Professor Kathleen Lynch:

I was trying to make a point at the beginning, which I know it may appear academic, but it is actually what the Deputy has just said. Caring is about relationships. When you get old, it is not just a matter of being kept clean. There is research showing this. I refer particularly to Professor Timonen from Trinity College Dublin. They have done many studies of older people about who are being cared for. This includes a former student of mine, Luciana Lolich. They say exactly what Deputy Bríd Smith said. They want to be cared for by people with whom they have relationships. It should not just be the case that somebody comes in and washes them, or that they are only there for five minutes.

Time-defined care becomes supervision. It is not care. Many people who need care on their own are lonely. I will come back to the mental health issue. The reason they want somebody who can talk to them is that they need company. They often need company more than they need washing. Deputy Bríd Smith is saying that we need relationships to build up in care. That means that people have to stay. As members will know, as in the childcare sector, which was discussed at the committee’s last meeting, and even more so in the home care and in the residential sector, there is constant mobility of people out of the sector. There is, therefore, no relationship. It is often the relationship that matters to the person. The Deputy is 100% right on that.

She mentioned migrants. The Migrant Rights Centre Ireland has done some work in this area. Many people are working that sector who are migrant workers. We know very little about them except that they claim that there is much exploitation. I cannot say that is definitive because we have not had a national study. I cannot say it for definite. However, I referred to report from 2015, which stated for example that in many nursing homes there are many people who are migrant workers. That is not wrong. That is fine, except how long will they stay? What is the security? There are many issues there. It is a matter of the quality of relationships. We have so much focus on a medical model of care that is about bodily cleanliness, if I may say so, and about physical safety. Yet, in fact, when you are old and alone and if you are there all day, what you want is a relationship. You want company.

The State has abandoned certain people in many ways in certain counties in Ireland. I am very familiar with County Clare, where I am from. I had this experience with my own mother. We fought tooth and nail not to have a private provider when we were supplying care. When people talk about full-time carers, as somebody who has done it for a long time, we have to have many commuting carers. They commute from Dublin, Cork and all over the country. My sister and I did for weekends ad nauseam, when we were up at night on Saturdays and Sundays.

If somebody has to be turned, you have to be there. I do not know why that is not counted in the census; it does not exist. It is a big national issue for people who are doing it. There are respite services and a grant of €1,800, but the amount is so small. It is tiny and does not remotely cover ancillary costs, such as the constant washing of sheets and ESB and energy bills, heating the house and all of those kinds of costs. There are enormous costs involved in being at home. It is an enormous issue and I agree that there needs to be some kind of home care package driven by the needs of people and not by making money.