Ms Mary Dunnion:

I thank Deputy O'Reilly, who is correct that when a person is transferred from a nursing home to an acute hospital HIQA is notified. It is a mandatory notification defined in the regulations to which we adhere, set down by the Department of Health. The regulatory model for nursing homes is based on the concept of a designated centre. What defines this is the premises and the care, and in this context Ireland is an outlier as it does not happen in other jurisdictions. We have done an extensive review of this and are quite happy to share the paper if it is of value to the committee. A change would involve regulating services for older people as opposed to a physical building and the care within it. The definition of a designated centre set out in the Health Act defines the type of services that nursing homes can provide. Sometimes when people deteriorate and require additional care, nursing homes may not be equipped to provide it. Some of what dictates this is the definition of a designated centre. If we had a model that looked at regulating services, it would allow an opportunity for providers to be more innovative in the type of care packages they can deliver and it would be more responsive to Government policy as the ultimate aim is for people to remain in their homes. It is a fair comment and it happens. We look at it, but it is not a matter for HIQA. HIQA is often cited as the cause but the notification-----