Mr. Bernard Gloster:

With regard to step-down beds and their use, the delayed transfers of care that the Deputy mentioned have now gone from a consistent 600 plus in March to below 500 and are targeted to go further below that. That is the first point. That is consistent now. Some of that is utilised by the constant use of the expansion, by the Secretary General and me earlier this year, for the period of this year to expand the terms under which transition care can be used. It can be used for longer periods. Indeed, in hospitals that are under serious pressure, it can be used as an avoidance measure if it is appropriate to assist a person coming into hospital. All of that is done in the private nursing home sector.

Separate to the Private Hospitals Association, I am considering the approach to a long-term framework for step-down beds from the private nursing home sector, which is different to the private hospitals. That takes some time to get through. We had to get to the private hospitals first for obvious reasons. There is no shortage of focus on that.

On the issue of the difference between public and private costs, the Secretary General may want to comment. I have nothing to do with the pricing of the nursing home support scheme. What I will say, and have said previously, is the cost of public nursing homes is different. It is different because of staffing numbers, pay scales, and terms and conditions but it is also different because of levels of dependency and we are also the provider of last resort. Last Monday week, when the regulator cancelled the registration of a significant nursing home in a part of this country, it is the public nursing home service that has to step in and ensure the continuity of care for those people. I am not indifferent to the challenges for some individual private nursing homes in relation to the financial circumstances they find themselves in but, certainly, in terms of their utilisation and maximising their use where it is available to us, there is no shortage of that on our part. As I say, on the pricing methodology, the Secretary General might want to respond.