Health (Amendment) (Home Support Providers) Bill 2025: Second Stage Seanad Éireann — 2026-06-16 ============================================================ Tom Clonan (IND), University of Dublin The Minister of State is very welcome, as are the Department's officials. I hope they will be able to address my concerns in the time provided. I echo what Senator Stephenson said. I have a concern about section 69B(2)(a) which states, "the person provides a home support service to fewer than 4 persons". Senator Stephenson quite correctly pointed out a concern about whether an unscrupulous operator could get a pile of smaller care providers, limit them to three clients and in that way try to evade regulation. That is a concern. The suggestion in that amendment is that an operator is deemed exempt from the regulator if they only provide care to that number of people. I do not know if the Minister of State or the Department's officials can answer this for me, but I am very worried about this clause for a different reason. I will give the House some context. My family has been receiving a number of care hours from the HSE for a very long time now, maybe ten or 12 years, and to echo what Senator Tully said, the experience is mixed. I also echo what Senator Costello said that without exception, the people who come into our home from all over the world are the most wonderful people, but it is the model of the provision that can sometimes lead to inconsistencies. For example, we had one service provider where we never knew from one day to the other whether somebody would turn up, and it was rarely the same person. The carers then would not understand my son's care needs and I would have to come down. It was just very stressful. That is one thing. For-profit care providers - I am not going to name them because I do not want there to be a suggested or implied criticism of them - can be hit and miss. Also, because they keep a certain amount of the money they take from the HSE for themselves, those carers tend to be paid very little. What happens all the time with our son is that he gets a wonderful carer and they really gel, but because they are only getting paid €12 or €13 an hour, they inevitably get a better offer of work and they say, "I am really sorry, but I have to move on" and so that continuity is denied. In all of those years, there has been a very unequal power relationship between families and the HSE. I am not talking about the carers, but the HSE itself and the people who open the funding gates. Across all of the regional health areas, they are all different. They are all capricious. They all have their own little kingdoms and their own little rules. I have had people say to me, "You are not getting that funding". When I ask why they say, "Because I say so", and because we do not have a legal right to any of these things, it is very hard to push past that. Under the brokerage model of care provision, with a company like Home Instead, a client gets to pick and choose their carers who then come in and provide a service. However, they would not come under the definition of the Bill because they would likely be dealing with just two or three clients. Would this legislation give the HSE----- --- Source: Houses of the Oireachtas. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). The Official Report is revised after first publication; the fetch timestamp below identifies the version quoted. Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/seanad/2026-06-16/debate/main Retrieved: 2026-08-14T04:55:03+00:00 Sitting date: 2026-06-16