Mr. Bernard O'Regan:

What I can tell the Deputy is that the HSE undertook a piece of work as part of a review of future service need in 2017. It produced a report which projected that an additional investment of €200 million per annum for a five-year period was needed, based on cost at that time, in order to meet known and future need. My understanding is that this is being updated by the Department of Health, which is looking at a ten-year project to build on that. That is the kind of cost at which one would be looking in terms of meeting current and future need. That does not include the type of issues we are raising around deficits or dealing with the things that are there. They would be on top of that. That is the kind of scale of investment we think is needed. That was work done by the HSE.

Part of the challenge in respect of the work in which we are involved relates to the challenges around contracting for services. We are in support of people who travel along the whole-of-life journey. We can engage with the HSE today to agree a budget for the provision of a service to a person but that person's needs can change quite significantly tomorrow. What we do not have is a system that permits renegotiation when those things happen. They are real-life situations. We cannot and will not abandon people in those circumstances but we need an arrangement with the State because, on the one hand, the State has a finite resource and has to manage within that resource and, on the other, we need something flexible and adaptable enough for us to be able to engage properly around when those changing needs occur and to be able to respond to them in a reasonable way.