Debate contribution: Domiciliary Care Packages: Northern Health and Social Care Trust
Debate contribution by Mr Danny Donnelly on .
- MLA
- Mr Danny Donnelly
- Party at the time
- Alliance Party
- Date
- 13 February 2024
- Type
- Debate contribution
- Business
- Adjournment
- Heading
- Domiciliary Care Packages: Northern Health and Social Care Trust
- Assembly identifier
- Official Report component 4206550
Read the official Assembly record
Text
I congratulate you on your new role, Mr Deputy Speaker. It is good to see you in the Chair. I thank the Member for Mid Ulster for securing this Adjournment debate. It is welcome that the importance of domiciliary care is being highlighted in the first Adjournment debate of the mandate. We all have constituents who need care or who have carers and families that are impacted by caring responsibilities. Domiciliary care work is a very important and seriously undervalued part of Northern Ireland's health and social care system; we have heard that again and again today. Our carers and nurses provide invaluable care to individuals in their own homes, and it is right that the Assembly and the Department do what they can to support them. The Alliance Party's position on domiciliary care is outlined in our policy document, 'Making Health and Social Care Fighting Fit'. In particular, we want to see improved pay and conditions for those working in domiciliary care — similar points have been made by previous contributors — to encourage more domiciliary carers and district nurses to continue working in the sector. We also want to see:
"more specialist training and pathways",
and the enabling of:
"longer stays, particularly to counter loneliness among the older population and to give more time potentially to identify any potential health risks (mental or physical)."
People are able to pick up on that when they come into homes, which can prevent future hospital admissions and get on top of things very quickly. It is essential that care staff who visit homes have adequate equipment. That issue has been raised by one Member. A sustainable domiciliary care system is important for the flow of patients through our hospitals, a point that has been reiterated several times. As we know, poor flow leads to overcrowding in hospitals, which is a public health risk — one that I have seen many times. The Bengoa report highlighted the "perfect storm" that the entire health and social care system faces, with patients:
" admitted to hospital unnecessarily because they can’t access the treatment they need in their community"
and being:
"forced to stay longer than they need to because of the absence of domiciliary care packages to support them at their homes."
That increases pressure on hospital beds, emergency departments and health and social care staff. More recently, the RQIA system inspection report of the Southern Trust highlighted the importance of a sustainable domiciliary care sector, and particularly the need to encourage more carers and nurses to consider working in the sector, since we are facing an unprecedented number of unallocated domiciliary care packages. I recognised the number that a Member mentioned in relation to that earlier. As an MLA whose constituency is largely within the Northern Trust area, I welcome the debate's focus being, in particular, on the Northern Trust and the pressures faced there. One of the advantages of domiciliary care packages that support individuals in their own home is that they can lessen the pressures on our main hospitals and reduce waiting times. We have seen that working effectively in the Northern Trust area. According to a survey of domiciliary care workers carried out in September 2022, 4,979 people in the trust area received approximately 12 hours of care and 27 visits. Although I note the 1,700 people who are waiting on care packages, as has been mentioned, that plays a small role in alleviating hospital stays and waiting times. It is my experience that people would much rather be cared for at home for the sake of their mental health and well-being, if possible. It is worth noting that the Northern Trust has both the highest percentage of patients waiting for under 13 weeks for inpatient or day-case treatment and the lowest percentage waiting for over 52 weeks. That shows us that, while a number of people are still waiting for care, when we provide the care, it has an impact on those waiting lists.
Finally, I want to discuss the proposal of domiciliary care charges and particularly the Secretary of State's revenue-raising proposals. The Department of Health had previously considered proposals to introduce charges for domiciliary care, for example in the 2016 report 'Power to People', which highlights that charging arrangements should be equitable and based on the principle that a person should pay or contribute if they can afford to do so. As a party, we objected to the Secretary of State's consultation on introducing domiciliary care charges, as that should be a decision for a locally elected and accountable Assembly and Executive. In fact, many issues facing our health and social care system have been exacerbated over the past two years by the absence of the Assembly and the Executive. It is important that any proposals are debated and scrutinised here and in the Health Committee, but our priority should not be charges; it should be how we reform and improve domiciliary care. That should be the focus of the Assembly and the Health Committee, so I welcome the debate.
843 words. Text as published by the Northern Ireland Assembly.
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