Health (Amendment) (Home Support Providers) Bill 2025: Committee and Remaining Stages Seanad Éireann — 2026-06-23 ============================================================ Tom Clonan (IND), University of Dublin The Minister of State and his officials are very welcome. I think the amendment has been ruled out of order in error, because when we spoke about this last week, there was ambiguity. Basically, the Bill says that providers with fewer than four clients do not have to be amenable to regulation, but they can continue to work and be paid. As I pointed out last week, the HSE acts in an idiosyncratic and capricious way when it comes to funding for carer and personal assistance support hours. I know this from my lived experience over the past 20 years. There is a terrible power imbalance between parents and disabled citizens and those who sanction payment for hours. Each regional health area acts differently in this regard. In fact, each community healthcare organisation, CHO, has its own rules. The CHOs make them up by themselves. I have been told by disability managers, after an assessment of need recommended that my now adult son needed, let us say, 24 support hours, that he did not need that number. The attitude is one of the health services will give him ten hours and we will take what we are given. The reason I introduced this amendment was to be absolutely explicit and remove any ambiguity that "a person who provides a home support service to fewer than 4 persons as described in paragraph (a) shall be paid with public funds in a similar way to a registered agency and shall not be precluded from payment as a self-employed carer." It is not adding any extra cost to the Exchequer; it is just clarifying a matter. That is why I believe the ruling out of this amendment was an error. All of these things, as Senator Boyhan referred to earlier, knit together. This time last year, on 25 June 2025, I introduced a comprehensive Bill on personalised budgets to this House. I worked with a corporate legal firm to do so. It was the first time in the history of the State that a corporate legal firm – one of the big internationals – worked with the Office of Parliamentary Legal Advisers, OPLA, to draft legislation. That major legal partnership came to me and offered me the use of a legal team, pro bono , for almost two years. The team did all of the research. It looked at every system internationally and every single consultation that this and previous Irish Governments had done, right up to and including the Action Plan for Disability Services 2024-2026 by the former Minister, Deputy O’Gorman, and the former Minister of State, Senator Rabbitte. When I presented the Bill to the House and argued its merits, the Minister, Deputy Foley, delayed it for 18 months. It is delayed until Christmas Day. I have seen in the Order Paper that it will be read again on Christmas Day. Should I come in after my dinner or will it happen before I take the turkey out of the oven? The legislation I drafted is in line with every single policy aspiration of the Government. If we have personalised budgets for disabled citizens, like my son, how will those funds be dispersed? That is why I am saying, like Senators Boyhan and Tully, that this should be person centred rather than administrative systems centred. Disabled citizens and older people should be able to choose the carers or support providers themselves. That should not be within the purview of an administrator in the HSE. When a lot of those administrators and disability managers move on, they move into the private sector. There is a revolving door in that regard. That is why they recommend in that way. I have had cases where HSE managers have told me to use a specific service and no other, and then I discovered that the people operating that service are former colleagues of that person. I introduced this amendment to be absolutely clear that no self-employed care provider or personal assistant would be denied access to public funding as a result of their not being amendable to regulation, as set out in the Bill. Last week, the Minister of State agreed that the intention of this legislation was not to exclude those people from payment, but I fear that, as a result of the little bit of ambiguity here, it could be used as a way for the HSE to shoehorn disabled citizens and elderly people into availing of the services of large agencies and for-profit providers, which pay carers very low wages. The carers who come to me are earning €13 or €14 per hour despite approximately €35 per hour being allocated. It is the agency that takes that money. That is the reason I tabled this amendment. I know that the amendment has been ruled out in error, one that revolves around the ambiguity I am trying to address. Whoever ruled it out of order thought that these providers would be paid in addition, but that is not the case. It is envisaged in the Bill, as confirmed by the Minister of State last week, that they would be paid anyway. I cannot see how this amendment would levy a charge on the State if it is already provided for in the legislation. It has been ruled out of order. I do not know whether the Minister of State would have supported it had it been allowed. I ask the Minister of State, when he and his officials are drafting the final legislation, to see whether there is any way they could include even one line to remove that ambiguity and ensure it is clear to anyone in the HSE that they cannot refuse to give public funding to someone on the basis that they are self-employed and not part of a large agency. I thank the Minister of State for his patience. --- 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/2026-06-23/debate/main Retrieved: 2026-08-14T04:55:05+00:00 Sitting date: 2026-06-23