Shane Cassells (Meath West, Fianna Fail) | Oireachtas source

I have a few questions for the witnesses, whom I welcome. The nursing home sector is important. As Mr. Daly stated, hospitals would effectively grind to a halt if the sector did not operate efficiently. When one considers that 30,000 people call one of the 458 private or voluntary facilities or the 122 public facilities home, it crystalises how important the sector is.

That 79% of facilities are private makes the points the witnesses have articulated for us all the more important in how we tease out the funding mechanisms. In the HSE's 2016 accounts some €900 million was allocated for nursing home support schemes. From a public expenditure point of view, the Comptroller and Auditor General would be interested in examining how that nearly €1 billion was spent and, if there were significant disparities in the funding models, determining how to go about addressing them. The facts outlined by the witnesses speak for themselves and show the major disparities. Under the fair deal scheme, a private provider has an average spend of €35,000 versus an average spend of €71,000 in the public sphere.

Deputy Marc MacSharry touched on the issue of geography. The methodology is similar to that used to fund local authorities. It is difficult to work out from the graph on screen. The Deputy used the example of Dublin versus Sligo and cited land costs. In my county of Meath there is an average weekly cost of €1,600 in the public sector versus €2,200 in the adjoining county of Westmeath, which is difficult to understand.

Mr. Daly touched on the type of care provided. According to his opening statement, many people with dementia were refused admission to HSE-operated facilities because they were "not independently mobile". If those with the most pressing and complex needs find themselves in private nursing homes and public homes are being funded to the tune of twice what private providers are receiving, how does it impact on the quality of care provision by and the resources available to private providers? I am interested in hearing his views on how such homes are even surviving.