2026-01-28

I thank the Minister of State for taking this Topical Issue matter in relation to a very important issue in County Cork concerning the provision of home help home support services. Home support is often known as home help and is one of the most essential person-centred supports provided by our health and social care system. It is a service that allows older people and those with additional needs to continue to live safely, comfortably and independently in their own homes and communities. For many families across Cork and throughout the country, home support is not just a convenience; it is a lifeline. Every single day, home support workers carry out dignified and compassionate work that enables people to remain connected to their neighbours, communities and the place they call home. This sense of place, familiarity and independence has a proven and profound impact on a person’s physical and mental well-being. It gives reassurance to families, reduces isolation and promotes independence, values that must remain at the heart of our health service. We also cannot ignore the critical role that home support plays in easing the pressure on our hospitals. When adequate support is available in the home, unnecessary hospital admissions can be prevented and hospital discharges can happen more smoothly. For older people in particular, remaining at home with proper assistance is often far safer and far healthier than spending extended periods in acute settings. Home support services are a vital part of the wider solution to overcrowding, delayed discharges and pressure on our emergency departments. However, to fully realise the benefits of home supports, the service must be properly resourced, properly staffed and delivered in a timely and consistent manner. Too many people are waiting far too long for essential hours to begin and too many families in Cork are left in distress trying to bridge that gap. This is not acceptable. A service that is so fundamentally important cannot be allowed to operate under strain, uncertainty and chronic short staffing issues. I want to mention a couple of examples while I have the time in relation to what I have experienced over the past number of months in terms of the acute waiting list for home support in Cork. As of 11 November, the HSE responded to a parliamentary question by saying over 890 clients were wait-listed for home support in Cork city and county. Of those, 543 are waiting for a first-time service and 347 are waiting for additional hours to be allocated. This is not just an issue in Cork but one right across the country. I put in another parliamentary question in relation to the lists for the entire country. We have over 5,000 people who have been allocated home support home help who are waiting for that care to be provided. I say this with real respect but the HSE is not responding to requests from politicians, including me. I know that the Cathaoirleach Gníomhach has been involved in meetings with the HSE as well. It is just not happening. Despite the fact that we raised this issue in October, we are back here again at the end of January and there is still no alleviation of the pressure on the home support that is available in Cork. In fact, I believe it has got worse. This is the reality of what we are facing. I am asking the Minister of State to intervene personally with the HSE in relation to this matter. I am asking that a proper plan be put in place to recruit home support workers, be it in the public health service or in the private service, to ensure this service is continued in future for the people of County Cork.

I thank Deputy John Paul O’Shea for raising this important matter. The Government is committed to supporting older people in Ireland and improving their access to healthcare services in the community. Budget 2026 saw an increase of approximately €215 million to maintain and enhance services for older people, resulting in a total allocation of over €3 billion for the first time. This includes a further substantial increase for home support services to bring the 2026 budget allocation to over €900 million, more than doubling the investment since 2018. The target for the delivery of home support hours has increased accordingly, from 24 million hours in 2025 to 26.7 million hours for 2026. That is an increase of 1.7 million hours. In the Cork area, provisional figures from the HSE indicate that over 2.2 million hours of home support were delivered up to the end of November 2025. This represents an increase of 6.5% compared to the number of hours delivered in the same period in 2024. There were 6,022 people receiving a home support service at the end of November 2025, compared to 5,796 at the end of November 2024, which is a 3.9% increase. The waiting list for home support services in this area at the end of December 2025 stood at 915 people. Of these, 547 people were waiting for new packages, while 368 people were waiting for additional hours. The HSE has stated that it is acutely aware that there are capacity issues across both direct and indirect provision of home support throughout the region. The HSE is committed to attracting additional staff and increasing its capacity to deliver support to as many clients as possible. The HSE is running ongoing recruitment campaigns as well as supporting the professional development of staff working in the area. HSE south west has advised that recruitment efforts in the Cork region are ongoing with a recruitment campaign currently live to recruit healthcare assistant staff in Cork and Kerry. Additionally, HSE south west has advised that dedicated recruitment co-ordinators for healthcare assistant, home support, run campaigns throughout the year. In the six months from August 2025 to January 2026, 29 healthcare assistants, home support, have been hired in the Cork region. More broadly, addressing the home support waiting list is a priority for the Government. Improving these lists requires more support and more workers at a time where there are international challenges with recruiting healthcare workers. The strategic workforce advisory group on home carers and nursing home healthcare assistants was set up in 2022 to address the challenges relating to front-line carer roles in the home support and long-term residential care sector. Work continues to deliver on the recommendations of this group, including a survey on the experience of healthcare assistants, which is due to be launched shortly. This will inform development of future target interventions to increase recruitment retention in the sector. I will take this matter up with the HSE, at national and local level. I have already held meetings with representatives of the HSE. I will meet with the HSE personnel involved in home support in Cork to see if we can reduce waiting lists and waiting times. For those who are waiting for them, home support packages are hugely important. The home support providers Bill has just passed the Second Stage. The purpose of this legislation is to improve the regulation of the sector. More importantly, it is the first step in ensuring that home care will be provided in the context of a statutory home care scheme. On the particular issue that the Deputy has raised in respect of Cork, I will follow up directly with my officials and the HSE in Cork. I will also follow up with the HSE nationally.

I thank the Minister of State very much for his keen interest in this matter. I would appreciate if he could follow up with the HSE in Cork in respect of it. Investment in the home support is an investment in dignity, well-being and independence for thousands of people. It is also an investment in a more efficient health system that supports people earlier, prevents avoidable illness and ensures better use of our limited hospital capacity. Home support workers must be valued, supported and recognised for the essential front-line role they play. They deserve for fair pay, sustainable working conditions and the resources necessary to carry out their jobs effectively. There was a campaign to recruit home help support workers in Cork in July. As of 11 November, when the responses had been assessed, the HSE in Cork had identified 64 potential candidates but not one new home support worker was in place. That is not acceptable when there is such a long waiting list. Over 1,000 people in Cork and Kerry are waiting for home supports. Some 64 candidates were identified in the period between July and November but they have not been appointed. The principle here is simple. It is not a funding issue; it is a resource issue. People should be supported to live at home for as long as possible. The State must ensure that the supports required are available to them when needed, not months later. Home support is one of the most empowering, cost-effective and socially valuable services that we provide in this country. Strengthening it must be a priority for the Government. It must also be a priority for the HSE and all of us going forward. I welcome the Minister of State's intervention. I encourage him to make contact with the HSE in Cork and to improve the situation. As public representatives, we cannot continue to have a situation whereby home help requests come in and action in respect of them is still not taken six months later. I would appreciate the Minister of State's support on this matter.

The home support services is a core service for older people. It is a highly valuable service used by them, their families and the HSE. Delivery of a high-quality consistent home support service is essential to help people to live well in their homes and communities for as long as possible. Recruitment to this sector is an ongoing challenge for both the HSE and private providers. Within the HSE, work is ongoing at the regional and national level to build capacity to support workforce development and improve access to home care services in the community. Within the Department of Health, work to deliver on the recommendations of the strategic workforce advisory group to support the recruitment and retention of workers in essential front-line care roles is continuing. Since the strategic workforce advisory group was established, record levels of care have been delivered in the community. Within the Department, work is ongoing to explore options to increase the effectiveness of home support and to address waiting list issues experienced by clients around the country. Among the changes will be to explore the use of assistive technology in home support initiatives in order to directly address rural home support provision. Research is ongoing in the Department to improve the current provision of home support in communities and enable our home support service to take advantage of new technology and the support available in the sector to support clients in the service. Going back to the specific request in relation to Cork, I will meet with the HSE in Cork to discuss recruitment, waiting lists, waiting times and the plans that are in place to recruit people and, more particularly, to bring down the waiting times. Home support is a priority for the Government. We have made record levels of investment of more than €900 million. As already stated, the home support providers Bill will increase and improve the quality of care available in the sector. Furthermore, there is a commitment in the programme for Government regarding the design of a statutory home care scheme. In the context of the practicalities, we have provided an addition of 1.7 million hours. That was a priority in the budget. On the Deputy's specific request, I will meet representatives of the HSE in Cork to discuss the delivery of home support hours and will update him accordingly.