Mr. John Dunne:

I felt I owed Senator Dolan an answer to his question about social and personal care. There are technical answers. There are activities of daily living and instrumental activities. There are lists of the kind of things one would do. The pattern is drifting. In general there is less of a focus on well-being, mental health and social needs. It is all about getting in, getting the person up, dressed, washed and possibly fed and then getting out again. There are complications around medication. One of the real shocks to me arose because we had been providing in-home and respite care where there was a family carer present and then we started going into homes were they were not present. If a family carer and the care worker pass each other when one is coming in and the other is going out, one of them can say the person being cared for did not take his or her tablets or would not do something else and the information passes seamlessly into the family that is managing it. Where there is nobody else there, the caseworker cannot administer the medication. There is a struggle. It is recorded that the person did not take his or her medication. It is not a very effective form of care. That is what I mean. Let us be fair to the HSE. It is operating on a shoestring budget in this area. It is trying to make €10 million go as far as €100 million. It is being distilled to the bare minimum. I am not saying there is an easy answer other than resources. It is not about people wilfully setting out to do this.

This is a function of the way the system is going.

I will move on to Deputy Durkan's points and I will start with the question on resources. I accept the point that it is not austerity, but I am getting a bit resistant to the resources line because my experience and observation is that when the system wants it, resources are available. I will give two examples. When there was a problem with the Waterford Crystal pension scheme the State came out very strongly and effectively said it had messed up because it did not translate something into law, and that is the reason the scheme crashed, but it could not afford to bail out the scheme to the tune of €30 million or €40 million. Within three months the State had bailed out the pension schemes of a series of quangos to the tune of €1 billion. That did not get any headlines, but there is the contrast. The State could not afford €40 million to help out one group but it could help out another group no matter what the cost. My main challenge in terms of resources is that the increase to the health system this year is €2 billion but more or less half of that will go on pay and a large chunk of it is for pay restoration. We are not ready for pay restoration. The resources are not there. Our sector is not doing pay restoration and we are not being funded to do it either. The State is getting very precious about that and saying it cannot afford it, but that is where a lot of the money is going.