Dr. Sarah Donnelly:

There are significant risks. As Ms Walker-Strong alluded to in her opening statement, the work of Dr. Nicholas O'Neill has been very enlightening on those worse outcomes in private, for-profit nursing homes. We have seen a significant shift since the early 2000s. When I started in social work then, nearly 70% of nursing homes were publicly funded and run. We now have the reverse, where nearly 80% of nursing homes are private, which is problematic. For me, there will always be an ethical tension between profit margins and providing good, high-quality care. Some of this comes down to staffing. We really need to look at the landscape of private versus public nursing home provision. There is no reason we cannot develop more not-for-profit or social enterprise models. That is really where we need to go.

Another thing we are doing poorly in Ireland is that we have home care, nursing home care and very little in between the two. We have very little access for older people or people with disabilities to supported housing. This is a significant gap regarding enabling people to age in place.