A group representing home care workers has warned that many carers will leave the sector unless they are given more guarantees over a living wage and certainty over their incomes.
Home and Community Care Ireland (HCCI) said it will sign up to a new contract with the Health Service Executive by today's tender deadline, but it still has many unanswered questions about whether carers will be guaranteed a living wage, as well as travel expenses.
"We were asked by the HSE to give a response to this tender, this contract, for home care services throughout the country. We've given our answer which is yes, but we've given that answer without knowing some key things," Chief Executive of HCCI Joe Musgrave said.
He added that the HSE has refused to engage on setting a guaranteed wage and that those working in the sector still want answers about whether they will now be given the 'National Living Wage' and what this means in terms of an hourly rate.
The group said the contracts previously offered an hourly rate of €28.50 to provide care services to clients. While it is understood this has been increased, HCCI said it is still not enough without clear expenses and that an opportunity to fix the homecare crisis has been missed.
HCCI also wants to know whether the new hourly rate will be indexed linked, to rise in the future. It said it is also unclear if other benefits, such as a travel allowance will be paid on top of this, or whether they are included, as the job involves stopping at several homes in one day.
"Carers around the country are the bread and butter of the 56,000 people that get home care. They don't know week to week what wage they're going to get," Mr Musgrave said.
"They can't get car loans, they struggle to get mortgages because they don't have a fixed income."
HCCI said further instability is caused because the HSE will not pay carers if a client goes into a care or into hospital, even on a temporary basis.
The HCCI says if this contract is not properly negotiated to attract and retain more carers in the sector, "we're squandering an opportunity to reform home care and set it on a sustainable path".
Home care services are tendered for by the HSE and are often delivered by private providers.
The HCCI said that the tender process is complicated and has destabilised home care in Ireland, by providing little certainty.
'Carers need a lot more recognition'
Gina Ebbs worked for seven years as a home carer before going on to become a Client Care Manager with the privately-run company Connected Health, which provides home care across Ireland.
She says the uncertainty about pay needs to be addressed urgently to make it a profession people will want to stay in.
"Like you can't get a mortgage as a carer. It's hard to get a loan as a carer because it's not a steady income. With the HSE if a client cancels a call, then the HSE don't pay us, so we can't pay the clients for a certain amount of hours," she explains.
"I feel that that needs to be taken away, like if you go into hospital, I strongly feel that we should be paid for the first three weeks so the carers can be paid, so we can offer contracts to carers of 30 hours, 40 hour contracts.
"Carers need a lot more recognition, than what they're getting. We have carers that go out every day and they're out all day, five days a week. They're out from morning to night. They're their best friends, they help them get ready for the day, they give them companionship for the day. Some clients wouldn't have visitors for the whole day," she says.
"There's more to a carer than just making a cup of tea, they bring them out, back into society," she says. She says the work can also be very physical including using hoists, cleaning and changing medical dressings.
20.8 million hours of home support provided last year
The Government said the delivery of home support hours in communities is increasing, in line with enhanced investment.
Since Budget 2021 it said it has provided an additional €228 million in funding, whilst the overall home care budget for 2023 is €723 million.
In a statement, Minister with responsibility for Older People Mary Butler said: "Last year, 20.8 million hours of home support was provided across the country, supporting people to age in place at home in their community. Today, over 56,000 people will receive essential home supports. I am committed to implementing the recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants which will make the sector more attractive and a more viable career option with the National Living Wage, travel time and legacy rates all being addressed."
A spokeswoman for Minister Butler said her Department accepted and wholly endorsed 16 recommendations which were made last October as part of a cross-departmental Strategic Workforce Advisory Group, that she convened to look into conditions in the home carers and nursing homes sector.
It was set up to address the shortage of frontline care workers which it was acknowledged have poor pay and conditions, as well as a lack of financial security. This also comes as Ireland is projected to have one of the most rapidly ageing populations in the EU over the coming decades.
The Government's strategy is to support people living in their own homes where possible - and the report recommended that the HSE should remunerate home support workers for time spent travelling between service users' homes as well as other vouched for travel expenses.
It said all private sector and voluntary providers should also "be invited to give a commitment to pay home-support workers and healthcare assistants at a minimum, the National Living Wage".
The HSE's service plan for last year, targeted the delivery of 24.2 million home support hours to close to 56,000 people.
Many more families purchase home support individually from private providers, whilst other family members also provide this support, caring for relatives for long hours for free.
In a statement, the HSE said engagement had been ongoing with groups representing carers as well as the Department of Health, in line with today's submission deadline.
It said the Department of Health had approved the new scheme subject to the provision of reform in the sector including travel time, addressing the living wage and reforming legacy rates as provided for in the Government's Strategic Working Advisory Group.
It said terms and conditions for home care workers were up to each provider and employer.
The new scheme is expected to commence in mid-August once it is fully approved by the HSE's board.
