HSE had warned Government it would be “almost impossible” to deliver planned multibillion-euro investments in new healthcare facilities in the coming years because of cost overruns at the national children’s hospital.
The warning was contained in a letter from the HSE to the Department of Health on May 3.
Mr Reid said they had been working with the Department of Health and the Department of Public Expenditure and Reform (DPER) in the interim, “to make sure the implications... aren’t to the extent they were looking like in early May”.
Mr Kelly said he could name projects that had already lost out because of the children’s hospital overruns, such as a new maternity hospital in Limerick that was part of the National Maternity Strategy.
Mr Breslin said “to date, there has not been an impact on the timing of what we can do”.
Mr Reid said 75% of the capital plan was “contractually committed”.