At last after many years of false alarms, it looks as if Minister Jim Daly is serious about moving towards regulation and a statutory right to homecare.
The plan is to introduce a pilot scheme with €7m funding ring fenced from the budget and then based on learnings from the pilot, to introduce a statutory scheme in 2021.
This will signal a watermark change in the sector with the likelihood of significant investment funds entering the sector because of home care becoming a demand lead scheme with guaranteed payments from the State. Both extremely attractive conditions for private equity and investment funds.
This investment charge will most likely lead to increased corporatisation within the sector and a concentration of providers, with large national corporate providers becoming the norm.
We have seen from similar events in the UK, that these trends can lead to problems in the form of depersonalisation of care, a race to the bottom on pricing and large corporates becoming too big to fail entities.
While regulation will be hugely welcome, the fear is that with increased corporatisation of homecare, quality will become a tick box exercise which forgets about the human side of homecare and cares more about filling in forms.
So what can we do if we are to avoid many of the issues and problems encountered in the UK market after regulation?
For me the biggest bulwark for protecting against the over commercialisation of homecare and declining care standards, is the enshrining of real choice in the system through the personalisation option. This is something that the UK are presently fostering in an important way, in response to their problems.
Personal budgets are about giving power back to patients and their families, by giving the option to use their allocated budgets as they see fit, within fairly wide parameters.
With personal budgets, instead of everyone being shoehorned into using a limited list of approved corporate providers, families where appropriate, have the option of using and managing alternative local options that suit their needs better and which in many cases may give them more bang for their budget.
These alternatives could be smaller local agencies, local care co-ops or indeed local qualified carers working directly with families. The underlying premise, is one of trust in families being able to make choices that are best for them.
It is vital that when regulation comes in, that these kind of options aren’t regulated out of the market but rather fostered and nurtured so that real choice exists and not the Henry Ford choice of “You can have whatever colour Model T you want so long as its black”.
Importantly, real choice not only is good for people receiving homecare but it’s also really beneficial to carers, the most important cog in the system, by giving them options.
Caring is presently not a very attractive career because of very poor employment conditions and because of this carers are leaving the sector in increasing numbers. By affording carers options of how they work with families, this keeps corporate providers on their toes and forces them to improve working conditions or risk losing carers to smaller local providers or indeed to carers working directly with families where appropriate.
If we want the introduction of a statutory right to homecare and regulation to herald an era of caring as an attractive profession and better quality homecare for our older and disabled citizens, we need to ensure CHOICE and TRUST are central to our systems.