Regulating and financing homecare services: how can Ireland learn from other countries

Research Commissioner: Dr Jean Long, HRB Evidence Centre

The problem

Ireland needs more formal support and regulation of homecare services, and we can learn from the experiences of other countries in this area.

The project

The HRB worked with independent researchers to collect and analyse information about home care services in four countries: Germany, the Netherlands, Sweden and Scotland. 

The outcomes

We now know that, for the countries studied:

  • Homecare services take the form of personal care and help with household tasks.

  • Support to keep people living in their own homes is the main principle underpinning home care policy, and informal care by close relatives is encouraged to fill the need.

  • Regulatory bodies are, or appear to be, partly funded through contributions made by longterm care insurances or by registration fees paid by care providers.

  • Countries have taken interventions to either restrict formal home care supply, such as tightening access criteria, or funding  additional demand through co-payments.

Minister Helen McEntee, TD, said: “ This evidence review carried out by the HRB concludes that there are several principles included in regulated home care in other countries, such as standards, transparency, consultation, choice, equity and sustainability. These principles are implemented through legislation, policy, strategy, service planning and financing. The experience of other countries will help to inform the debate around future consideration of approaches to formal homecare regulation and financing here in Ireland. This is an important step towards the development of a new statutory homecare scheme for Ireland.”

In summary

A public consultation for Sláintecare, the proposed new national health strategy for Ireland, highlighted the need for more formal support and regulation of homecare services. The Department of Health asked the HRB to study approaches that other countries in Europe take to financing and regulating homecare services. The study found that these countries could reportedly meet the demand for homecare needs, but that they had taken steps to reduce the need, such as encouraging informal caregiving, and tightening the access criteria for services.