Mr. Mervyn Taylor:

The Senator has made a very important point about culture. At the end of the day, culture beats all these other things, including legislation. Legislation can help but it is more about how people are towards each other and the power relationships. I would caution about taking the approach that if it is private, it must be more suspect. Not too many years ago, I was involved with a particular large-scale facility which is a Famine-era building currently in use. The issue there was trying to get staff who had the real power to work later so the people were not having their tea in the late afternoon in order to be put to bed early. I may be getting older, but I am not that old. This is recent.

I take the point about the residents' committees. We have had considerable experience of supporting some of them. At the end of the day, it comes down to the culture at the top. A residents' committee will only work if people want it to. Many residents do not want to engage. In some places it is a very difficult thing and people are almost going through the motions of it.

This is why I would encourage a special session on the future of nursing homes. Dr. Donnelly mentioned Bruff. We have a number of facilities, but they are small enough. I am working on a project in Mayo, smart sustainable neighbourhoods. Some really good things are happening around the country. The communities are doing things but they do not know about each other and they are not talking to each other. I remember sitting in a small room recently with a builder looking at the drawings and plans. People were saying if they had known that, they would not have gone for the planning permission that way.

I make this important point before I finish. I checked it yesterday. There are over 1,000 pieces of literature on evidence-based design - the impact of the design of buildings. That RTÉ programme effectively shows a hotel-style design. The big issue is that 30% to 50% of the culture in any organisation is determined by the physical design of the building. People going down long corridors, answering bells and all this background noise disorients people. Why are we talking about a shortage of hoists when in fact there are load-bearing structures? Some places are as big as the local hospital. Why are we talking about large numbers of people when they can be broken down into smaller units whereby people have to interact with each other and they can relate far better with the staff? That is good design. There are examples of it around the country, including in Dundalk, Drogheda and Crinken Lane in Shankill. Wherever we try to progress these ideas of household models, we run into enormous official resistance because the unit costs are not suitable.