Fórsa advises on urgent Home Support reform

Oireachtas Committee told Home Support service reforms urgently needed to modernise service and meet growing demand

Fórsa trade union has today (Wednesday) advised the Oireachtas Health Committee that a number of key reforms are urgently needed to sustain Home Support services across the country. The latest ESRI figures show that Home Support services are delivered to more than 65,000 people annually, providing needs-appropriate supports to older people, enabling them to remain in their own homes for as long as possible, as well as supporting family carers.

Officials from Fórsa trade union told the committee that priority reforms include a standardised approach to service delivery by all Community Health Organisations (CHOs), and a streamlined recruitment system for Home Support staff in order to speed up the process in a highly competitive job market.

The union’s head of Health and Welfare, Éamonn Donnelly, told the committee that the current delivery of Home Support services is split between direct provision of services by the HSE, delivery by non-profit service providers and delivery by a number of private sector, for-profit providers: “It’s noteworthy that HSE standards for the service only apply to services delivered by, or through, the HSE. Where home support services are privately purchased, there are no similar standards,” he said.

Fórsa assistant general secretary Catherine Keogh added: “The burden of delivering five million additional hours, under the HSE’s 2021 National Service Plan, fell on the shoulders of Home Support Resource Managers to incorporate these hours into an already overburdened system.

Standardisation of service delivery is needed because different CHOs take widely differing approaches to the delivery of Home Support services.

“At the same time, the nine different CHOs took widely differing approaches to the delivery of the service. Some saw the increased budget as solely for the delivery of additional hours with no additional resources, while others recognised that maximising the benefit of these additional hours, for those on the waiting lists, included the provision of the full range of ancillary supports they needed,” she said.

Catherine said just over 100 Home Support Resource Managers coordinate the delivery of 10 million hours of service by 5,000 directly employed Home Support staff, as well as administering the complex Home Care Package scheme. She said there is also now an urgent need for appropriate clerical and admin support for a service of its scale.

She added: “Our home Support Resource Manager members have expressed their frustration at the lack of investment into the service over the last 20 years, which has had a negative impact on waiting lists, in addition to the recruitment and retention of staff.

The lack of investment over 20 years has had a negative impact on waiting lists and timely recruitment.

“This includes continuing to deal with time consuming, and out-of-date payroll systems, ad hoc recruitment and long delays between job offers and starting dates. All of these factors make the delivery of a modern and sustainable service especially challenging, and these reform measures need to be implemented quickly so that the rising demand for services by an ageing population can be met,” she said.