Liam Twomey (Wexford, Fine Gael)

With regard to training of home helps, has the Minister reviewed any of the curricula? Can he list Piaget's four stages of cognitive development or Erikson's eight stages of development? These are included in one of the courses for people who are studying to be home helps. I do not know what they are and I am sure the Ceann Comhairle, who is also a medical doctor, does not know what they are. I wonder about the content of some of these courses which are supposed to teach people to be home helps. Who devises and monitors them? This was a FETAC course. The Minister should investigate the content of these courses. They might not be appropriate to what people are doing.

The lack of transparency regarding the number of home help hours is causing a huge problem for Opposition Members. Even the person in charge of this area in the HSE could not tell me how many home help hours were provided last year. If medical services are to be provided using the home care packages, is VAT at 13.5% being applied to those packages? If there is an element of a social service involved in the home care packages, will VAT be applied at 21%?

As the Minister of State knows, the HSE does not have to pay VAT. There is also tax relief at source for people who put their relative in a residential nursing home. Will VAT be an issue for people accessing these services or in providing value for money for the people getting the services? Will this service be a value for money issue for taxpayers rather than being a service provided by the HSE?

Over past years, especially with regard to the health strategy, Quality and Fairness — A Health Strategy for You, the Department has failed to implement many of the recommendations it promised at community care level with regard to home help services and looking after carers in the community. There are so many contradictions in what has come out and what was announced in the most recent budget that value for money and delivery of the service could continue to be a problem.

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