Dr. Joanne McCarthy:

Perhaps I will start but I imagine some of my colleagues will be able to better illuminate the experience of design and service delivery. In the case of many of the community-based organisations the HSE does not even say it desperately wants them and that is part of the problem. Let us consider Sláintecare. We recently had Ms Magahy in with us. There is an interpretation of what a core disability service amounts to. As we heard on 19 June, even those core services are being significantly challenged in terms of how they agree to deliver services. The term "auxiliary services" is often used to describe community-based services. There is probably a lack of understanding or appreciation of the value of those services because organisations do not necessarily have face-to-face meetings ever with the HSE to agree on the service. There is no discussion even around what the HSE is willing to fund. I reckon we need to take a step back. There is a historical funding relationship that gets delivered through the service arrangement. I am unsure whether there is a contemporary understanding of what these organisations are doing or the fact that this is the future model. It is about delivering person-centred community services as close to the person's home as possible. This is being put into operation by these organisations. We fund a particular model and that is where 90% of the funding goes. That is where the relationship is being driven. I do not know if my colleagues want to talk about a particular point.

I would like to direct one question to Ms Jones. She gave us an example. Could she describe what would have happened if Epilepsy Ireland's service was not there? What services exist for that gentleman? Ms Jones's service is right there with him. He is dealing with a fairly traumatic event in his life and Epilepsy Ireland is giving him practical support. If it was not doing so, who in the HSE would step in to meet his needs?