Mr. Sean Dillon:

It is very hard to get precise information on how the HSE is implementing the process, although we have asked to know how it is happening. The evidence percolating from the ground is that the HSE is picking an arbitrary figure of a number of hours based on percentage needs, and a directive will go out that there must be a reduction of 2,000 hours in an area, for example. If the supply exceeds demand, there is no problem but we know demand for these services far exceeds any supply. As this is a budgetary matter, there must be a reduction. We have heard cases where an hour is reduced to 30 minutes or 30 minutes is reduced to 15 minutes. The 15-minute unit seems to be entering some equations.

There are approximately 10,000 people in receipt of a home care package and according to some parliamentary questions, approximately 40,000 or 50,000 people get home help service. The argument is that we will be able to review that in time to deliver these cuts; in reviewing the process we will be able to reduce the service sufficiently to save €8 million. The public health nurses are at the end of their wits because, quite unfairly, they must play God. They get a direction from a local HSE office that 100 hours must be cut, for example, and some person therefore has to lose the service. One of the easiest ways to accomplish this is by taking 15 minutes from everybody. The letter I mentioned is from a local HSE office within 50 miles of here and is dated 3 September. In most cases it is a desk-based cut.

With regard to the statutory basis for quality of life, we fully endorse the need to introduce legislation to protect community services. The fair deal nursing home scheme affects approximately 5% of older people, with approximately 530,000 people over 65 in the country. Approximately 30,000 of those people are in long-term residential homes. We have legislated for that through the fair deal scheme. I am not saying the remaining 95% need a carer service but in most cases the service needed would be a community or home-based service. If we believe in the continuum of care, ranging from a little home help to end-of-life care - our colleagues in the Irish Hospice Foundation can give more detail on that - there are different care needs along that continuum. We must ring-fence and protect the budget used in that respect.

There was a question as to why this is happening differently in certain areas, and this is down to discretion. Where there is discretion, the cut opted for is usually the easiest and quickest.

Therefore, the allocation of the service is discretionary and the cut is discretionary. That is why we need to ring-fence the funding.