Homecare needs and costs set to spiral if not tackled

Rapidly ageing Irish population requires care staff, cash injection and better system

With waiting list figures for homecare spiralling in 2019, demand and cost projections show how much worse things could get if not quickly and decisively addressed.

A statutory scheme, details of which should be unveiled as early as December, is now considered essential in a debate squarely shaped by Ireland’s quickly ageing population.

Home and Community Care Ireland (HCCI), an organisation representing providers, has done a lot of work figuring out exactly what will be needed and those demands will begin to increase very soon.

It estimates that by the time a State support scheme comes into existence in 2021, the current demand for 18.2 million care hours per year will jump to 25.1 million. The associated costs will follow, rising from €446 million per year to €753 million, a jump of 69 per cent in just two years.

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The organisation says these figures are at the lower end of estimations. Such figures give a bleak picture for health planners seeking to ensure those with care requirements can remain living at home. It also estimates a further 7,000 care providers will be required in a sector already experiencing difficulties in recruitment.

Waiting list

A cash injection of about €45 million would immediately eliminate the current waiting list of more than 7,000 people. Minister of State with Responsibility for Older People Jim Daly would not on Tuesday be drawn on whether he had sought funds for a quick-fix ahead of next week's budget but regardless, there is a growing appreciation of a much bigger funding picture. He was speaking at a HCCI conference.

Data presented to the conference by Seán Lyons, associate research professor at the Economic and Social Research Institute (ESRI) gave some insight into the scale of demand coming down the line and the current ability of a creaking system to meet it.

Its analysis identified 14.3 million home help hours supplied in 2015, of which 10.5 million (73 per cent) were publicly financed. It projects an increase in demand up to 2030 of almost 38 per cent.

When Daly unveils a statutory support scheme in the coming months, a key question will be the funding model. HCCI’s research has established that care recipients, on average, would be happy to contribute about 20 per cent of the cost.

Means-tested co-payment

"I am very confident we will meet the deadline of having that [scheme set out by next December], it's whether we can get everything implemented in time," said its chief executive Joseph Musgrave.

“Will we have all the pieces in place – the co-funding mechanism for homecare, the regulation . . . and crucially the training part of this; how are we going to recruit those extra carers?”

Daly confirmed a means-tested co-payment from service recipients would make up part of the scheme but could not give any indication of proportion.

He also said one of the biggest problems in understanding today’s service is a simple lack of data on how the Health Service Executive operates it. “The private providers are actually ahead of the curve on data collection and being able to share data with me,” he said.