Mr. Michael Fitzgerald:

I will make a broad point about congregated settings. Rather than in mental health services, they are more often used in the context of disability services. The Deputy is correct about the policy which intends to move forward with smaller, individual units. What might have once been a very large residential facility in disability services may be decongregated and reduced to a population of four or five people, who would take up a new residence together. The best way to look at that is to go and visit such a setting one, two or three years after its decongregation and compare it with the model that was there previously. In my time, I have seen centres decongregated. I have compared the services that were available before decongregation and after it. People's lived experience in the smaller setting is very different. A person-centred model of service is available in a smaller unit compared with a larger unit. That is a specific thing in the disability services in particular. It is unquestionably the correct approach in that area. It is a difficult thing to do because there is an impact from a housing perspective and on the provision of services. However, it is certainly a good model.

In older person services, we still have larger settings such as nursing homes etc. Through HIQA regulation, there is a push towards fewer multi-occupancy bedrooms and that type of thing. Over the coming years, as we replace units and services, there will be more smaller units. There will be more space for privacy and dignity for people who reside in such settings. That is a common trend across all of those particular services. People are, in general, happier to live in those circumstance when they have the experience of doing so. Services in places such as those can maintain the privacy and dignity of people in those settings much more easily. That is always the challenge of regulation. We are probably always going to be following regulation as opposed to being ahead of it. There is a financial challenge involved, both from a revenue perspective and a capital perspective. They should go hand-in-hand but these are very large models to move away from and towards a model of smaller facilities. Mr. O'Connell might be able to answer the Deputy's question about costs.