Fórsa officials have told the Oireachtas health Committee that key reforms are urgently needed to sustain home support services, which currently support more than 65,000 people each year. The service supports older people and enables them to remain in their own homes for as long as possible. It also gives support to informal carers.

Fórsa told political representatives that a standardised approach to service delivery across community health organisations (CHOs) was needed. The union also called for a streamlined recruitment system for home support staff to speed up the process in a highly competitive job market.

Fórsa assistant general secretary Catherine Keogh told the committee that the “gold standard” in the service was to work for the HSE as opposed to the private sector. But she said the HSE had a great difficulty with delays in recruiting staff.

She called for the removal of the for-profit model  from home care.

Fórsa’s head of health, Éamonn Donnelly, told the committee that the current delivery of home support services was split between direct HSE provision, delivery by non-profit service providers, and delivery by a number of private sector operators.

“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.

Catherine said 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, who had to incorporate them into an already overburdened system.

“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 ancillary supports they needed,” she said.

She said just over 100 home support resource managers coordinate the delivery of ten million hours of service by 5,000 directly-employed home support staff, as well as administering the complex home care package scheme. There was an urgent need for appropriate clerical and admin support for a service of this 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.

“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.”