Professor Kathleen Lynch:

I will make a brief comment on the point Deputy McAuliffe made about cost-cutting and reducing the number of players in the market, as it is called. It is extremely dangerous. It is a real problem in this country. It may be bureaucratically convenient but it means, as I have said, and I have provided the figures in my presentation, that the big providers can outbid the smaller ones and, because they have the capacity, the HR, the finance and the tendering experience, the time it takes them to tender is minuscule relative to their size. The time it takes a very small community group to tender is enormous. There is a very serious issue there. As I said earlier, it is well known internationally that once you start to corporatise care, the corporate carers dictate the terms on which care is tendered for and provided for and, eventually, will squeeze out the small players. Then we are in a monopoly or quasi-monopoly situation. That has to be looked at because people prefer community care. That is a policy consideration that has to be looked at because the cost ultimately results in what is called gouging and financialisation of the care sector, whereby private equity firms, as referred to already, invest in the sector and then start to indebt it and to gradually withdraw the private equity. The body or the nursing provider is left with the debt. That body then appears to be unviable and then raises fees. There is a question here as to how we provide care and how it has become a money-making exercise, which we have to look at, as opposed to providing a service where people need it in their own communities.