Mr. John Dunne:

Absolutely. I am saying that because the hours are changing, the system is caught in a bind. The level of work required is diminished but the number of staff is not, so the question of redeployment arises. What is happening, and it is an accelerating process, is that people who are formally under-qualified or not trained in the role are being sent to deliver the care. This is a generalisation. People who might not necessarily be trained in patient moving and handling, for example, which is not a very high level skill but is significant for the health and safety of both the patient and the person doing it, are getting into the higher dependency care. Effectively, people are being offered a service which is less good than it needs to be and, in some cases, less good than it must be in medical terms. I gave an example yesterday but I will repeat it. There is a case where an older gentleman is being put to bed at 3 p.m. in the afternoon, and the reason is that the home help who has been redeployed to do the job will not come later than that. There is no medical reason for it. He will not die because he is going to bed earlier, but that is not the point. My argument is that it is a waste of public expenditure, yet if one looks at the global figures one could argue that the budget for home care packages is holding up well and that it is a priority.

They are the examples of waste.