The issue I wish to raise relates to the provision of home care. I have raised it on a number of occasions. There is a need to grow the service across the country because more people will require home care and we want to keep people out of hospitals and nursing homes. My concern is the policy of the HSE at present. I understand that the HSE cost per hour to provide home care is approximately €35 per hour per person. That is based on the cost of administration and paying the person providing the home care. Private sector providers are charging €24 per hour. That is made up of administration costs, insurance, whatever else is involved and paying the carer.

What are they paying their staff?

They are paying the staff the same rate as the HSE.

They are not.

They are and if the Senator wishes to debate it I have no problem-----

Please allow Senator Colm Burke to make his comments.

If the Senator wants the taxpayer to pay €35 per hour-----

I want decent wages for those workers. They are not getting them.

I have no problem with €35 per hour being charged to the taxpayer but it is important that the taxpayer realises-----

We are talking about the minimum wage.

It is important that the taxpayers realise what is happening. It is costing the HSE €35 per hour to provide home care per hour per patient. There is now a policy in the HSE of stopping people from the private sector without any cost analysis of what it is costing the taxpayer to provide that home care. I am seriously concerned about that. I can give another example relating to the cost of home care. I am aware of a situation where two new nursing homes were built by the HSE. One is being run by the private sector and the other is being run by the HSE. It costs €911 per bed per week in the home run by the private sector, while the cost in the home run by the HSE is more than €1,500 per bed per week. That is the difference. While people may criticise the private sector, it is providing and delivering the services.

I am worried about what is happening with the provision of home care. No cost analysis has been produced by the HSE about the provision and it is also directing the private providers to only provide a half hour of care when people want an hour.

Client-directed care is not being sufficiently advertised. The HSE pays for the cost of this form of care, but the client, rather than the HSE, decides when - that is, at what time - the care is required. I think we need to review this. I also think there is a need for a cost-benefit analysis of the provision of home care by the HSE.