Mr. John Dunne:

No. In the context of the legislation, there are three systems in Europe. First, the Scandinavian system ensures the lead responsibility lies with the State so the State takes responsibility. The problem there is that if one rocks up to the hospital, care home or local health agency and says "I am worried about my mother", the staff there can say, "Go away. We are looking after her".

Second, in former Eastern European countries it is the responsibility of the family. Therefore, the State says it will do nothing for a person as he or she has family and it is their job to provide care. We are saying both of those systems would be unacceptable in Ireland.

Third, we cite the Portuguese model, not because it is perfect but because it has a pretty clear constitutional kind of text. In that instance, the primary responsibility lies with the family but the State recognises a duty to support the family in fulfilling its primary responsibility in regard to care. We think that model strikes the appropriate medium.

In terms of some work on hospital satisfaction, roughly about 18% of people in hospital do not have a family member visiting them or keeping in touch. We interpret that as 80% of people having family carers while 20% do not.

I echo what Mr. O'Sullivan said and appreciate the comments the Chairman made about carers. On the subject of respite care, our sense of what is happening is that there are stepdown beds. Many respite facilities have been taken over to deal with hospital discharges. Good, bad or indifferent, that is a dilemma.

Let me outline the biggest issue with respite. There has been no serious discussion about respite. Last year, there was a programme broadcast called "Prime Time - Carers in Crisis". A week later the Minister for Health announced that ten new facilities would be opened to provide respite and I thought to myself, Mother of God, the speed of reaction is wonderful. Later I realised he was responding to the previous year's "Prime Time" special that highlighted buildings around the country that had been bought for respite but were not being staffed and so they came through. He announced, with some satisfaction, that there was €10 million in extra spending, all of these new beds and that there would be a great increase in respite this year, although mainly for people with disabilities. So far this year the level of respite provided is down and I do not know where it has disappeared to. Stepdown beds and hospital discharges have absorbed or taken over a lot of capacity.