Debate contribution: Home Care Provision

Debate contribution by Mr Philip McGuigan on 12 May 2026.

MLA

Mr Philip McGuigan

Party at the time

Sinn Féin

Date

12 May 2026

Type

Debate contribution

Business

Private Members' Business

Heading

Home Care Provision

Assembly identifier

Official Report component 5528647

Read the official Assembly record

Text

I beg to move

As my party's health spokesperson, I am continually discussing and debating in the Chamber issues of great importance to the people whom we represent. In health, there are so many such issues that, at times, it feels hard to prioritise them, but I can say without contradiction that the crisis in social care is one of the most important issues that the Health Minister must address, because of its impact on the whole health system and because it affects large number of families in every constituency across the North. It is not an exaggeration to state that for me, as an MLA, one of the most common and distressing issues raised in my office is the struggle that families face in trying to secure appropriate home care packages for their loved ones so that they can remain and live safely and independently in their own homes. The motion rightly begins by recognising the essential role played by home care workers across the North. More than 30,000 people work across our wider social care sector, all of them carrying out demanding and often deeply personal work every day. They deserve our praise and our gratitude, but, obviously, care workers deserve more than my warm words and thanks: they deserve fair pay, decent conditions and recognition for the vital role that they play in sustaining our health and social care system. Those workers travel long distances in all weather, often under intense time pressure, to provide personal care and support to some of the most vulnerable people in our society. In many cases, they are the only regular social contact that a person has. Colleagues will touch in greater detail on the impact that rising fuel prices are having, but the Minister will not be surprised to hear me once again demand that the very least that he does is implement the real living wage for our social care staff, fulfilling a promise that he made to that sector in January 2025. That is the right thing to do to show that we value the vital work that is carried out in that sector — mostly, it needs to be said, by women, which is another inequality. Not only would it send a signal that the work that those workers do is valued, but it would help the independent care sector, which continually tells us about the pressures that it faces in recruitment, retention and sustainability. The North has an ageing population. That will not change; it will continue to be the case. Demand for home care is increasing year-on-year, and the level of need is becoming more complex. We need to get to grips with the situation. We need to plan for a future where more people live longer with frailty, dementia, disability and multiple long-term conditions. That plan needs to take on board the other realities that are happening at the same time. Care providers are dealing with rising costs, workforce shortages and growing difficulties in retaining experienced staff. Those pressures are felt particularly sharply in rural communities. In parts of my constituency of North Antrim, families are told repeatedly that no care package can be sourced because there are simply no carers available in their area. In places such as Armoy and surrounding rural areas, constituents who come to my office are regularly told that they live in what has effectively become a home care black spot. That is not sustainable, nor is it fair on patients or their families in North Antrim, including Armoy, or in any other rural part of the North. Last week, we heard reports that providers may withdraw services from some rural areas because continuing to operate there is no longer financially viable. If we lose providers or provision in rural parts, that will make the existing problem much worse. That should concern all of us, because, when those services disappear, vulnerable people are left with few alternatives. Home care providers raise those concerns with me repeatedly. Independent providers deliver the majority of home care hours across the North, yet many warn that the current model is becoming financially unsustainable due to rising fuel costs, operational pressures and workforce challenges. Retention is an increasingly serious issue. Experienced care workers are leaving for sectors that offer similar pay for far less demanding work. To repeat: Minister, that is why you must fulfil the commitment to introduce the real living wage for social care workers. We need to reflect carefully on the quality and dignity of the care provided. We in the Chamber know that many home care visits still last only 15 minutes. We have to ask ourselves whether meaningful, compassionate and person-centred care can realistically be delivered in such a short period, particularly for people with significant physical or cognitive needs.

Home care should not be a rushed, task-based exercise carried out against the clock. It should be about supporting people to live safely and with dignity in their own homes. The motion calls for meaningful engagement and co-production with providers, workers and service users. That is essential, and I want the Minister to respond, hopefully today, that he intends to engage directly and meaningfully with care providers to find solutions to the issues being identified. I support the Minister as he tries to shift left, and I hope with all hope that that is successful. I hope that the new neighbourhood model will help that and allow for care to be provided in the most appropriate environment. However, on the issue of social care, the Minister needs to do more. He told me at the Health Committee that he knows not paying the real living wage and not resourcing social care are counter-strategic. Given the creaks in the health service and the importance of social care as a solution to those creaks, we can no longer make counter-strategic decisions. If we are serious about shifting care into the community, improving hospital flow and helping people to live independently for longer, we must be serious about building a sustainable and properly supported home care sector. We know the wider consequences when suitable home care cannot be accessed. Patients who are medically fit for discharge remain stuck in hospital beds because no care package is available to support them at home. Figures continually show that, at any given time, around 600 patients across the North are fit for discharge but remain in hospital because appropriate care arrangements are not in place. That has a direct impact across the entire health system, on hospital flow, emergency departments, ambulance waiting times and cancelled procedures. The crisis in home care is contributing directly to the wider crisis in hospitals and emergency departments. Today, I met by chance representatives of the Royal College of Emergency Medicine (RCEM) to talk about its recent report on excess deaths caused by long delays at emergency departments. They were clear about the connection between pressures in social care and the dangerous conditions developing across our emergency departments. The major issues are hospital bed capacity and delayed discharge. They pointed out that even small improvements in social care provision and discharge capacity could have a significant impact on pressures in emergency departments. That is something that I hear in my many engagements with those who work across the healthcare sector. If we all recognise that dealing with social care is a major problem, why can we not do more to solve it? Too often, the focus is placed solely on ambulance handovers or emergency department processes. While those issues obviously matter, they are symptoms rather than the problem. If there are no available hospital beds because patients cannot be discharged safely into the community, pressure builds throughout the system. That is why home care cannot continue to be treated as separate from healthcare planning. It is a central part of how our hospitals function. I am conscious that when talking about problems and crisis solutions, it is vital that we do not lose focus on the real issues, which are patient outcomes and supporting families. That means people such as the elderly lady from Ballymena who, after spending time in hospital, wanted to return home. Three weeks later, she is still waiting for a care package. Her daughter has to decide whether she will give up her full-time work to provide the care that is needed: to manage medication, as well as moving, handling and nutrition, without the necessary training, respite or adequate support. These issues are impacting on that mother and daughter, and on families like that across the North. Families are being pushed to breaking point because the support that they need is simply not there. Those are not isolated cases. Similar situations arise repeatedly across constituencies. Families are exhausted. Many are trying to balance employment, childcare and other caring responsibilities with little or no support. Home care has to be one of the foundations on which the entire system depends, so I hope that the Minister will respond positively to the motion and bring forward a comprehensive action plan that delivers long-term stability for the sector, better support for workers and, most importantly, better outcomes for patients and families across the North.

1,535 words. Text as published by the Northern Ireland Assembly.

Assessment

Not qualifying

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Assessed 21 October 2026 at 15:37 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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