Mr. Michael Fitzgerald:

In the discussions for the 2016 tender and through the consultation in the forum, all parties felt that 15 minutes was being used to do work that required far greater time and that a 15 minute visit was not enough. Even though people wanted us to increase the minimum call to one hour, our staff was anxious to retain the half hour call, specifically for the reasons I described.

The issue of multiple people visiting a house to provide the service was raised. This occurs when the carers available change and new staff have to be introduced, which is not good from an outcome perspective. It is true that this is not a good approach and we expect our care staff and providers to minimise the need to do that. We are anxious, however, from a best practice perspective to ensure the person receiving care knows a number of carers because there will inevitably be times when carers are on leave or sick leave. For maintaining the relationship between the person and the carer it is sometimes better to have a number of people involved rather than having people becoming dependent on one carer. This is another aspect.

On the main question on what differences regulation might bring compared with the current regime. One of the main issues is to be able to say, through our own tendering arrangements with providers and our own provision of services, that it is all quality assured and to a standard. We will need regulation to do that appropriately and we will all have to comply with it. The Senator raised the concern about audit teams and further levels of management. Our audit teams are not for the purpose of increasing management but to ensure that, as a forerunner to regulation, we can say what type and quality of service are being delivered by all providers. This is done through surveys and oversight of the services currently being delivered by providers. We cannot get away from the whole issue of having proper oversight of personal care. This is a significant issue and the more personal care we provide in people's homes the more we have to be satisfied that there is good governance and good clinical oversight of providers, and that if issues arise, they will be identified and addressed.

We cannot give that assurance today in the absence of regulation. I do not believe any of the providers, voluntary or private, can say that to that degree either. The history of bringing in regulations - as Mr. Healy alluded to - shows that we have to be clear that it is not just to shrink the service to a size we are comfortable with. We have to maintain the flexibility and the good parts of the service, which are really important. We are going into the homes of people and delivering services. We are guests. It is not the same as residential care, and we have to have a regulation that reflects that type of service.