Mr. Peter Tyndall:

I will first come back to the issue of the title of the report. It came from a conversation I had with a gentleman in a nursing home who described being admitted as a young man and now being middle aged, and that his life had been wasted. That struck a very powerful chord with me and I wanted to reflect that in the title of the report. I realised it was an emotive title, but the gentleman concerned had that kind of impact. I am sure he would love to speak to the committee to reflect the point the Chairman made.

We had had a small number of complaints to the office with common characteristics, which got us started. We spoke to 28 people individually. We held a workshop with the NGOs who were able to bring us information about many others, and we also looked very carefully at the extensive published research. We had a number of sources to draw on when bringing the report together. That was the methodology. It is set out to some extent within the report but I am happy to go into more detail if that is helpful.

I do not believe there are as many again as 1,300 people. I notice it has gone up by 20 people or so since the last figure we had today, which is interesting. Our sense was that there are small numbers of people who either self-fund or who are being funded from other funding streams. The cost of their care is being met out of other budgets. I suspect this is a small number. The challenge we all have is that there are no hard data. I am very grateful to hear what is being said by the Department of Health and by the HSE today. I look forward to seeing the outcome of that and developing the database.

It was also very clear that there was very little consistency in the way in which people's preferences and needs were being assessed.

We must get consistency in that regard, compile the information and then develop an action plan. That is the way forward. We are hearing that today and I am looking forward to seeing the results of the process.

I also heard what was said concerning people being entitled to the same access to health facilities in the community as are received by others. The experience of the people we heard from was that it was not just a matter of waiting lists. They felt a view was being taken that they should not be able to access community-based care because they were in nursing homes. I realise that is not anybody’s official position. However, these things happen in reality and sometimes it is necessary to go with people’s lived experience. Rather than considering what should be happening, we must ask ourselves what is happening.

Beyond that aspect, I will return to a point I raised earlier. It is absolutely the case that there is no quick solution to this situation. It will take time. Everybody understands that. Doing this properly is costly, difficult and time-consuming. Therefore, many people will continue to live in congregated settings for a time until it is possible to meet their requirements. I re-emphasise the need for a two-pronged approach in this regard. Work must be undertaken to ensure that the quality of the lives of those people now living within the congregated settings is improved while they are waiting to move on.