David Norris (Independent)

The Minister of State is correct in her interpretation of what we were saying. Because funds for community services are not earmarked in the HSE, the Minister of State has no idea of the availability of services in the medium to long term and can assess only in the short term. This presents a real need for re-assessment of the client every 12 months where lack of available services is a determinant in their need for residential care. If community care becomes available the individual should be facilitated to return to the community should this concur with their wishes and in accordance with current Irish policy, which is the point the Minister of State was making. This is especially important given that low-dependency patients may be under pressure to enter nursing home care from their acute sector bed owing to the acute care charge. The Minister of State is correct. While I am not 100% satisfied with what she has said, she has gone some way to assuaging my concerns.

Regarding amendment No. 26 and the idea that the person doing the reassessment should not be the same person who did the assessment, I take it the Minister of State is saying there is provision that it need not necessarily or automatically be the same person. I can accept that there may be circumstances in which it is appropriate for it to be the same person. The Minister of State makes a clear and cogent distinction between "review" and "appeal", but one must bear in mind all the time that these are vulnerable people. Unfortunately, there have been situations in some hospitals where consultants, on whom the community would normally place a high degree of reliance, have violated that trust. To have someone such as that reviewing their own practice and recommendations for treatment would not be appropriate, so one has to be concerned. I presume this is why Age Action Ireland has expressed an interest in this matter.

I will not press the amendment because it would be fruitless. However the Minister of State has, yet again, returned to the issue of the limited number of specialists available in this country. That indicates an underlying problem and we are unlikely to solve it in these economic circumstances. It suggests there is a defect. Time and again in the discussion of this Bill the Minister of States has referred to the scarcity of personnel resources and that a limited number of people have the qualifications necessary to deal with particular circumstances. That is worrying and I hope this is addressed when the upturn in the economy comes, as it surely will. I am not sure when it will come as I am not gifted with prophecy.

It is very worrying that the financial figures according to the OECD report released at lunchtime, appear to be very significantly worse - 2% - than the Government had predicted. That is a very dramatic situation which must worry everyone regardless of party affiliation or lack thereof. We are told there may be some stabilisation in 2010. While I accept that in these circumstances one must confront a situation where there is limitation in professional expertise, at the very next available opportunity this should be one of the priorities of whatever Government is in place at that point. It should be unacceptable in a wealthy, western society that we have to make excuses for inadequacies or use as an alibi for a less than perfect system the fact that there is a shortfall in the number of experts.

I am involved in the Joint Committee on Foreign Affairs. I have a couple of amendments remaining, most of which have already been discussed. I have asked Senator Fitzgerald if she would very kindly move them in my absence. I will return for the vote but I have to leave the House now.