There are many promises made in the programme for Government in the area of health, but there has been a serious deterioration in the health service being delivered to people during the lifetime of the Government. Almost every area of the health service is in crisis. Today I will deal with the issue of home care hours. During the past year there has been an embargo on the provision of new home care hours. The home help service, vital in ensuring that elderly people can remain in their homes, remains largely closed to new applicants until January 2020 at a time when almost 7,500 people are on waiting lists. The only new home help hours being sanctioned are more or less recycled hours that become available when a person in receipt of home help dies and those hours are reallocated. No new hours have been allocated for a long time.

In my constituency of Cork South-West hundreds of people are waiting for home help. One of these people has been in Bantry General Hospital since June and has been ready to be discharged since September. However, this patient is wheelchair-bound and cannot return home without home help. My office has made representations on behalf of this man several times, but no home help hours have been made available. Therefore, he must remain in hospital, occupying an acute bed and at a high risk of picking up an infection. Lying in bed week after week is detrimental to his physical and mental well-being, while this man could be back in his own home with a minimum amount of home help. Another of my constituents is a woman with stage 4 cancer. Her family has been repeatedly told that no home help hours are available to her.

I know hundreds of others in a similar position to these patients. This is just the tip of the iceberg with regard to people looking for new home help hours. These people need help with everyday simple tasks such as getting out of bed, washing, dressing, attending to personal care, feeding and taking medication. The most basic things that we all take for granted are being denied to these vulnerable people.

I have heard from home helps throughout the country that the situation is at crisis level such that where an existing home help goes out sick, no replacement home help is available and many elderly and vulnerable are forced to stay in bed and wait until the home help returns while receiving a basic level of care from a kind-hearted neighbour who is untrained to look after a vulnerable person with special care requirements. This embargo completely contradicts everything the Government has said about supporting community-based care and helping people to remain in their homes for as long as possible. It also contradicts the principles of Sláintecare whose focus is on shifting care from the acute sector to the community.

In my constituency I know of several cases of elderly people who are being placed in residential care because their families cannot provide the care they need without home help support. These people could stay at home under a modest HSE home care package among their family and friends in their own community at little cost to the State. Instead, many have no choice but to go down the fair deal route, forcing people to end their days away from family and people they value most and at an enormous expense to the State.

It is widely accepted that due to medical advances in the previous century, people are living longer, and therefore forward planning is vital to ensure people have a good quality of life, even in old age. That includes enabling them to remain in their own homes for as long as possible with the provision of a home help as a basic support.

While I acknowledge that 1 million extra hours were announced in the budget, that is a quarter of what is needed to clear the backlog that has built up, and they will only become available in 2020. I ask the Government to lift the embargo on new home help hours. Will the Tánaiste instruct the Minister, Deputy Harris, to lift this embargo and give these vulnerable people the home help they need immediately as a matter of extreme urgency?

I thank the Deputy for raising the issue. I know it is a very important issue for many households in different parts of the country. The challenge with home help hours and home supports is a very personal one for many households. The Government is committing significant increases in resources to provide more home care hours all the time. A €26 million fund has been made available for winter funding for the HSE. This is to provide new hours and to support hospital discharges where possible. The Government has invested an additional €52 million to bring the total funding for home supports to €487 million for next year. In 2020, the HSE will deliver in excess of 19.2 million hours of home supports, which I suspect is significantly higher than we have ever done before.

We have an ageing population.

This represents a substantial increase of 1 million extra hours more than this year's target. This investment is focused on enabling older people to remain at home when they want to and reducing the current waiting list for a service being experienced in almost all areas. As appropriate, provision of hours will also be targeted at times of peak demand in winter 2020, at the beginning and the end of the year, to ensure more timely support is given in order that people can stay out of hospital and live with dignity in their own homes.

I accept that there is more demand than available resource, but we have to operate within the funding available to us. We are making an extra €52 million available next year and an extra 1 million hours throughout the country. That will have a significant and positive impact.

I thank the Tánaiste for his reply. At the outset I said there had been a serious deterioration in the health service being delivered to the people during the lifetime of the Government. Waiting lists are growing longer. Every day I am fighting to get people off trolleys and given a bed in Cork hospitals. SouthDoc services in parts of west Cork, particularly Castletownbere, have collapsed and SouthDoc in the rest of west Cork is on the verge of collapse. People in pain waiting for hip and knee surgery are being left in pain. People urgently waiting for cataract operations are left to go blind and this has all happened on the Government's watch. The list of failures is endless and the people of west Cork and elsewhere feel the pain. I have raised the issue of the lack of home help hours many times in the Dáil.

On 30 May last, I raised the issue of the embargo on new home help hours with the Minister of State with responsibility for older people but like the Tánaiste he defended the Government line. We read in the press in the past week that, while addressing a Home and Community Care Ireland conference recently, the Minister of State said he felt ashamed at the waiting list for home help hours. By July of this year, the number waiting for home help hours had reached more than 7,300. The home help service is in crisis. Constituents of mine now tell me that people will not get home help if they are actively dying. They have to be on a morphine pump to qualify for home help. This is an outrage. If we lived in a State where accountability was the norm, heads at the top would roll. The 1 million hours in the budget is far too little far too late. Will the Tánaiste instruct the Minister for Health to lift the home help embargo immediately?

There is no home help embargo. We all need to be accurate in what we say in this House, particularly when we are talking about people's health and elder care in the home. The Deputy should reflect on some of his commentary on that. I am not saying that many people are not frustrated, under pressure and on waiting lists, they are. I am also saying, however, that we will have over 19 million hours of home supports funded next year. That is a significant increase on what we have seen.

In respect of investment in healthcare infrastructure in the Deputy's area, there has been significant investment in Bantry hospital, which the Deputy has advocated for at different times. There are sectors and elements within the health service that are under pressure and have had recruitment difficulties but there are also success stories in the health service. We need to continue to focus our investment and prioritise where it is needed most to make sure we have recruitment campaigns where there is pressure. However, we also need to operate within budgets, otherwise parties in this House will rightly criticise the Government for dramatically increased Estimates at the end of the year for money that has not been accounted for. We have to try to balance all of those pressures and provide the best possible health service we can, while spending more money than this country has ever spent on healthcare annually.