Dr. Sarah Donnelly:

That is a really important question. Our very chequered history in terms of Emily, Grace, Brandon, Áras Attracta and "RTÉ Investigates" is very clear evidence that poor care is often constructed as not being institutional abuse and that there is a failure to recognise some of the institutionalised practices we see in nursing homes where there are very rigid meal times, bed times, lack of person-centred care for what they are. However, we have to look at the wider context. I was really glad that Senator Roche mentioned the issue of staffing levels. For me, that is the elephant in the room that we have not really addressed today in terms of safe staffing in nursing home settings. There is also the value we place on care work. Whether that is in nursing homes or in home care, it is very problematic. As a society, we do not value it. We do not value it as regards the actual value we place on it or in the context of people's working terms and conditions. Until we see improvements there, we are going to continue to struggle with provision in the areas of home care and community care. When I started as a social worker 20 years ago, the issue and challenge we had was that there was not enough of a budget for home care packages. We are now seeing the reverse, whereby there is funding for home care but we do not have the workforce to deliver that care. I have colleagues and friends in different parts of the country who have older parents and who cannot get home carers for them. Until we rectify that situation, we will continue to have difficulties around providing safe care.