I call Deputy Verona Murphy, on behalf of the Regional Group.

Yesterday, I put a question to the Taoiseach during Questions on Promised Legislation in regard to the plan in place to deal with the chronic shortage of carers available to deliver the home care support service. The scheme was brought in by the Government to ensure that people could stay in their homes with a level of support. Without such supports, they would be likely to end up in a residential or nursing home facility. The budget granted a massive increase in the home care support hours available. I am critical in that regard because there is no delivery.

Without delivery, that increase is, in effect, spin and it creates false hope. Nothing is more demoralising for people, our older age cohort and our most vulnerable people, than to receive letters giving them the good news that they have been granted a home care support package, only to go to the next line which states that it is not possible to deliver it because there is such a critical shortage of carers.

In general, the people receiving these letters have paid tax all their lives and their children are working and paying tax to contribute to the Exchequer so we can provide these schemes. Yet, a review of the critical skills requirements by the Department of Social Protection states that no critical skills permit allocation is required within the sector as recruitment difficulties and challenges faced by the sector are primarily due to contract issues and the terms and conditions being offered. That is serious. It is not an issue of money in that we have the finances to deliver the hours. We must consider the money being made available to carers. Carers, particularly in rural Ireland, are using their own vehicles to drive from house to house on an hourly rate of €12.70. It is not making sense. If there is an issue in the HSE in regard to terms and conditions and if it transfers the provision of services to the private sector, then we must examine that aspect.

To put this in context, 5,000 people are waiting on home care hours. Some 1,000 of those people, a disproportionate number, are in County Wexford. One fifth of the overall number of people waiting are County Wexford. I am dealing with a lady who is in her mid-70s and who is looking after her husband, who had an accident recently and is now a paraplegic.

He is in his mid-70s. She gets care five days a week but gets no care at the weekends when she is on her own lifting her paraplegic husband. I am aware of a lady who has been in a nursing home for the last 18 months. She went there on the basis that it was a step-down facility and that she was going to receive home care support. She cannot go home without it.

I thank the Deputy for raising this important question. The Government is committed to better community-based services, shifting care to the home and offering greater choice for people. Progress has been made on the number of home care hours delivered through increased investment in recent years. Last year, the Minister of State, Deputy Butler, allocated additional funding of €150 million for home support. This year's HSE national service plan sets a target to provide 24 million home support hours, 5 million hours more than was provided last year. It is estimated that at the end of September some 15 million hours had been provided to over 53,000 people. This is 2.2 million more hours compared to the same period last year. That is a real increase in the amount of service being provided to people. The funding secured in budget 2021 to secure the additional five million hours has been maintained for 2022.

Significant inroads have been made into reducing waiting lists for funding approval for new or additional services, from more than 7,800 in January 2020 to just 400 now. While waiting lists for funding approval for new or additional home support services have decreased substantially, there can be delays between funding approval and the provision of home support hours. At the end of September 2021, there were just under 5,000 people assessed and waiting for a carer to become available. That is a significant increase on where we were in January of last year. Although there has been a steady increase in the number of people waiting to receive home support over recent months, it is important to say that the total number of people waiting for home support across both categories has reduced from more than 9,000 at the start of 2020 to about 5,300 now. Efforts are ongoing to enhance the provision of home support and to meet existing demand, including through the ongoing recruitment of home support workers, although this is a challenge. In order to deal with issues around carer capacity in the HSE, it is endeavouring to prioritise services for clients with the highest care needs to ensure that service can commence for those who require it most urgently. The HSE continues to recruit home support workers at local and national levels.

The Minister of State, Deputy Butler, is committed to establishing a cross-departmental strategic workforce advisory group. The role of the group will be to facilitate the views of stakeholders and examine workforce challenges in home support and nursing homes. Potential issues to be considered include recruitment, retention, training, career development and the sustainable employment of home care workers into the future. A call for submissions to identify the issues that need to be considered and to inform the establishment of the group was announced just last Friday. The Department's project team will analyse submissions received to inform the setting up of the group early next year.

I thank the Tánaiste. I suppose I am asking the Government, the Taoiseach, the Tánaiste and the Minister of State, Deputy Butler, who I appreciate is doing her best and a very good job, to ensure that we do not wait until that review is complete to make good on delivery for carers. The Tánaiste was previously Minister for Health. All we are going to achieve, if we do not address this situation immediately, will be to drive people into residential care and nursing home settings, which would be the total opposite of what the scheme is intended for. I am talking about the Tánaiste's or my mother or father and people whose children are out working to contribute to the Exchequer and who are doing their best. The scheme was supposed to support those most in need. Our oldest and most vulnerable need the service.

There are several issues with the service. In Wexford, for instance, if a carer is available in Rosslare and care is required some distance in away in another district such as Enniscorthy, the policy is that they will not be asked to go there because it is not affordable. We have the money to deliver the hours and we need to use some of that money to make it affordable and make the carers available. We cannot continue like this.

I take the Deputy's point. Her arguments are very well made. If home care is not available, what is the result? More people end up stuck in hospital with delayed discharges. More people end up in nursing homes long before they need to go into a nursing home. That is not right. People should have the autonomy to stay in their home for as long as they can. As the Deputy acknowledged, it is not a matter of money. The amount of money provided for home care has increased dramatically in the last couple of years. It has probably increased by 40% or 50%, if it has not doubled in recent years. The kind of waiting lists we used to have that were a result of inadequate budgets are no longer the issue. The issue is finding and retaining adequate staff to provide home care. That is a real challenge.

One area that my Department operates is the work permit system. Home care workers are currently on the ineligible occupations list. In order to have an occupation removed from this list, there needs to be a clear demonstration that recruitment difficulties are solely due to skills and labour shortages in Ireland and the European Economic Area, EEA, and not to other factors such as salary or employment conditions. The view of my Department is that removing home care workers from the ineligible occupations list would not solve the problem. What we need is a more comprehensive, longer term approach, dealing with the wider issues the Deputy mentioned such as pay, career progression and costing. I appreciate this needs to be done sooner rather than later.