We have a problem in our home care sector. Corporate home care providers despite having the margins to do so, don’t pay their carers enough which means they have problems when recruiting and retaining carers which in turn leads to rising waiting lists for home care. It means Minister Mary Butler had about €200M of unspent funds available for home care.

Corporate providers proposed solutions to these issues mainly revolve them being paid more money and the protection of their eye wateringly high profit margins. Let’s look at some of those proposed solutions.

Firstly, they propose that social welfare rules are relaxed so that carers can work more hours without their take home income being affected. This is basically them asking the government to subsidise the insufficient wages they pay carers. It’s them looking to continue paying low wages so they can maintain their already generous profits and for the State to pick up the tab so that they can better recruit and retain carers.

Secondly, they propose that the HSE pay them higher rates so that can introduce tiered pay rates for carers and pay carers with more experience and qualifications, higher rates. At first look this seems reasonable but the question arises would they use increased rates to introduce tiered pay rates or would they just pocket the difference? It’s instructive to look at what happens in practice in situations when corporate providers do receive higher rates. Presently corporate providers get about €27/hr for HSE funded older persons work and they pay carers around €12/hr. However corporate providers receive significantly more around €35/hr when they do privately funded home care and also when they do HSE funded disability work. Do they pay carers increased wages when they are carrying out that type of work? The simple answer is NO. Carers still get the same €12/hr but the corporate providers profits are much healthier. Why would they suddenly start to act differently if they got increased rates for older persons work?

A third solution they proposed and which they have gotten, is to allow them bring in carers from outside the EU. These carers have to be paid a minimum of €27,000 and work 39hr week. Of course, the question here is, why don’t they just offer these conditions to the existing cohort of carers?

A fourth solution was for the HSE to pay them extra which would allow them to pay carer’s travel expenses. On this point they conveniently ignore the fact that in the existing tender, all providers had to put in a cost for travel. Unfortunately these funds never found their way to carers and are instead dropping to the bottom lines of corporate providers.

The principal lesson from the above, is that corporate providers can’t be trusted to put carer’s interests at the heart of their businesses. Instead carers are a cost which have to be kept to a minimum, in order to maximise profits and independent of the effect this might have on quality. Until this is understood by the HSE we will continue to have rising home care waiting lists.

The best way to encourage corporate providers to treat carers better, is to provide more choice. To open up other options for families and carers outside a limited approved corporate providers list as they do in other countries. Real choice will drive a better deal for carers and in turn improve the quality-of-care families receive.