Mr. John Dunne:

I thank the Chairman and members of the committee for the opportunity to present today. I will start by endorsing what Dr. Browne has said in terms of the findings of long-term care report. My role today is to broaden the agenda and consider the wider dimensions of family and community care in Ireland. Family carers underpin and enable most of the major components of the current health strategy from accelerating hospital discharge to the treatment of chronic care in the community. Whatever plans the committee recommends I have no doubt family carers will be central to their implementation and success.

As Dr. Browne said, there is a major discrepancy in the how the health service funds the care of people with acute illnesses and those with debilitating illnesses. Between 2008 and 2015 the HSE has reduced its expenditure on home care by €11 million despite the fact that the target population of older people has increased by 25%. During the same period the HSE increased its spending on residential care by €68 million. In spite of all the rhetoric the pattern is getting worse. One of the reasons is funding for nursing home care is available on a statutory basis but there is no equivalent provision in respect of funding for home care thus creating an imbalance in the system.