Concerns over the growing crisis in rural home care provision were shared by cross-party members during Assembly debate this week, with MLAs warning that vulnerable patients are being “left stranded” in hospital while exhausted carers struggle to make ends meet.
The motion, which was passed by the Assembly, was put forward by North Antrim Sinn Féin MLA, Philip McGuigan.
He called on Health Minister Mike Nesbitt to deliver on a long-promised real living wage for social care workers and produce a “comprehensive long-term action plan” to strengthen domiciliary care services across the country.
During the debate, Newry and Armagh MLA Aoife Finnegan highlighted the pressures faced by her largely rural constituency, where long travel distances and workforce shortages are placing increasing strain on both carers and families.
Said Ms Finnegan: “In recent months, I have met care workers from the Southern Health and Social Care Trust, along with providers and agencies, including Enable Care, who voiced their concerns about the growing pressures on the sector.
“They spoke about workforce shortages, the increasing demands that raise operational costs and, critically, the additional burden of delivering care in large rural areas.”
She argued that those care workers often travel “40 miles or 50 miles on a single run” to reach vulnerable people living in isolated communities.
“They travel long distances on rural roads in all weather conditions to try to ensure that people receive the support and dignity that they absolutely deserve,” she added. “That cannot continue to be ignored.”
Mid Ulster SDLP MLA Patsy McGlone added: “We have come to the Chamber on numerous occasions and heard the same issues: people cannot be discharged from hospital; there are growing waiting lists for care, especially in rural areas; there are fewer carers; there are mediocre wages and a mediocre career structure for carers; and there are growing travel expenses.
“In essence, it is not Groundhog Day; it is Groundhog Year, year in and year out.”
Ms Finnegan thanked the member and agreed the issues needed to be addressed as a “matter of urgency”.
“I record my sincere appreciation of every home care worker across our community for the incredible work that they do every day,” she said. “However, appreciation alone is not enough. The workers deserve to have fair pay, proper support and a system that values the essential role that they play in caring for some of the most vulnerable people in our society.”
Echoing the sentiments of those before him, DUP MLA for Newry and Armagh, Gareth Wilson challenged the Health Minister’s own words of, “If we can crack the issue with discharge, we will crack the issue of emergency department queues” by commenting: “I say to him, get cracking!”
Mr Wilson added: “The Health Minister made those comments some weeks ago. However, the situation is not improving. It is getting worse, with care providers stating recently that they can no longer service some rural areas with care packages. That is a serious problem that demands very serious engagement.”
Responding to the debate, Health Minister Mike Nesbitt acknowledged the seriousness of the pressures facing the sector and accepted that a lack of community care capacity is contributing directly to hospital overcrowding and delayed discharges.
He reiterated his commitment to introducing the real living wage for social care workers but said “financial constraints” had prevented its delivery.
Addressing those constraints, Mr Nesbitt said: “Today, we believe that our shortfall is £760 million. That is unprecedented and potentially unmanageable.”
He defended his failure to meet an earlier pledge to introduce the wage increase, saying he had made the promise in “good faith” before being advised it was “unaffordable without cuts”.
The Minister insisted that while fair pay is essential, wider structural reform is also needed.
Despite frustration from across the Chamber, there was broad political consensus that urgent action is needed.
The debate concluded with the amended motion passing, underlining growing cross-party recognition that unless home care provision is strengthened – particularly in rural areas – pressures on hospitals, families and care workers will continue to deepen.
