Mr. John Dunne:

I have a few very quick points. Going back to Deputy Catherine Byrne's question, I am happy to say that we have a care line for family carers. If a person is filling out an application form, the person can ring the care line and get support. This is one of the services it provides. Anyone dealing with clinics can be referred to this care line. If they need further help, we will provide it through our local staff. We are examining the possibility of online tutorials. There is an issue with a lot of online information in terms of access, literacy and so on. We are looking at the possibility of providing video tutorials to help.

I do not want to go over everything, but I will mention the domiciliary care allowance reforms because it is being referred to consistently. That was a very useful, albeit stressful, process. A lot of improvements came out of the process which are slowly percolating through. As Ms Cox stated at the outset, we acknowledge the situation but it is not foot dragging. It is moving carefully in what we think is a very good direction.

Deputy Ó Snodaigh mentioned people putting in a form as a marker. I can understand the logic of that from their point of view. From the point of view of an organisation which is trying to monitor carefully the level of delays, I would not be happy holding anyone to account for a delay in processing an application form which has a name and address and nothing else on it. We have spoken to the Department about making a distinction between what is clearly a bona fide, albeit perhaps inadequate, application and one that is clearly not a serious attempt at all by not putting the latter into the process and sending it back and asking the applicant to do it again. I understand the logic of the other side but from our point of view, it is a dilemma.

There is nothing inherently wrong with desk reviews. They are normal international practice. The practice becomes slightly problematic and challenging for people on the receiving end who are told, having had this anonymous review, the form they submitted in a bona fideway and which they thought was a good case, which if we are being honest is most cases, has been overruled and they cannot understand the connection. Deputy O'Dea asked how one gets past the resource questions. First, only cases which are being rejected are examined. Second, the Department has improved the process, as was stated earlier. In the old days, the applicant would have lost the application because of inadequate evidence and would have had to come back and appeal. Nowadays, the applicant is more or less told beforehand. That is a major improvement in the way it is being dealt with.

I share some of the reactions of the committee members to the issue of payments to GPs. It is not something that was on my radar before today. I do not know if, in the overall scheme of looking at the total costs and expenditures, there are economies or efficiencies to be made, but it will not be easy to take fees away from anyone. The other side of the coin is that we have separate assessments. This committee deals with education and social protection. That is fine and it is the Department of Social Protection which is here. However, a carer may be dealing with the Departments responsible for health, education and social protection and could be dealing with three separate medical assessment processes. In some cases, the Departments are quite explicit in saying they do not care what the HSE says; the person has to pass its criteria. From the customer-client point of view, that is a challenging agenda. However, from a Government point of view, it is a challenging agenda too. However, I wish to make the point on the record that there are three separate sets of obstacle courses which cover much the same ground and they are all problematic in their own way.