Cúram dár dtuismitheoirí agus dár sean-thuismitheoirí; an bhfuil aon rud níos tábhachtaí? Irish society knows well the value of caring for the older people in our society, the value of community and the right of everyone to live with dignity but those values are simply not reflected in the Government’s policies and actions on home care. That was evident from this morning's debate on the Labour Party motion on supports in the home-care sector. We know there are approximately 6,000 people across the country who are stuck on a waiting list for home support, having been assessed. That is no way to reward older people who have contributed to Irish society and our economy over their whole lives. They deserve care and support to live a happy and fulfilled life in their own homes. The State is supposed to care for its citizens but it is failing those who are denied access to care in their own homes - many of us know people who are in that position - and those who have been trapped in acute hospitals for over a year at a time due to delayed discharges, as revealed by Deputy Kelly just now.

This is due to the avoidable recruitment and retention crisis in the home-care sector. We would have expected to see drastic and radical action from the Government in budget 2024 to tackle this crisis, particularly with an ageing population and overcrowded hospitals, but that is not the path the Government chose with its health budget. Instead, it has frozen recruitment, which is extraordinary. Yet, some of the most important work in the country is provided by the unsung heroes, as Deputy Duncan Smith said, namely, those who work in the home-care sector providing care in people's homes. These workers are mostly women and are among the most undervalued professionals in our society. They are particularly undervalued when it comes to pay and conditions.

This year, under pressure, the hourly pay for healthcare support assistants in the private sector was increased. That is welcome but that move was funded by quietly cutting home support hours by 1.9 million hours this year. We might call that "robbing Peter to pay Paul" or, more appropriately, "robbing Patricia to pay Paula" because these workers are mostly women. There is no plan to ensure a living wage for these workers into the future and no plan to ensure the system will work for those who need care. It is simply not working. When an older person cannot be discharged from hospital or cannot access care at home, their health outcomes are affected. It is fundamentally unfair to older people and their friends and families. So often, I hear from people – again, mostly women – who are hit with the double whammy of caring for their children and their ageing parents, often while holding down a full-time job. These are women who are struggling and panicking and do not know how to keep the plates spinning. As long as the State services are not there, they will have no option but to keep them spinning. That is why the Labour Party brought a motion this morning calling on the Government to make real reforms to the home-care service system and ensure we will be able to cater for an ageing population and a workforce struggling with the ever-increasing cost of living. Instead of pressing the Government's whitewashing amendment to a vote this evening, will the Taoiseach accept the motion and work with us and others across the House to pay Ireland’s heroic home-care workers their worth, reverse the ridiculous embargo on recruitment and ensure that Ireland becomes a place where care is genuinely valued and older persons can receive the care they so desperately need in their homes?

I thank Deputy Bacik for raising this important issue. We can all agree, on all sides of the House, how valuable home care is. Most important, it provides older people and younger people who need care with the dignity they deserve in life. Crucially, it enables people to get out of hospital quicker, which frees up beds for patients who need them and enables people to avoid going into nursing homes. The length of time people spend in nursing homes has gone down considerably in recent years precisely because home support has improved and people can stay at home for longer.

The overall budget for home support this year is €723 million. That is an increase of €228 million since this Government came to office, so nearly a 40% increase in funding for home care just under this Government. Far from being cut, the number of hours we will fund next year is 22 million, which is up from 21.5 million this year. The amount that is ring-fenced for dementia will increase from 5% in 2021 to 18% in 2024.

A new and improved HSE support tender for private and voluntary providers has been in place since August and is bringing about significant reform in the sector. An increased hourly rate is in place to ensure that home support workers are paid appropriately and to help deal with some of the issues affecting the waiting lists and recruitment and retention. This includes a new payment rate for travel time, requiring private and voluntary providers to pay the national living wage, at a minimum, and also reforming the legacy rate. On the number of people waiting on home care, the figure was 9,000 in 2020 when the Government came to office. At the moment, it is below 6,000.

The Taoiseach's response did not address the crucial issues. I will spell them out. The crucial issues, which are evidenced in the Government's and the HSE's figures, include, first, the lack of healthcare workers. There are simply not enough healthcare workers to meet the need. The second crucial issue is the number of people who are awaiting care, having been assessed for home-care supports, and simply cannot access it because of the lack of workers. The third is poor pay and conditions across the healthcare sector. Notwithstanding the new tender, the Ministers of State at the Department of Health, Deputies Butler and Rabbitte, in response to our motion, admitted what we all know to be the case, namely, that we cannot be sure that the new rate of €13.10 per hour, basic though it is, is being passed on in the private sector. The truth is we have seen a creeping privatisation of home-care services. That is having a knock-on effect on recruitment and retention. It means we simply do not have enough home-care workers to meet the crucial demand for older persons, persons who are awaiting discharge from hospital and persons who desperately need care in their homes to be able to live with dignity into older age in a way we would all wish to do. The Taoiseach has not addressed those crucial issues.

We have never had more people working in our health service or public service than we have today. We have full employment in Ireland. That is a great thing but there are downsides to it, one of which is the fact that recruitment and retention are a challenge everywhere. That includes the public and private sectors, urban and rural areas, big and small companies-----

Pay them.

-----and well-paid and poorly paid jobs. It is an across-the-board issue when there is full employment and that is a challenge we face. It is a challenge I would rather face than unemployment, which affected this country for a long time.

The new tender rate, which was backdated to July, is a core rate of €31 per hour for providers, which works out at an average rate of €34 per hour taking into account weekend pay, evening pay and premiums and travel rates. The national living wage is set at €13.10 and there is also travel time between appointments. There is an inbuilt review process on the national living wage after 12 months and I am advised that there is no evidence that this is not being passed on or being paid by providers.