Public-private partnership could deliver optimum homecare solution

Irish Examiner

04-05-2025

Homecare should be delivered by the State and private providers working together rather than waiting for more public-only services, Frances Fitzgerald has urged.
The former justice minister and MEP was recently appointed chair of Home and Community Care Ireland (HCCI) representing private and voluntary homecare providers.
Her comments come as 4,888 elderly people either do not have a carer at all or are waiting for more carer-hours despite the state increasing the hours provided this year compared to 2024.
Ms Fitzgerald said the independent sector — private and voluntary — is developing strongly in Ireland.
'As long as the service developing is quality and has standards, I think that's where the public is coming from unless one wants to take a highly ideological approach to it that it has to be the State,' Ms Fitzgerald said.
'I think we recognise now in many areas it is a public-private partnership gives the optimum result.'
She highlighted the growing proportion of private care in many counties.
It seems to be responding more than the State has been able to, and I think what needs to be recognised is this is an on-going partnership.
Ms Fitzgerald was closely involved with the European care strategy in 2022.
She acknowledged the sector 'needs development in relation to the status, the pay, the valuing, the career path just like in childcare'.
She called for 'a real flexibility' in how private, voluntary, and HSE services co-operate together.
She added 'the relationship seems good' now, but said: 'We have to think about the client and what's best for the person.'
Among hospital patients delayed in leaving after treatment is complete are some people waiting for homecare, the HSE has previously said.
Ms Fitzgerald said this essentially means 'there are people in hospital who would be out of hospital if they had the right homecare'.
In this situation, she urged: 'The costings actually become a moot point, because we've just got to get people into the community and keep people in the community because it's what a lot of older people and their families want.'
Support in the community for people with disabilities
This is also an issue, she indicated, for people with disabilities living with support in the community.
'One size fits all isn't going to work here,' she said.
'Clearly disability services need to be integrated into the homecare services, there's a need for homecare to be provided.
'They are doing it at the moment, and that's going to be a big area in the future definitely I think.'
Services have moved away from large institutions and she said: 'We're gone away from that, and there are implications. You're not paying for institutions, you're paying for what should be quality care at home.'
New HSE data shows between January and March 58,898 people got homecare coming to over 5.9m hours.
The HSE said this was an increase of 313,185 hours compared to early 2024.
4,888 people waiting for care
However by the end of March some 4,888 people were waiting for care. This includes 2,195 people who do not have a carer.
Some 2,693 people have some help and were assessed as needing more but local services cannot find a carer.
There are no delays in accessing funding for packages.
A HSE spokesman said home support is helping older people live at home with 'confidence, security and dignity'.
It is estimated Ireland will see a 38% increase in people aged over 65 by 2031.
'As a result of the increase in demand, there are waiting lists for home support, now primarily associated with an increasing capacity issue related to the availability of care staff,' he said.
'Priority is given to people in the community with acute needs and people assessed and waiting in acute hospitals, who are in a position to return home with supports.'
Minister of state for older people Kieran O'Donnell has committed to funding homecare in a similar way to how nursing homes are funded. This was first proposed in 2017.
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