Mr. John Dunne:

Yes. We latched onto the problem with fair deal when we came across cases where a person was in extremisand a health service manager said he or she could not give people home care support but could put them in institutional care. A person looking for €200 to stay at home was offered €1,000 because there was a statutory entitlement to that funding. Four or five years ago we were saying this was insane and we have said it every year since. It is great that people are now beginning to focus on it but we did not set out to propose a fair deal model for community care. We said that by introducing fair deal with a statutory basis for one sort of funding, we have destabilised and created a perverse incentive within the system. If somebody who qualifies for fair deal could be offered a package of home care which is cheaper, would it not make sense to allow fair deal funding under the legislation? Fair deal funding has ballooned, and while it is all very well to have a statutory entitlement, if the funding is not in place, we are left with a big waiting list. Under fair deal there was a statutory entitlement and a big waiting list until the funding was increased and there was an improvement in supply. In community care there is no statutory entitlement but there are still waiting lists. The key to it is the funding level. We suggested accessing the fair deal funding if it was going to be cheaper. The magic number is €41,400 per year. In other words, that is the net cost of fair deal after the family contribution under the scheme. This would provide five hours care in the home per day, seven days per week, which is approaching a Rolls-Royce home care package, for the same cost and with no contribution required.

An extension to or variation of the fair deal scheme to community care has been suggested. The fair deal model levies savings, which is fair enough. It also levies income, but it seems a bit crazy to reduce the income going into a house where the house is providing the care out of that income. The house is also being used as a centre of care so it is difficult to understand why some of the value of the house should be consumed to fund it. The funding model for fair deal does not look like a very good fit except, perhaps, in the case of assets. We have consulted widely on this and the feedback from carers has been that if they could be guaranteed the quantum and quality of supports they needed, they would be willing to look at any arrangement. They also said that, as things are at the moment, they have zero faith in the capacity of the system to deliver it. At the moment they would see any move in the direction of front-loaded charging as a grab on funding with no assurance of the quality of what would follow. Carers recognise the reality of budgets and challenges but it does not make sense to reduce their income when they are trying to do a job. The fair deal model, as it stands, would not work. A modified fair deal is not out of the question in principle but it would have to be backstopped by categoric assurances of the quantum and quality of the services that would be provided once somebody started paying for them.