Mr. Tony O'Brien:

There are two components to the issue. The first is a slightly bigger discussion that we have touched on, which is that we need, over time, to provide for a wider and more sustainable scheme aimed at providing the supports to which many people would prefer to have access to remain living in their own homes and communities rather than in residential nursing care. This is a discussion we have had with the committee discussing the future of health care. We also spoke to that committee about the overall capital envelope for the health sector. As was referenced, a little tangentially, in 2008, before the music stopped, so to speak, we were on track for a level of capital infrastructure development that was double the rate that has occurred in the mean time due to the inability to fund it. We have put forward very strongly the notion that we must get back to that earlier trajectory, and if we did so we would certainly be looking at the blend of public-private nursing home facilities.

There are two reasons for this. The first is the figure of 21% for public facilities, which is probably as low as we would wish it to go. There is a requirement for the particular type of care that those facilities can provide that is not as well provided elsewhere. Additionally, we are the provider of last resort, called upon in circumstances where the regulator is effectively revoking the licence of private providers. In order to be able to do that, we need to retain a certain core ability from which to call upon to manage those facilities. Those combined factors, combined with demographic change, mean we are of the view that the total bed stock would need to change. Under the Department of Health, led by the Minister, Deputy Simon Harris, there is an overall capacity review being undertaken this year. It is often referred to as a hospital capacity review but it is not; it is a system capacity review that will examine bed capability in all sectors. Our view is we need more beds outside the acute sector. We may need some in the acute sector but the preponderance should be outside the acute sector.