Harney pushing two tier home care system

Problems are already occuring with private home help in the Dublin area. Scott Millar reports

Last week Mary Harney, the Minister for Health, announced that she intends to encourage private companies to expand their role in 'home help' care provision paid for by the Health Service Executive (HSE), while launching the American Comfort Keepers franchise in Ireland. However the partial privatisation of home help provision in the Dublin area is already advanced and in some cases leading to problems with service provision.

Currently in the parts of the country previously covered by the old Eastern Health Board (EHB) area, which covers Dublin and parts of Kildare and Meath, there are estimated to be 39 voluntary and private bodies offering home help care. Some of these organisations are voluntary, such as the Wheelchair Association of Ireland. It provides services for their own members, while others are private, profit making companies. All receive funding and referrals from the Health Service Executive (HSE). The HSE was unable to confirm exact figures on the numbers of elderly and infirm in receipt of the service but they are estimated to number over 5,000 in the old EHB area.

Killian Forde, a Dublin Sinn Féin councillor, says he has received a number of complaints from people currently receiving HSE funded home care provision from private home care agencies.

He said: "I have received complaints from persons in receipt of private home help provision funded from state funds that they have to deal with a new home helper on nearly a weekly basis. I have also been approached to make representations on behalf of non-national home helpers who have not received regular payment as far back as November. The private company involved said that the HSE was late in paying them. The people making these complaints feel unable to personally voice their concerns because they rely on these people in some circumstances totally.

"These are the most vulnerable in our society. That is why they are provided with home care. Why then are we allowing the profit motive to interfere with this essential service? Why when it is not working in the Dublin area does Mary Harney think it is a good idea to roll it out for the rest of the country? I have contacted the HSE on this matter but I fear this is what happens when you allow neo-liberal ideology to run riot in the health care system".

Village contacted Communicare Agency Ltd, a private home care service provider, that has been providing for health board clients for over four years. A spokeswoman for the company said: (about the arrival of Comfort Keepers in Ireland) "I reckon it is going to be the exact same thing, although if a huge amount come over some of us could go out of business".

At any time Communicare has approximately 100 carers working with 60 per cent providing for health service clients. On the issue of HSE payment she said "it can be a long drawn out process".

Noel Dowling, SIPTU national organiser, said: "According to Comfort Keepers, they offer a service costing €22 an hour to elderly clients. Of this €9 to €11 is paid to the carer although health boards are paying between €12.59 an hour to €13.99 an hour to around 12,000 existing home helps. Yet they expect to employ 1,000 more carers when already health boards have difficulty recruiting enough and when they go over budget home helps are often told to discontinue the work or seek payment directly from the client, or the client's relatives. Harney seems to be preparing a parallel private home help system, which would fit into her wider privatisation plans, to eventually take over. This can only add to the apartheid system, based on income, that has come to characterise our health services."

The HSE and department of Health were forwarded a list of questions on how it monitors and pays private home care services that were not answered.