Mr. John Dunne:

I would make two points. I am conscious we are wandering into the ambits of other committees. On the housing adaptation grant scheme, which is a constant source of concern for us, generally speaking, the budget for it is underspent. The scheme operates by requiring co-funding by the local authorities. Local authorities democratically arrive at a position it is not something they tend to prioritise with respect to maximising their spending. I am not trying to cut across that but, fairly pragmatically, we are exploring the idea that in some way we might act as a co-funding body instead of the local authorities to enable the scheme to be used more flexibly.

It becomes a real crisis in the context of something like a hospital discharge. I have been working with carer organisations for 12 years. When I came into this sector, there had been a "Prime Time" special investigations programme on the sector. I still have etched in my memory the picture of an elderly woman carrying an adult man, her son, up the stairs because the only bathroom in the house was upstairs. That is life for some people and it is extraordinary. To be fair to everybody, there is a scheme. It is not working in the way most people would like it to work. I do not believe in jumping up and down and blaming everyone for bad faith. There is a problem with the scheme. If there is a way to tweak it administratively to make it work better, that is where I would go with that.

On the question of equipment, it comes more under the remit of the Joint Committee on Health and the health budget. There is something strange about the culture of what is good enough. We were speaking on our way into the Houses of a pre-budget submission a few years ago concerning a mother with a child with scoliosis who was in a full-body case to try to straighten her spine. That is something a child grows out of very quickly. Such a child would also be in a wheelchair because the child is in a body case and the child would grow out of the wheelchair less quickly. Such a family would quite regularly have a significant expense. This family had a discretionary medical card, which at that time had been withdrawn. They faced the prospect that if they did not have a medical card, they would either have to pay privately for the body case for their daughter or, presumably, they would have to take off the case when it became too small and leave their daughter with none. That is an inconceivable situation. At the end of the day, what was probably going on at a policy level was a game of chicken with the Department of Public Expenditure and Reform, although I do not know that. However, that family was put through the wringer in terms of having to worry about that right up to the day it happened.

Access to appropriate equipment is essential. Ms Ryan said that it makes a difference in terms of a family's quality of life. I would say it is more fundamental that. It has to do with health and safety. The use of a hoist for some people is essential. I would refer to the number of carers who come to us having already crocked their backs, and I am putting that in a mild way. There is no going back on that. It can be fixed but those carers will always have that weakness in their backs. That is an extra burden and challenge for those carers. The idea they cannot have the equipment they need is wrong. Many of those hoists are operated by two people if they are to be used safely. That prompts the question as to whether somebody would be sent in to help a carer at home to use it but, of course, the answer to that is "No". If a worker is sent in to care for a person who needs to use it, there must be two workers sent in to use it. However, if a carer is at home alone, that is the carer's business. What happens is behind the front door.

Both of those are very rich veins to be mined. In particular, if any member of this committee is also a member of the Joint Committee on Housing, I would be more than happy to talk to them about that scheme in due course. I would acknowledge those two points.