Ms Louise Loughlin:

There is already quite a bit of private provision funded directly by the HSE in the form of home support and personal assistance. A lot of that goes through private providers. Additionally, the HSE and the traditional section 38 and section 39 services we have are using private providers to provide residential placements. That can be welcome, but I would add a note of caution that the positive experience Dr. Walsh and Ms Walsh have described is not reflected across the board. Sometimes there can be providers coming in and going out of Ireland quite quickly for different reasons, and that can lead to a lot of inconsistency in services. While we have regulation around residential service providers, it does not always look at the quality-of-life issues. HIQA is focused on what is in its regulations. Our experience of quality of life and some of the issues Ms Condon has described is that the variety of provision is huge when we look at traditional providers and private providers. Another experience we have had is that many private providers in the residential space are using properties that are very far from people's home locations or their bases of interest, that is, their families and communities.

We all love the hybrid models these days. We need to think a bit differently about this and look at private providers. We really have to look at the values and ethos of those services as well and make sure they have the commitment the Chair described such that it is not just an in-and-out, money-making exercise. They have to have certain standards to which they operate. Again, it has to go back to a person-centred service. It cannot just be the provision of a bungalow for six adults with intellectual disabilities. It has to be tailored to those individuals. That is the critical piece if we want to bring in private providers. Private providers should not be used just for a quick fix; it should be ensured that the design of what they are delivering meets the needs of the people the service is for.