The Irish Times view on home-care services: Stark inequality

Those who remain at home are happier, healthier and live more fulfilling lives

A decade after then minister for health Mary Harney promised that applicants for home care packages would be treated in a standard fashion across the State, the Health Service Executive (HSE) continues to operate a discriminatory system.

An additional 2,300 people received help to remain in their own homes last year, through the provision of non-medical care.

But waiting lists continue to grow. Two health districts reported a backlog of more than 600 applicants, three had more than 500 and 10 had more than 200. Six districts had no waiting lists.

As the population ages, the demand for this service, designed to allow people remain in their own homes rather than enter long-term nursing home care, will grow. Because of that, the allocation of resources should reflect the demand in differing communities and seek to eliminate existing, stark inequalities.

Keeping ageing citizens out of expensive hospitals and nursing homes makes good social and economic sense

Home-care packages are provided either directly by the HSE or through contracts for services with non-profit and private companies. 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 average waiting time for this review is 14 weeks.

Because the service is free and not means-tested, demand is intense. As with long-term nursing home care, however, the State has stepped back from being the primary provider of services and has encouraged private sector companies to become involved.

In recent years, most home care packages have been contracted out to private agencies. And because the number of HSE-allocated hours invariably falls short of what is needed by elderly people living alone, families pay privately for additional time.

Keeping ageing citizens out of expensive hospitals and nursing homes makes good social and economic sense. Those who remain at home are happier, healthier and live more fulfilling lives. Limiting this service while facilitating the introduction of private charges points towards creeping, health-based age discrimination.