Home care services weeks away from ‘chaos’ without new tender, sector warns

Home care services for more than 40,000 people are weeks away from chaos and “legal limbo” in the absence of a new HSE tender, the sector’s main representative group has said.

Discussions have been ongoing since the start of last year to agree a new tender between the HSE and home care service providers to replace a tender expiring on April 30th.

About 40,000 people receive home care through non-profit and private home care service providers with a further 6,700 people on waiting lists for home care.

The existing tender between the HSE and home services providers expired at the end of 2022 and a four-month extension was agreed while a new tender was being put in place.

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Home and Community Care Ireland (HCCI), which represents private providers employing 10,000 carers, said that the legal extension will expire at the end of the month and that it was “in the dark” about whether a new tender will be issued.

The group has warned that the absence of a new tender was putting the national home care service “at serious risk” and that if a new tender was not agreed, it may mean no new home care packages are issued at a time when thousands of people waiting for such packages.

“It is going to get very messy very quickly. It is going to create chaos,” said Joseph Musgrave, the chief executive of HCCI.

He warned of the risk of a “true postcode lottery” for home services with some HSE community health organisations (CHOs) continuing to operate home care packages under the old rate but with others unwilling to agree to providers increasing their home care pay rates.

“We would enter a legal limbo where, from a legal perspective, there would be no basis to underpin the issuing of home care hours,” said Mr Musgrave.

“This would affect every single carer in the country that doesn’t work for the HSE. The tender governs all home support services for people over 65.”

A spokeswoman for the HSE confirmed discussions were continuing regarding the new tender.

“We expect, further to previous ongoing engagements, to be in touch with the home care providers again on this next week,” she said in response to queries last Friday.

The HCCI said that, without a new tender system in place, the home care system could “grind to a halt creating absolute chaos for our most vulnerable”.

“This all means that more and more older people and people with disabilities stay stuck in hospital or struggle at home with no support,” the group said.

Mr Musgrave and HCCI chairman Jim Daly, the former Fine Gael minister for older people, wrote to the current Minister for Older People, Fianna Fáil’s Mary Butler, at the end of last month raising concerns about the continued delay in the new tender process.

“It is imperative that a new framework is agreed as soon as possible to ensure the smooth operation of the home support service for the benefit of thousands of older people across Ireland,” Mr Daly and Mr Musgrave wrote in their March 30th letter to the Minister.

The group is looking for improved terms and conditions for home care workers, including the payment of “a living wage”, payment for travel and remuneration for travel mileage.

It has sought “a reasonable uplift” in the standard rate to reflect inflation since the 2018 tender, having agreed to a below-inflationary increase of 2.5 per cent on the understanding that the new tender system would be in place by May 1st.