Dr. Joanne McCarthy:

The issue of nursing homes is an ongoing concern for DFI. As the committee knows, we have been on this issue for almost a decade. We welcome the commitment made in this regard in the programme for Government. As a matter of urgency, we will look to establish real pathways so that people have other options besides needing to go into nursing homes. We had been looking for a specific measure to be put in place and we are awaiting an announcement from the Ombudsman, who is about to make a ruling on this issue. We are hoping that will provide further evidence of the need to put in place a package of payments and supports in order that people have other options.

All of this comes back to the fact that 80% of the money in disability services funds about 30,000 people with disabilities. We are not saying that is a problem but simply showing that this figure illustrates the lack of investment in community-based services, especially personal assistance and home supports. They are the vital services that are needed in the community to support people who are out of nursing homes. They are also the services that are needed to support the resilience of families.

This pandemic has shown that the HSE, like all of us, when faced with a crisis back in February, put in a place a plan that prioritised what services families or individuals needed and then directed those services to them. As we moved through the past six months of the pandemic, many families and individuals who were not at risk presented as not being able to sustain the level of care or supports that were required independent or outside of services. We are talking here about the personal assistance and home support services. When we made a plan for Covid-19, we planned for residential care settings. We did not plan for community-based services. The responsibility and onus then fell on individuals and families and we are feeling the impact of that now. Rare Diseases Ireland did a survey of its members, almost 70% of whom spoke of the mental health impact of Covid-19. The reason was the additional level of responsibility and stress, as well as the caring needs that have been required.

To support Mr. O'Connor's point, we also know of at least 400 families who provide full care to ageing people with intellectual disabilities. Those providing that care are aged over 80. There are real pressure points. We have a lull, as our colleagues from IHREC noted. This is a moment in which we need to reflect on where these pressure points are. We have residential supports in place and we can begin to strengthen them. However, we do not have as clear a pathway to providing community-based supports such as personal assistance home supports and the outreach supports for day services that will be required to sustain families and individuals if we have another surge of Covid-19. These are important questions that merit being put under the spotlight so that we feel confident and families and individuals can be confident that services will be there for them in the community should a second wave occur.