Mr. Bernard Gloster:

As I have said many times, the National Treatment Purchase Fund, NTPF, sets the rate for private nursing homes. Am I satisfied with the cost of public care? In general, I am, given the dependency level of our residents. We are also fixed with public sector staffing costs and other issues that drive some of the costs. I have looked at the issue in Abbeyleix and I am due to go there to meet people in the near future. One of the things driving the cost there is that it has a small number of residents but the staffing level still has to be maintained. I will not argue with the Deputy. It does appear to be high.

The example of St. Vincent's University Hospital is called emergency department in the home, EDITH. We have just given them a second car and we are hoping to give them a second team because the results are exceptional. In March, a consultant, a clinical nurse specialist, an advanced nurse practitioner and a therapist saw 250 people who were mostly in nursing homes. Of the 250 people they saw, they referred approximately 18 to hospital. Otherwise the 250 people would have come. Mr. Healy is looking at it with the integrated care of older persons teams which are all over the country now. There are 30 of them. From September, they, with their primary care colleagues, will be going into nursing homes to create hospital avoidance measures. I am hoping to give the Secretary General a three-year urgent care bid shortly and we hope to include an expansion of EDITH. It is a fantastic service. It is outstanding.