Mr. Pat Healy:

There are a number of components that I will address and I will ask Mr. Fitzgerald to deal with one or two of them. Deputy Murphy O'Mahony mentioned a number of things. It can be gleaned that there is a challenge for us in maintaining and developing the workforce into the future. That is the biggest challenge. One of the underlying issues over recent years is that we have invested €112 million on the public side over the past three years. We have increased the workforce. There is €408 million. About €200 million is the HSE. There are 6,300 people working for us as an employer and we are running home care services. The private sector runs about €120 million of that, which is about 30%. The voluntary sector is about €80 million of that. We have been growing the sector in recent times but we have come close to full employment in Ireland and therefore we are now in competition with many other businesses like McDonald's, community hospitals, the health sector generally and private providers. There is competition for care staff. That is a significant issue.

A lot has been done by the HSE itself and I have set that out in my briefing note. Working with the trade unions and under the auspices of the Workplace Relations Commission a lot has been done to develop the contract, to make the job more fulfilling for the staff and at the same time to bring the standard up to FETAC level 5 so that the care for the individual is good. That is important. There is a challenge facing us. We have to work collectively to try to address that challenge into the future. Looking to 2031, we could require between 70% and 120% growth in home support when we take account not only of the needs of home support itself, but the shift to primary and community care called for in Sláintecare.

That will require significant resources. It will also require proper training and investment. This also plays into the regulation. We are all agreed that there should be regulation, as Deputy Donnelly has said.

Deputy Murphy O'Mahony specifically asked about the regulation. The Department has indicated that it is preparing the ground for regulation. It is receiving consultation on the statutory scheme, regulation and licensing. The Department has responsibility for driving that. We are supporting the Department, and it is actively engaged in that. We expect that over the coming months it will have the output of that ongoing consultation. That will be valuable in addressing how we move forward on regulation.