John Dolan (Independent) | Oireachtas source

I cannot fully acknowledge the value of the contributions made this morning. I have known nearly everybody who has come in as a witness for many years. We use the term "service providers" for these organisations. That is true but I think we should underline the service they are providing to us today, which is about their reflection, intelligence, insight, problem-solving and analysis. We have a conundrum as a committee. How will we pull that into different streams? I apologise that I was not here at the start of the meeting. I think what I have heard is a proxy for many of the ills and challenges in our health provision. I am deliberately not saying "health system" because I hear over and over about all the things that clash with each other in that enterprise.

It would be useful for the committee to reflect on what it has heard this morning aside from each of the particular things that witnesses have said to us. I can list things such as hospitals versus the rest of the health system, statutory underpinning versus schemes that are ad hoc or on an administrative basis where the rope can be pulled out from under a body, and whether it is person-centred or system-centred. There are social aspects to consider. Other Departments are involved, such as the Department of Employment Affairs and Social Protection, which has useful involvement in employment. There is the housing issue. This committee was involved in work earlier this year when it collaborated with a couple of other committees. We can talk about this over and over with regard to health but some of the solutions are with other Departments. The institutional care clashes with community and home care. I have said it before. I see young people going into nursing homes and institutions and cannot but think that some or all of that relates to the rationing of supports on the other side. There are issues with respite to address. Those are my opening remarks which I wanted to make public. There was much directed at us as a committee.

Ms Deane from Age Action talked about eligibility and entitlement going back many years. That brings us back to the statutory underpinning versus administrative schemes. Do people have any comment on it? If I am not mistaken, there is a commitment to introduce legislation that opens up a fair pitch to play on. That would have the objective of redressing the pull away from where we want people to be. Mr. Pat McLoughlin from the Alzheimer's Society of Ireland made striking comments. Am I right in what I am saying? Since the recession ended at the end of 2013, the witnesses gave a scenario that €11.2 million of State funding was provided with voluntary funding going from €2 million to €3 million. That is the opposite to the end of a recession. Is that more or less what the witnesses are all experiencing? If it is, we have a mammoth issue with where our health system is going. It has been a year and a half since Sláintecare, our ten year plan, was made. We are still not on the road with it. We have a microcosm here of the large ills in the system. I think Mr. John Dunne talked about social care vis-à-vishome care. Will he address that? Where does care reach people beyond their home, if it does?

This is maybe a provocative question. We all hear about the hospital crisis, the trolley crisis and the winter issue. What is the "trolley crisis" for the witnesses? Is there something that can be expressed that captures the witnesses' side of trying to provide for and support people in the community? We all have the vision of the trolleys backed up. Nobody sees what is going on here. One can go around the edges of a hospital or photograph the ambulances backed up but one cannot do so here. What is the image here that captures starkly the essence of the problem for people and families?