Elderly face means test and charge for home care packages
Public 'understands there's finite resources' to fund scheme
Elderly people are facing a means test and are likely to be forced to make a payment towards their home help for the first time under a new Government-backed scheme.
The proposed scheme will give people assessed as 'in need of support' a statutory right to a minimum level of care hours to allow them to remain in their own homes. It will be in place in two to three years' time.
However, health officials signalled yesterday that HSE-provided home help and home care packages are likely to involve a financial contribution when the scheme is in place.
Services for an older person or people with a disability who qualify for the supports are currently free.
Department of Health official Frances Spillane revealed a public consultation on the scheme, which is currently being devised, generated 2,600 responses and 1,700 of these have been analysed.
"We need to come up with a scheme that is as equitable and fair as possible.
"In consultation we asked questions on funding to get a feel from people and asked would they be willing to contribute to the cost of care," she said.
A majority said they would be willing to contribute - and also top it up by buying supplementary home care privately, she added.
"That would suggest there is an understanding that there are finite resources.
"Obviously that is going to be a sensitive issue and one of the main issues we have to develop," she told the Oireachtas Health Committee.
She added: "The new scheme will improve access to home care in an affordable and sustainable way."
It would be applied in a consistent and fair way across the country, she added.
The level of co-payment or type of means-test are still to be worked out but the assessment is likely to involve an examination of income, assets and savings.
Jean Long, of the Health Research Board, who looked at statutory home care schemes in four countries, pointed out there was evidence they were coming under pressure.
"Scotland has increased the budget allocated to home care and asked citizens who earn over £16,000 (€17,800) to pay for household tasks," she said.
Members of the committee stressed the current crisis faced by many families who are pleading for some form of home help.
Sinn Féin Senator Rose Conway-Walsh said she was aware of people in their 90s who are being denied care.
However, although they are assessed as being in need, they have no automatic entitlement to home care and there is a waiting list of 2,456 who are desperate for some support.
Age Action's Justin Moran told the committee that around 50,875 older people should be getting home help - but 22,300 of these were not receiving the home care they needed.
"The reality is that home help hours and home care packages are simply not available in many parts of the country," he added.
It is being exacerbated by the postcode lottery which exists in different counties.
North Dublin, Cork and Kerry are waiting-list blackspots for people needing home help from the HSE.
There are also waiting lists in Galway, Roscommon and Mayo.
The crisis is worsened further by the difficulty in recruiting home helps who face uncertain contract hours, the committee was told.
Ms Spillane said when the new scheme was introduced it would also involve regulation of home help services for the first time. The aim is to make this "pragmatic" - with regulation applying to the providers, rather than inspectors visiting people's homes.
Ms Spillane said that in the recent Budget a further €37m had been made available for older people's services, particularly to speed up their discharge from hospital over the winter.
"A significant proportion of this additional funding will go toward home care services," she added.
But the resources are limited as demand grows annually.