Mr. Pat Healy:

Yes, there are more people. We flag this issue frequently. The population is ageing and the number of those aged over 85 years is increasing at a significant rate. The dependency levels of those whom we are maintaining in the community are far higher than they were. That is a good point and what we need to develop. The Sláintecare report stated we needed more of it. In the nursing home sector there are private, voluntary and public providers. In this sector it will be the same. The HSE accounts for over half of service provision, while the private sector accounts for 30%. We will require the three components of the sector to work collectively to maximise results for service users.

We do not specifically survey care staff, but we carry out a survey of all HSE staff periodically. Home helps and home care assistants would be involved.

Deputy Kate O’Connell asked about the separation of the budget. There might have been some confusion when I was replying to Deputy Bernard J. Durkan. We are not talking about separating the home care budget. Instead, we see the home care budget being separate from the budget for the nursing home support scheme. Nursing home residential care is different and has its own requirements. There is also a large private sector involvement in it. It is a Vote in its own right, on which we have done a significant amount of work. There is confidence in the Departments of Health and Public Expenditure and Reform that it is a well managed service with good controls, as well as good identification of costs and so on. On the home care side, we have a single resource and budget for all home care services, whether they be private, public or voluntary. It all comes from the same budget.

Deputy O'Connell may have thought we were saying we would separate the home care budget, but I do not think that is the case. I will ask Mr. Fitzgerald to deal with the question on outcomes and how it is linked to our audit and so on.

Senator Conway-Walsh expressed a concern that we were in some way breaking a service that was working well. That certainly is not our view. What the public looks for in the service has changed. Private sector offerings emerged and the private sector is very much part of the system now and the public want to use it. The public wants to have choice. In many locations there are home care offerings from the HSE, the private sector and the voluntary sector. Members of the public want the capacity to have the choice. It is not that the HSE went out looking for the private sector to become involved. It was more the case that the private sector become involved and developed offerings the public was interested in using.