We have a real capacity crisis in home care at the moment. Demand for services is soaring, funding is in place but there is a lack of carers to meet that demand mainly because wages are so poor for such an important role.

No problem I hear you say. Let providers just increase carer wages, problem solved. Unfortunately, it’s not quite that simple.

The way the home care sector works in Ireland is that roughly 60% of provision is outsourced to a limited list of approved corporate providers. This means they have a monopoly on funding and this together with the dispersed nature of the business, means they have huge power when it comes to setting carer wages and in turn their own profits.

The first issue is, do these providers have sufficient margin to increase wages? A recent blog we published demonstrates that they do (https://homecaredirect.ie/blog/how-can-we-ensure-a-better-use-of-funding-within-homecare/ ) without any need for price increases from the HSE.

The second issue is, do they have the will to do so? The question to ask is what’s in it for them? Their present situation is that they are making very generous margins even though they might not be growing that much. Taking into account home care is an extremely pressurised business because of its highly people orientated nature, is it worth corporate providers to reduce margins to increase turnover but maybe only end up with the same bottom line?

Remember a large number of these providers are husband and wife type operators with turnovers between €2M and €5M making a lucrative return with unlimited demand. Do they want to run faster just to stand still?

If the will isn’t there from existing providers to increase capacity significantly surely the sensible thing is to allow those idle funds be used in other ways to help meet the demand there is for home care?

One simple and obvious way to do this would be to allow families use those funds to contract directly with carers in their locality where appropriate. If it costs the HSE say €27/hr to provide care through outsourcing, where they can’t provide care, why not allow families use those funds to contract and manage their own care directly? At €27/hr families would most definitely find local people that suit their needs. This kind of option is available in most other countries.

An option like this would bring new people into caring but also ensure those funds are spent locally rather than being lost to corporate overheads and profits, generating a huge economic benefit that would be really welcomed in these challenging times.

With waiting lists for home care rising, surely it is better to give families other options rather than leave them waiting for care and leaving funds idle in Government coffers?