Mr. Mervyn Taylor:

There is danger of a partial collapse in the market - I hate to use that word but that is how some people are viewing it. There is a danger of a partial collapse in the sector. If one looks at the Business Post any given Sunday, one will see ads along the lines of "Nursing home for sale - 50 beds – owner retiring". Some of those were almost social enterprises where they were owned by the garda married to the nurse who bought an acre of land outside years ago, and availed of the tax incentives and ran a reasonably good show. Post Covid, they are absolutely tired, including of HIQA, and they just want out and to retire. The issue is that, in those circumstances, the State is not stepping in at the level it should. In each HSE region, there needs to be a university-linked teaching nursing home facility designed to the best quality of international practice so that people start learning what good looks like. I have been told by people who are in the business that they tried to get private investors to invest in the newer models but they will not invest because they do not have the confidence that the State is backing this new approach and, as far as they are concerned, the State wants hotel-type nursing homes. That is a core issue.

The Deputy rightly raised the issue of what the NTPF paid. I would argue it is time to get the National Treatment Purchase Fund out of this picture altogether because it is for the regulator to have the role of the regulator in this. We have one body negotiating, supposedly, or telling 80% of the sector's members what they get. It does not negotiate with 20%. The system is administered by the statutory health service, which is the provider of last resort and does not get involved in any way in the running of those things. It is then regulated by a body that, as yet, does not set any indicators in relation to staffing levels and does not have any role in funding levels. It is a completely dangerous situation.