Mr. Stephen Mulvany:

Page 29 of the report of the Comptroller and Auditor General deals with that difference, which is referred to as approximately €200 million. The largest single element of that difference is the €125 million that is the cost of our care which is not long term. Similar to the private system, our public nursing units provide long-term care, which is the subject of the fair deal scheme that we are discussing, and care for short stays, such as for rehabilitation, convalescence etc.. The fair deal scheme does not deal with those aspects, so €125 million of that figure arises from those short-stay beds.

The figure of €54 million arises from the different supports that might be provided in the public system rather than the private system, and the last portion concerns instances where units do not obtain the necessary occupancy level. We are then effectively spreading the total cost over a smaller number of beds. We do not allow that cost to hit the fair deal scheme, because that would contract the total funding available for patients and for the private sector. That is an internal matter which is managed.

The 26% referred to by the Deputy concerns the movement over time, from 2012 to 2018, in the cost of public care. That has been largely driven by changes in standards and our need to reduce the number of beds across the public system, particularly given the age of some of our units. When the number of beds is reduced, an element of the costs is fixed and that is spread over a smaller number of beds and that in turn drives up the cost.