Taoiseach Leo Varadkar has told the Dáil that the extra €1bn provided to the health service in Budget 2019 must go to patients.

Mr Varadkar was responding to a question from the Sinn Féin leader Mary Lou McDonald who described the publication of a report by Care Alliance Ireland, on the shortcomings in the provision of homecare, as a stark and shocking reality facing thousands.

The Taoiseach called on TDs to "come together as a House" to ensure the €1bn does not get "lost up in red tape, pay demands and other things".

He said it should go to patients, extra home help, extra homecare packages, new medicines, new services and new equipment.

Mr Varadkar said ensuring that the money goes to patients is "a challenge" and he added that the money should not go towards "paying more for the same", because he said that was not the solution for the health service.

It comes as a report by Care Alliance Ireland found that some people aged over 65 are waiting for up to two years from home care for the Health Service Executive.

Care Alliance is the national network of voluntary organisations supporting family carers.

The group also found that many patients do need receive all the hours they require.

It estimates there is an average 15% gap between the care people have been assessed as needing and the care they receive.

It also estimates that the average waiting time for home care is 3.3 months.

The alliance said the information it has received suggests some HSE regions are keeping waiting lists down by giving people much fewer hours than they need, while others are concentrating on giving full care hours to fewer people with longer waiting lists resulting.

But these figures are based on partial statistics as it could get only patchy information from the HSE.

The alliance submitted Freedom of Information requests to the HSE and said it received full responses from only three of nine regions.

On the waiting list issue, that was based on it accepting information on a small number of sample cases. 

It says the lack of information provided is of concern and raises serious questions about record-keeping and organisational processes within some HSE regions.

It says while Government funding for home care has increased in recent years it has not closed the gap between what care is needed and what is provided.

This it says is because demand is increasing as the population ages.

The alliance is calling on the Government to increase the home care budget by 10% every year for three or four years and to close the gap to provide the level of care needed with an injection of €110m in 2019.

Responding to the report the HSE pointed to 17.6m home support hours provided in 2018; 52,000 people receiving home support at any given time; budget increased from €306m in 2014 to almost €420m in 2018.

The HSE welcomed the Care Alliance report as it contributes to the discussion of home care and supporting carers.

It added that in 2018, the overall home support target is 17.6m hours with home support provided to more than 52,000 people at any given time.