Mr. Paul Reid:

The private provision of home care packages is a concern for us due to the agencies' resourcing levels and their capacity to sustain resourcing levels. That is also an issue with our own staff but we feel we have a stronger base within the HSE of directly employed staff. It is a concern. I know from the Minister and the Department that it is an area to be looked at from a policy perspective because it is a major tenet of the shift of care to keeping people at home. That is not just from a cost perspective but because of people's standard of living and quality of life at a time when they need it. It is a constraining factor. We always try to be careful that we are not cannibalising the sector by recruiting in but inevitably we do and people come to work with us. It is a sector that needs to be looked at. The pay issues are a concern and retaining staff is a concern.

We will get the Deputy a note on the nursing homes. It is a very small number. In some cases the regulator would ask us to go in and take a home over and we would do so. However, it is a smaller number. Our concern in the sector now, although it is a smaller number again, is that nursing homes are deciding not to continue to practise or be a nursing home for older persons. That is a concern for us. While bed capacity has increased over the last few years, we would have a concern about that in some parts of the country.

Regarding the Dean Maxwell home, the Deputy has escalated this directly to me on many occasions. We are working locally both in terms of long-stay and day care services that can be integrated in appropriate accommodation. There is a dialogue going on. There is a private nursing home close by. We are looking to see how we can integrate the services it provides and those we will provide and how to make best use of all resources, as I would encourage the CHO to do. The CHO manager Maria Bridgeman is working on a strategy down there locally and politically. We have a bit more to do on it but we are anxious to come to a resolution.