Professor Cillian Twomey:

We can give some reassurance. A programme of ongoing testing of staff in all nursing homes is under way. Two such exercises have taken place already, one in June and the other over a four-week period ending in August. All staff in all nursing homes were tested. It is good news, though thankfully not surprising, that the positivity rate was very low, 0.1% to 0.2%. I am confident that the process is in place.

We are equally confident that there is a significant and real commitment to ensuring that every nursing home has a core supply of personal protective equipment and, in the event of a surge, will be able to access more without delay. Let us not forget that the PPE dilemma was not confined to nursing homes but was also a difficulty in the acute hospital sector. We all remember the aeroplane arriving from China with equipment that was unsuitable for either type of facility. I am confident on that score.

The Deputy asked if I am confident that the model will change. It must change. The 80-plus age group is going to treble in the next 30 years. Quite frankly, if, in 30 years' time, we have a model of care for older people that is three times the current one, we will have failed abysmally. For example, Denmark has not built a new nursing home since the late 1990s. Finland, which has a population a bit like our own although it is more scattered, has 7,000-plus residential care beds for older people. We have almost 32,000 beds. What is Finland doing that means not everyone requires to be institutionalised? That takes us back to the point I made earlier about the need to have alternative models. Let us be clear and fair that a considerable number of older people are being looked after in their own homes with the support and help of their families. That is to be commended and often occurs under difficult circumstances for the carers involved. That is where the majority of older people are. There are other models of care that will lighten the load on carers, such as the smaller congregated settings that I mentioned.

My nature is one of optimism - one might say it is utterly misplaced, but that is the way it is. I have been involved with reports in the health area for many years. I heard the pessimistic comments that the Chairman made earlier about reports generally. I understand that, but there is an urgency here. Perhaps one of the fortunate spin-offs of Covid-19 is that it has concentrated minds. Perhaps it will be the case that cross-departmental and cross-sectoral support will achieve the change that I believe absolutely must take place.