People waiting for home care services in Cork and Kerry make up more than one quarter of the national waiting list, according to an analysis of Health Service Executive figures by RTÉ's Upfront with Katie Hannon.
Some 1,648 people in the two counties are waiting for services out of a national waiting list of 5,986.
Of the total waiting list, 51% are waiting on a carer to be assigned to provide new services and 49% are waiting on staff to deliver additional hours.
Cork and Kerry fall under a single geographic HSE Community Health Organisation, CHO 4. There are nine CHO areas nationwide.
The CHO with the second-largest waiting list is CHO 5. It covers South Tipperary, Carlow, Kilkenny, Waterford and Wexford. 16% of the total waiting list live in CHO 5.
Third is CHO 8: Laois/Offaly, Longford, Westmeath, Louth and Meath. People there make up 12% of the national list.
Just 1% of the total waiting list is living in CHO 9, which covers north Dublin. There, just 32 people were awaiting support hours.
The figures provided to Upfront with Katie Hannon are for people waiting as of 31 August 2023.
They show 14m support hours were provided in the first eight months of the year, an increase of 4% on the same period in 2022.
Home and Community Care Ireland (HCCI) separately analysed data for home support hours provided between 2018 and January 2023. The figures were released by the Department of Health on foot of parliamentary questions by Fine Gael TD, Colm Burke.
HCCI says their analysis shows in 2022, 20.7m hours of support services were provided nationally, which was up 1.6% on the previous year, but remained 11% below the national target.
It says almost 40% of the hours were provided by directly employed staff at the HSE, with the remaining 60% coming through non-profit providers and private companies.
Over the four-year period, the total number of hours increased by 3.6million, a 22% increase. Some 3m of these hours were covered by non-profit or private service providers.
HCCI represents 32 private home care providers, which employ 12,000 carers nationwide.
Its analysis says targets for home support hours to be provided were missed each year between 2018 and 2022.
CEO of HCCI, Joseph Musgrave says the figures show "it is rural areas that are suffering most."
"Areas like Sligo, Leitrim, Cork and Kerry are all going up, a third of the people on waiting lists are waiting two years. Areas that have been outsourced by the HSE are actually performing better," he says.
"The success of the private sector in increasing home care capacity should be capitalised on. Where the private sector cannot meet this target - and in rural or hard to reach areas - the HSE’s service should provide care. The public sector model is different to the private one – we should recognise the strengths of each and deploy them to best effect."
Mr Musgrave is calling for a 'maximum waiting list target’ to be introduced, saying "no one should wait more than 14 days to be discharged from hospital back to their own home when they are deemed fit to do so"
In a statement the HSE said "demand for Home Support continues to increase due to population growth and the increasing dependency of the growing numbers of people aged 80 years and older."
"Waiting lists for Home Support have become a feature of the service, now primarily associated with an increasing capacity issue related to the availability of care staff," the statement said.
"In terms of those waiting, priority is given to people in the community with acute needs and to those assessed and waiting in acute hospitals, who are in a position to return home with supports. Funding approval for Home Support for those assessed as requiring same is expedited across the system to ensure minimum waiting times."
