Mr. John Dunne:

I echo the answer to the question earlier. In our experience, residential respite is typically preferred by carers of younger people who regard the respite as a holiday, a break and a chance to socialise. I cannot speak specifically for dementia, but for older people in general, they prefer to have respite at home in a way that sustains their routines. We provide what we call in-home respite but it sounds like day care at home. Regarding the model for this cohort’s population, that is probably the better way to go, which is not to say day centres and the odd residential respite might not be useful.

On the overall situation, I do not think any part of the country has adequate respite. If my feet were put to the coals, I would say that from our experience, CHO 3 is probably the best resourced for this. As an example of the anomalies or inconsistencies I was talking about earlier, Roscommon is probably the best resourced county in the country for in-home respite but CHO 2 overall is not. This means that the people in Roscommon can access in-home respite quite reasonably and the people in Galway and Mayo have very little access to it. Given that those are three areas within a single CHO, the only reason we can see for that geographical anomaly within a single local health structure has to do with history and a reluctance to tackle historical practices and rationalise things. The budget is there. If it was distributed differently, CHO 2 would probably be at the norm in respect of in-home respite. However, because it is not distributed evenly, Roscommon is very well endowed – I do not begrudge it to them – but the rest of the CHO is under-supported with regard to respite.

If I had a magic wand tomorrow, I could not fix this. The fact of the matter is that if the Government doubled the budget overnight, we could not staff it. We have pulled out of providing in-home respite in CHO 4 because historically the pattern there was direct provision by the HSE. As a result, the private providers operating in the area were reduced to operating on the margins and it was impossible to have, over time, a sustainable service that we could maintain ourselves. Therefore, this year we are effectively disengaging from in-home respite and are handing over the packages we are delivering to the HSE and other providers.