Home help scheme may be changed to include ‘co-payment’

Similar format to Fair Deal considered as Daly says scheme is struggling with demand

 Jim Daly has said one option is to    change the structure of home help  involve a co-payment. Photograph: Bryan O’Brien

Jim Daly has said one option is to change the structure of home help involve a co-payment. Photograph: Bryan O’Brien


The Government has conceded it is struggling to keep up with demand for home help packages and has suggested changes to the scheme.

More than 6,000 people are waiting for home help packages. The Health Service Executive (HSE) this week said budgetary constraints may limit their ability to provide new packages.

Home care packages provide medium to high level supports so people dealing with illness or old age who wish to continue to live at home rather than enter long-term nursing home care.

The assistance includes someone who can provide assistance with getting into and out of bed, dressing, and showering. Home-care packages are provided either directly by the HSE or through contracts for services with non-profit and private companies.

An assessment of an individual’s needs is conducted by a public health nurse who recommends that a certain number of home-help hours is required each week. The service is currently free and not means-tested.

On Friday Minister of State for Mental Health and Older People Jim Daly said one option would be to change the structure of home help to one similar to the Fair Deal which would involve a co-payment.

Fair Deal is the State’s Nursing Home Support Scheme which effectively finances long-term care for most older people. It costs the State just over €1 billion each year.

People generally contribute 80 per cent of their income towards the cost of their care and 7.5 per cent of the value of any assets every year.

Mr Daly said despite additional funding and hours the State “simply can’t keep up with demand” for home help packages, he said.

Mr Daly stressed that despite the waiting list, the home help scheme is not closed to new entrants. He pointed out the budget for the home help scheme this year is €450 million, up from €300 million four years ago.

“That’s a 50 per cent increase. For 2019 there are 800,000 additional home help hours, there’s a total of 18 million home help hours available this year.

“There’s no question whatsoever of there being a freeze, or closed, the reality is today there is fewer people waiting for home help this year than there was this day last year,” he told RTÉ radio’s Morning Ireland.


“We simply cannot keep up with the demand. We increased the budget by 50 per cent in the past four years and we still can’t go anywhere near the demand that is there for home help.”

The Minister said 53,000 people will avail of home help this year and said the waiting time can vary, from hours, to days, to up to a week, he said. Waiting for months is not typical, there are many complications that could arise, such a medical condition, clinical aspects, availability of resources.

“On Wednesday of this week, I looked for the figures, of how many people were in hospital in Ireland on that day, waiting for home care package. The figure was 26.”

He denied that a new agreement to pay care support assistants for travel time will impact on the number of home help hours available.

“We allocated an additional €30 million to the HSE to cover 800,000 additional home help hours and in addition to that the travel costs - the HSE have committed under the national service plan to deliver 800,000 additional home help hours over and above what they delivered last year and that is not impacted in any way, shape or form by the travel costs because they have also been accommodated in the €30million additional we gave for the budget this year.”

He repeated that demand was outstripping supply: “that’s why we have a statutory scheme committed to by 2021 which will be along the lines of Fair Deal where we will deliver home help on a statute basis, guaranteed by law”.

He said: “The Fair Deal scheme is a demand-led scheme, so we have to accommodate everybody who applies for that. That’s what we want to do with home help.

“So far there is no indication that we are over running our budget in any area in my remit, the challenge is to maintain that position and ensure it is kept within budget. There are 6,000 people who want home help but we have to keep within the allocated budget.

“There is a better way of delivering home help and that’s why we have committed to bringing in a statutory scheme by 2021 which will actually meet the demand and will actually ensure that it is fully funded and will probably realistically involve a co-payment method where at the moment home help is 100 per cent free at point of receipt.”