ONE in three people in Limerick city and county who receive home help had seen their hours reduced by November 23 - and more service users will suffer cuts between now and Christmas, the HSE has confirmed.
Bernard Gloster, area manager for non-acute services in the Mid-West, said the HSE was all too well aware of the distress being caused to the elderly, the disabled and their families.
But he stressed that even as savings of up to €340,000 are being sought from the home help service in Limerick by the end of the year, the HSE locally would still deliver more home help hours than it was budgeted for in January.
“We’re not saying that this is all fine or that it’s easy for people. It’s not easy. Home help reductions are of their very nature undesirable because people have become used to and rely on them, because people have built up relationships. It’s a very difficult and sensitive area so it’s not surprising the level of coverage there has been about it and level of reaction there has been,” said Mr Gloster.
Minister for Health James Reilly announced over two months ago that 450,000 home help hours nationally would have to be cut to help the HSE save €8 million. While the non-acute services in the Mid-West - whose budget for this year is €310 million - are within budget, they are part of the national effort to contain costs.
By November 23, 621 people of the 1800 in Limerick city and county who receive home help had been identified for reductions - totalling 1072 hours per week. Extended out to year end, this would amount to 9,787 of the 18,876 hours the HSE Mid-West was instructed to cut in the final quarter.
“That (18,876 hours) is the level of reduction I was given to achieve over the three months. We have achieved 9,787 of it but based on figures given to me by Christmas I should have achieved a value of 18,800 hours. I don’t expect to have done that,” Mr Gloster said.
He said that while it was inevitable more service users would see their hours cut, it was getting more difficult for the HSE to identify those who could afford reductions.
“You will still see situations where people’s hours will have been reduced. However, what the home help organisers are telling me is that the opportunities to do that within the way we have been doing it are reducing because they have already identified a lot of the people that could be reduced.”
While he acknowledged it was painful for people who had been assessed by the HSE as being in need of home help - and were now seeing that service cut - the HSE was prioritising according to need.
“When you have to reduce expenditure for whatever reason, you then move from a position where your assessment moves away from what is desirable to what is essential. Of course it is desirable that people would have time for social interaction and contact and friendship, care and compassion and all the things that exist between a home help worker and their client – but when the resource of that home help becomes more scarce because of cutbacks or increase in demand, you then have to refine it to what is essential,” he explained.
While cuts were becoming progressively more difficult to stand over, the HSE still had an opportunity to make savings by “recycling” those hours which could be freed up when somebody goes into residential care or, in some cases, passes away.
Home help organisers and HSE staff tried to exercise as much “compassion” as they could before a decision was made and tried to minimise the impact of the cuts, Mr Gloster stressed.
“I had a representation on a case yesterday where a person who had been getting 10 hours home help a week and was getting it twice a day because they needed that input twice a day. In applying a reduction to that person, the home help organiser made sure that that person still had a service twice a day and the reduction of one hour was spread over four days at 15 minutes a day. That’s an indication of the extent to which we are obliged to go to and should go to minimise the damage, the risk or hurt that could be caused to somebody by a reduction like this,” Mr Gloster said.
At the start of the year, Limerick city and county were budgeted for 402,000 hours of home help for 2012. And in spite of the cutbacks in the last quarter, that target is to be exceeded.
But it would be wrong to therefore assume, Mr Gloster said, that the HSE Mid-West had been overspending on home help earlier in the year.
“Because we manage our budget so well across the whole profile of services, we could afford to put those extra resources in...and if you were to look at this in the context of the Mid-West non-acute services only, you would say we don’t need to do this at all. But because we are part of a wider (national) financial management system, we have to do it and make a contribution. It’s not a choice, it’s just the way it is,” he said.
“Even if we were to take out the maximum amount of hours that we could take out during this three-month period, which is about 18,800, we would still finish the year providing more than we were contracted to provide at the start of the year. It is important that the public understands that.”