Mr. John Dunne:

We are talking to Departments about a register. The Department of Health's response to me, which I believe has merit, is that they are getting calls for a dementia register, a this register, a that register, and a whatever register. I believe the Department would really like to be able to create a single, broad-based register that would be sliced and diced to generate the relevant data out of it. This would not be problematic from our point of view. Certainly, some sort of register is needed, be it a family-carer-only one or a broader one that includes family carer as a category.

A national planning unit is a sensible proposal. This month in Tullamore, the HSE is creating a national office to manage home care.

I am not being facetious about this but I do not know how much planning there will be. It is an operational unit. However, I do not see how you can do operations without doing planning. That could be a positive step forward. The bad news is that the planning will be done on the basis of a computer algorithm called interRAI, which Ms Duffy mentioned earlier. This is run after a house is visited to assess the resources needed. How much further away from the human side of caring can you get than sticking the answers to some questions into a computer to be told that a person is entitled to or needs 5.75 hours care a week? The first of these questions is whether there is a family carer present. If there is, a penalty is applied. To go back to an earlier comment when somebody said that this is terrible, I fully accept that my mother is in a better situation than another woman in her late 80s who has nobody looking after her. With regard to urgency and prioritisation, it is not unreasonable for the presence of a family carer to be a consideration. The compromise we have won with the Department and the HSE is that, where there is a family carer present, the score with regard to the need of person being cared for is reduced but a separate exercise is done to assess the needs of the carer, who is now part of the equation. That is a better way of approaching this than ignoring whether there is a carer involved because, to be fair, having a carer there does make a difference. The algorithm itself is highly problematic and probably will not produce the best outcome. This has been going on for seven, eight or maybe even ten years now. These things have a terribly long lead time. They are very hard to stop when they get to a certain point. The new unit will be an improvement but I do not know whether interRAI will be an improvement. I totally agree with the idea that we have to somehow inject the human and the personal back into it all.