I move: "That the Bill be now read a Second Time." I am very pleased to introduce the Health (Amendment) (Home Support Providers) Bill 2025 to the House. I look forward to hearing the contributions of Deputies today, and to working with all Members of Dáil Éireann and Seanad Éireann to progress this important legislation through both Houses. Home support is a vital service that is delivered to thousands of people nationwide every day. It provides a very important service to individuals of every age and their families, as it enables people to maintain independence and dignity while living at home. In line with Sláintecare, this Government is committed to ensuring that we take concrete actions that support and empower people to stay in their own homes and in their communities. At the outset, I wish to acknowledge the services provided by the carers and service providers that deliver home support. Improving access to home support is an absolute priority for this Government, and home support hours have increased every year since 2020, from 17.8 million hours in 2020 to 30.6 million hours in 2026. This represents 26.7 million hours for older persons services and 3.9 million hours for disability services. The programme for Government commits to designing a statutory home care scheme to allow people to stay in their own home for as long as possible. The first, essential step towards the scheme is to ensure that home care is regulated and that there are quality standards in place that services can be inspected against. This legislation will therefore ensure that, for the first time in Ireland, home support providers - whether public, private or voluntary - are required to operate in a regulated environment. There are inherent risks for service users in the provision of health and social care services by an unregulated sector. In vital areas such as infection prevention and control, staff training, and clinical governance, there are no standards or regulations that all home support providers must comply with. There are standards of service that can be expected from the HSE, through HSE funded services, or through the terms of private contracts. However, there are currently no consistent, minimum standards of care that apply universally to home support providers. There is also no independent oversight of the provision of services, so, therefore, there is no independent mechanism to ensure that the standards that do exist, such as HIQA's National Standards for Better Safer Healthcare 2012 are complied with. The regulations that will be made on foot of this legislation will therefore offer quality assurance to service users that their service meets the same minimum standards wherever and however it is provided. The introduction of a statutory framework to provide independent oversight of home support providers will ensure increased compliance with regulations and quality standards, which will increase public confidence in home support services. The Health Act 2007 established the Health Information and Quality Authority, HIQA, and the Office of the Chief Inspector of Social Services. It also provides the regulatory framework for residential services for older people, persons with disabilities and children in need of care and protection. The Chief Inspector of Social Services monitors compliance with this regulatory framework. The Bill before the House is modelled after the regulatory framework for designated centres as set out under the Health Act. This was outlined in the general scheme. It amends the 2007 Act, establishing a regulatory framework for home support providers who will be required to meet minimum requirements set out under Ministerial regulations in order to provide a home support service. This framework will be further supported by HIQA’s National Standards for Home Support Services. These amendments will act to safeguard service users and raise the quality and consistency of home care nationally and will be a first step in meeting the programme for Government commitment to design a statutory home care scheme. The framework will extend to all service users regardless of age who by reason of illness, frailty or disability require a home support service. As such it applies to home support provision funded by both the Departments of Health, and Children, Disability and Equality. The Bill will introduce, for the first time, the registration and regulation by HIQA and the Chief Inspector of Social Services of all home support providers in Ireland. Among other measures, it will provide the chief inspector with a range of powers and will make it an offence to provide a home support service without being registered. The chief inspector will also be responsible for monitoring and assessing compliance of registered home support providers against regulations and HIQA standards. The new system of regulation for home support will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice. I will take the House through the Bill to briefly outline the content of each section. The legislation has two Parts consisting of 22 sections. Part 1 relates to preliminary and general matters and contains sections 1 to 4, inclusive. Section 1 provides for the Short Title of the Bill, collective citation, and for the commencement of its provisions. Section 2 provides definitions of key terms used in the Bill. Section 3 provides that the operation of the Act must be reviewed within five years of enactment after which a report on the findings is to be laid before the Houses of the Oireachtas. Section 4 repeals a section of the Human Tissues (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Act 2024. Part 2 sets out amendments to the Health Act and consists of 18 sections. Section 5 amends the principal Act to provide for the definition of key terms relating to the regulatory framework for home support providers. Section 6 amends section 8 of the principal Act to provide for new functions for HIQA to set standards on safety and quality in relation to home support services. Section 7 provides for HIQA to conduct investigations of registered home support providers. Section 8 expands the functions of the chief inspector to establish and maintain a register of home support providers, collect key data in relation to home support providers, inspect premises where he or she suspects the business of a home support service is being carried out, and register and inspect home support providers against both ministerial regulations and HIQA standards. Section 9 inserts a new part, Part 8A, to the principal Act to provide for the registration of home support providers through the insertion of 29 new sections, Nos. 69B to 69ZD. Section 69B provides for the definition of key terms used in Part 8A and provides for exemptions to the requirement to register as a home support provider. Section 69C provides for a prohibition on carrying out the business of a home support service without being registered. Section 69D provides for a prohibition on making false or misleading statements in a material respect when applying for registration or renewal of registration. Section 69E provides for the application process for a person seeking to register or renew the registration of a home support provider. Section 69F provides for the establishment of a register of home support providers. Section 69G provides for the grant or refusal of the registration of a home support provider. Section 69H provides for grounds under which the chief inspector can cancel, vary or remove a condition, or attach an additional condition to a registration of a home support provider. Section 69I provides that the chief inspector may remove a condition attached to a registered home support provider's registration where they deem it is appropriate and will not adversely affect a service user receiving support from that provider. Section 69J provides that a registered home support provider may apply to the chief inspector for the variation or removal of any condition that has been placed on their registration. Section 69K provides for notices to be issued by the chief inspector to an applicant or a registered home support provider, as appropriate, in respect of a proposed decisions to an application submitted under sections 69E and 69J. Section 69L provides that an applicant or registered home support provider, as appropriate, has 14 days after a notice is given of a proposed decision of the chief inspector under section 69J to make a written representation to the chief inspector concerning the proposal. Section 69M provides that the chief inspector is to give written notice to an applicant or registered provider of a decision to refuse or grant an application, to cancel a registration, remove or vary a condition or attach additional condition or to remove a condition of a registration. Section 69N provides for when the chief inspector proposes to make certain decisions where the home support service is provided or proposed to be provided by an applicant or a registered home support providers from more than one business premises and a single application has been made for registration. Section 69O provides for required and prohibited conduct for registered home support providers. Section 69P provides for the appeals process from a decision of the chief inspector regarding an application for registration. Section 69Q provides for the chief inspector to seek a District Court order enforcing certain decisions under sections 69G, 69J, and 69H. Section 69R provides for the chief inspector to seek a District Court order where they believe there is a serious risk to a service user due to the actions of a registered home support provider or person acting on their behalf. Section 69S provides for the chief inspector to make an application under section 69R as an ex parte interim order. Section 69T provides for a final determination of matters dealt with in an ex parte interim order under section 69R. Section 69U provides that an appeal of a District Court decision under section 69N lies to the Circuit Court. Section 69V provides that the chief inspector is a party to any court proceeding taken under this Part of the principal Act and is entitled to appear, be heard, adduce or give evidence. Section 69W provides for the submission of information to the chief inspector by registered home support providers. Section 69X provides for the collection of key data from registered home support providers, the sharing of information with the Minister and public bodies, such as HIQA and the HSE, and the publication of this data in aggregate form by the chief inspector. Section 69Y provides that a registered home support provider shall not submit false or misleading information to the chief inspector under sections 69W or 69X. Section 69Z provides that where a registered home support provider decides to cease to carry on the business of a home support service, they are to notify the chief inspector of the date in which they are to cease operating in accordance with the timeline set out under regulations. Section 69ZA provides that where a registered home support provider ceases to carry on its business, the chief inspector will make a note in the appropriate register and cancel the registration of the provider. Section 69ZB provides that where a person is appointed by or under law to take charge of the business of a registered home support provider, that person is to notify the chief inspector as soon as practicable and no later than 48 hours after the appointment. Section 69ZC provides for the notifications by the chief inspector relating to certain home support providers. Section 69ZD provides for transitional arrangements for persons providing a home support service immediately before this Bill comes into operation. Section 10 provides for the HSE to appoint persons to examine business premises of a home support provider that is providing service on behalf of the HSE. A person appointed under this section will be authorised to enter any business premises of the home support provider and examine any records relating to the service and interview any employees of the provider. Section 11 provides the right of entry and inspection by the chief inspector to the business premises used or proposed to be used by a home support provider or the private dwelling of a service user where a home support service is provided with the consent of the service user concerned. Section 12 provides that if the chief inspector has reasonable grounds to believe that the business of a home support provider is being carried out on a premises which is not registered, the chief inspector may enter the premises to inspect it. Section 13 provides for the District Court to issue a warrant to authorise the chief inspector entry to premises where the chief inspector suspects the business of a home support provider is being carried out, if required. Section 14 provides the inclusion in the definition of dwelling of any part of the business premises of a registered home support provider that is occupied as a private residence by that person or a member of staff of the provider. Section 15 provides for the inclusion of a reference to home support providers in relation to the further circumstances in which the District Court may issue a warrant. Section 16 provides that HIQA may prepare and publish reports relating to the monitoring of compliance and standards by registered home support providers, and the manner in which those reports should be prepared. Section 17 provides for the serving of compliance notices on registered home support providers. Under this amendment, where the chief inspector is satisfied that a registered home support provider has contravened a relevant provision of legislation, he or she may issue a compliance notice. A registered home support provider who fails to comply with the compliance notice by the date specified in the notice shall be guilty of an offence and liable to prosecution. Registered home support providers will have the right to make an appeal to the District Court within 14 days. Section 18 requires the chief inspector to maintain a non-compliance list of providers on whom a fine or penalty has been imposed. Section 19 amends section 79 of the principal Act providing for offences for home support providers. Section 20 amends section 99 of the principal Act providing the Minister for Health, in consultation with the Minister for Children, Disability and Equality as appropriate, to make regulations relating to the registration of home support providers under the Act. Section 21 provides the Minister for Health, in consultation with the Minister for Children, Disability and Equality as appropriate, to make regulations for home support providers to ensure proper standards in relation to the home support services they provide. Section 22 inserts a new section 101C into the principal Act providing the Minister for Health with regulation-making powers to prescribe the collection, sharing and publication of data regarding registered home support providers. Regulations will determine the type of data to be collected, shared and published and the frequency of the submission and sharing of information. It will be necessary to introduce a small number of Government amendments, including technical amendments, as the Bill makes its way through the Houses of the Oireachtas. The most significant of these relate to necessary enhancements of consent provisions to reflect the more recent policy change to include home support services provided to under-18s within the scope of the Bill. This legislation is the major first step towards designing a statutory home care scheme. The establishment of a regulatory framework for home support providers will act to provide new protections for service users and will raise the safety, quality and consistency of care nationally. I look forward to the contributions of Deputies and to working with all Members of Dáil Éireann and Seanad Éireann to progress this important legislation through both Houses of the Oireachtas.
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It is three or fewer.
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Write to us on that.
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I will work on that.
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Three or less.
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I thank the Members for their contributions. There were 27 contributors in total and they spoke on a range of aspects of this issue. I welcome the general support for the Bill in terms of regulation. To recap, the objective of the proposed legislation is to improve the safety and quality of support services by ensuring that registered home support providers do not operate below the standards set by ministerial regulations and that those regulations are provided in a consistent and systematic way. Before getting a registration, providers must satisfy the chief inspector of social services that they can comply with these regulations and other requirements under the legislation. In the limited time I have, I want to go through a number of the points that were raised by TDs. Deputy Newsome Drennan brought up a number of points. I want to deal with family carers. Deputy John McGuinness referenced this and brought it up last week. The Revenue Commissioners have said today that they will not in any way be looking at previous years. That is to be welcomed. I want to put on record the fantastic work that family carers do. It is acknowledged and respected. They do phenomenal work for their families and loved ones. Hopefully the measure today from Revenue will bring reassurance in that area. Deputy Newsome Drennan made reference to the adult safeguarding legislation. At the end of last year, for the first time ever, we brought out the first national adult safeguarding policy. Legislation is being prepared and I want to bring it forward as quickly as possible. It was a priority for me as well as the home care providers legislation. I want to see the safeguarding legislation coming forward as quickly as possible. It is something I am absolutely committed to doing. People made reference to consent for the under-18s. The under-18s are now included in the Bill. They were not included in the general scheme. There was a discussion with the Department of children and they are now included. We will be bringing forward amendments around the whole consent area for people under 18 years of age. That is a very important point. The other issue was the personal assistance, PA, exemption. It was exempted under the general scheme. It continues to be but there is work ongoing by the PA review group under the Department of children. We want to respect the work it is doing. Depending on the outcome of that, we will look at amendments if the review group wishes to bring them forward but we want to respect the integrity of the PA service. It is hugely important. We want to allow the PA review group under the Department of children to do its work within the HSE. The three or less clients provision is included in the Bill because it is proportionate. It was in the general scheme and we want to ensure it is proportionate. This is all about improving the service. Deputy John McGuinness raised the funding model. Based on the regulatory impact that was done, it was estimated that the cost would be €1.1 million over the first three years for HIQA to be able to bring in the legislation and the process itself. We will engage with the sector on the regulation of costs. We are conscious of that issue. It is important that Members are aware that the legislation is to regulate home care providers, regardless of whether they are in the public, private or voluntary sector. That is going to bring about an increase in the quality, safety and consistency of service delivered throughout the length and breadth of Ireland. It is also important to note that this year alone we are looking at 1.7 million additional home care hours. Since 2020 we have increased from 17 million hours to 30.6 million hours. This year there are 26.7 million hours for older person's services and 3.9 million hours for disability services. I am conscious that, like me, Members here represent people the length and breadth of Ireland. I am in continuous engagement with officials in the Department and the HSE on the issues that arise in respect of the current home care service that is delivered. I will continue to engage with them on the particular points Members have raised today. These are matters I will take up with the HSE in terms of the delivery of the service. We want to get value for money. We want to look after people that are in receipt of the home support service. It is something that I will continue to work on. Regulation is hugely important. We committed in the programme for Government to design a statutory home care service in the lifetime of this Government. When I came into the brief I looked at it in great depth with the officials. The first step in doing that is to regulate the home care providers, which we are doing with this Bill. I want to get the Bill through. I will work with Members, both here and in the Seanad, to get this legislation through as quickly as possible. I am committed to working with the officials and my Government colleagues to progress the design of a statutory home care scheme. It is an absolute priority, but it must be built on a process. As it stands at the moment, the sector is not regulated. I want to see the home care providers sector regulated. We owe that to the people to whom they deliver the service. The Bill is welcomed by the sector itself. It is something I want to work with it on to ensure we get it up and running as quickly as possible. The other issues that were raised by Members relate to their own areas and regions. That is something we will take up and work on with the HSE. Regardless of where someone lives, I want to ensure the quality and safety of the level of service that is provided to the public. That is something that is hugely important. Many of the speakers in the House today have worked in this sector, and that came across. I very much take on board what was said. No one has a monopoly on knowledge in this area. I very much want to work with colleagues to improve all aspects of the home care service. The issue we are debating today relates to the regulation of the sector, which is the first step in the roll-out of a statutory home care scheme. Other issues that were raised include the work healthcare assistants do. That is hugely important. I very much value that. Members have raised particular issues that currently arise. My understanding is that the HSE is engaging on those aspects. I hope a resolution can be arrived at. Ultimately, this is all about getting to a point where we can put in place a statutory home care scheme in Ireland. This is something the Government and I are utterly committed to, but to get to that point we must regulate the sector. We have had a very constructive debate here tonight. We will continue to work through the legislation. I welcome further ideas or amendments from Members on Committee Stage when the Bill proceeds to that Stage. The single most important point is that we have now published a Bill to regulate the home care providers sector, which will involve independent regulation of the delivery of the service. I believe this will greatly enhance both the safety, quality and consistency of the home support service delivered the length and breadth of Ireland. I thank all Members for their very comprehensive contributions tonight. I look forward to continuing to work with them on the legislation.
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