Professor Kathleen Lynch:

Following on from Mr. Dunne's comments, I agree with what he said about non-means testing and giving the rate to have people cared for at home that we give to people who are foster carers. We also need to survey and talk to people who are care recipients. I found that there is an importance to hearing the voice. Have we had a national survey of people who are in nursing home care? Do we know if they want to be there? I am sure that the committee is aware - and I have been in three such homes lately - that they are all digitalised access. Many of the old people do not know the codes, so they cannot get out. There are very significant human rights issues that arise in places where people are not able to freely move in and out. Do they want to be there? What kind of home care do they want? Do they want local people who can talk to them in their own language, who know them and who understand them? Maybe they do not. Some people do not. I hear no mention of voice in the discussion about people and care. This is fundamental to addressing what was said about quality.

Perhaps we could look to other jurisdictions but that would be slow and painstaking. Reference was made to time. Care is driven by a different logic. It cannot be measured in quantifiable outcomes. Reducing it to packages, as I have said, is to commodify it and to treat people as if they are getting a box of groceries. We cannot treat it like that because it is not a product, it is an experience. Therefore, the voice, and discerning what people's voice is on an annual basis, including how they feel about the service, would be absolutely fundamental. Indeed, there is a lot of research on small children that shows we could do a lot of things with what they like as well. There is new research around how we talk to, understand and know what children like. As I have said many times, we need to recognise that we cannot produce fast care in packages like fast food. If we do that we get poor health and in the case of care one would get poor mental health.

The carers' health must also be considered. It is extraordinarily stressful for people who are running from one place to the other. I believe that the emphasis must be on the relationship. If one is assessing it we must ask what is the nature of the relationship and what kind of relationship people want. How much do they think they should be listened to on a regular basis? To say that people with dementia do not know is ridiculous. There are numerous ways in which we can discern what people want. Social research is very advanced in this area. If we are to talk about new ways of doing it that would be a fundamental principle.