I am again raising the crisis in the private and voluntary nursing home sector, where 17 homes have closed this year. These homes tend to be independent, small and family run. While some of the chains are replacing some of the lost beds, that is not happening in rural or smaller areas where family-run homes are closing. More and more older people will not be able to remain reasonably close to family, friends, GPs, pharmacists and so on. That is just wrong. In a small, 35-bed private nursing home, the current fair deal funding model would pay, on average, €1 million less per year than it pays to the same size HSE home. I keep hearing that HSE homes deal with more complex cases but where is the evidence? The Department of Health did a study, although it was too small, which showed there was little difference in the levels of dependence between public and private homes. We need an urgent review of the fair deal funding model.

I thank the Deputy for the question. The Department of Health acknowledges that there are variations in the cost of care across community hospitals and private nursing homes, with public community units generally having a higher cost of care. The HSE will always step in where a resident's needs are sufficiently complex that they are not able to be cared for anywhere else in the community. The HSE needs to be staffed to deliver that kind of complex care. I have put in place a €10 million scheme to cover 75% of energy costs from 1 July this year up to 31 December. Each nursing home can claim up to €31,500. Some €70 million in free PPE and oxygen has been provided over the last two years while €145 million of financial supports through temporary assistance payments has also been provided. Residents in HSE-run community nursing units, CNUs, which are often staffed at a level that allows the delivery of more complex care, represent less than 20% of those on the fair deal scheme. Last year, 4,500 residents were in these public CNUs.