Professor Kathleen Lynch:

I put out this idea about the national planning unit and I think it is very important we take care as seriously as we take education. We plan for education. We plan how many places we need. We plan the services and where they will be. If we have no concept of planning nationally for family carers and for childcare, how are we going to have it? It does not just happen by osmosis. I suggest a care convention be held, like the education convention in 1994, which led to very significant changes in education. Very importantly in this case, those people who are potentially moving into the care category, where I might be myself in due course, and people who are already in it should be part of the discussion. The medical model is too powerful in relation to care. It is not a medical condition. Care is a requirement for our human well-being. If we do not focus on the relationships and the quality of the experience, we will get obsessed with whether somebody is able to get out of bed twice a day or once a day. That kind of thing is not the most important thing to most people who need care. They need relationships., they company, they need to be attended to and they need consideration and compassion.

Ms Hughes is right to some degree to worry about a register. We need documentation about carers but, as I have seen happen, sometimes registration bodies can become very controlling and develop vested interests, or that is how I would put it. Professional bodies have of their nature become of that type. I have seen them regulate and control things in ways that are not always right. I am not an expert on it but I can speak with some authority about the education sector. I have seen a change in the entire teacher education sector by virtue of the Teaching Council and people having to register with it. One needs to think very carefully about the registration body, about who will be on it and about the voice of the people who will be the vulnerable other in this context. If you do not have those people present at the negotiating table, you will have a faulty service. That has to be ongoing and people have to change.

I think there was a major shift in policy in this country when we eliminated the National Economic and Social Forum where we had the third strand. Where we had the NGO sector, we always had the voice of the marginal. They were at the Government table. That has been removed. That is a major omission because the voice of people with dementia or people who are ill in hospital needs to be heard. Will they all be woken up at six in the morning to be tested? Nobody ever asked them because we do not take the care of people as something that is a priority. We drive the service from the top rather than from the feelings and needs of the people who are in the service. That is key for me.