Dr. Marita O'Brien:

The system does not encourage people to stay. People become demoralised working in such a system. If a public health nurse visits people who need a service, he or she has to say he or she cannot do anything for them. Public health nurses wonder why they visit people when they cannot provide them with what they need. People become demoralised because they are in a profession that helps people but they cannot access what they need for the people. The same applies to social workers. It is demoralising when a multidisciplinary team does an assessment. There is the cost of doing an assessment for a multidisciplinary team. If a person needs 21 hours, the team comes back with ten hours. Then somebody else from the community does an assessment and looks at the resources we have and how we can give this person the minimum and still give him or her something but comes back with ten hours. There is such wastage even in carrying out all these assessments when the person will not be given what he or she needs anyway. It is very entwined, as Deputy Kelleher said. One action causes the other; it is like a domino effect.