Phil Prendergast (Labour)

I join Senator Fitzgerald who spoke about children such as Joy and the other 100 children that are waiting for vital heart surgery in Crumlin and elsewhere around the country. Priority should be given to freeing up beds to allow that vital surgery to take place. It is well recognised that surgery that is elective or planned has to happen at a certain point in a child's life to improve his or her quality of life without considerably worsening his or her life expectancy. That issue should be dealt with as a matter of extreme urgency because time is of the essence and that is the one thing those children do not have.

I attended the launch today of the report by the National Economic and Social Forum on the home care package scheme. I concur with the points made by Senator Boyle on the problems that have been identified in managing the scheme, which is riddled with inconsistencies. A number of home care package providers have noted that having different budget lines for home care packages and other types of community care doubles the level of administrative work. Double or triple assessments of the care needs of older people are being carried out.

One social worker said the current assessment process for application approval of a home care package does not always work efficiently in terms of meeting a patient's needs. In many areas the hospital social worker submits a home care package application and care plan, following which a case manager visits the patient while in hospital to carry out a needs assessment. The home care package application already includes a needs assessment which has been completed by the hospital multidisciplinary team. There is often duplication of assessments that have already taken place.

That is yet another example of how the HSE malfunctions and misappropriates funding that could be better spent on the delivery of the service on the ground to the people who need it. It is a ridiculous misuse of funding to have two or three professionals involved in assessing one person's needs. In regard to how €4 billion might be saved, this is one area where we should examine what has been realistically assessed and was found not to be working. We should try to implement policies that are positive.