Tánaiste, for many years there has been an unfair and unacceptable divergence in the rates of subvention made to different private nursing homes. This affects small nursing homes in rural areas in constituencies such as that which I represent, Cavan-Monaghan. The Department of Health, the HSE, and the National Treatment Purchase Fund have not listened to the very reasoned claims of smaller scale nursing home providers. These nursing homes need additional financial support without further delay. Decision-makers should be cognisant of the exit of a substantial number of smaller scale providers and the fact that more control of this sector is now being exercised by major companies, some of which are international. If that trend continues, we can be sure that those big companies will develop larger nursing homes in the bigger towns and that rural communities and smaller towns will lose nursing home facilities. That would be most regrettable. The typical family run nursing home is an essential healthcare provider and must be protected for the long-term good of the sector and, most importantly, the patients involved.

I thank the Deputy for raising this issue. I appreciate the points he made. We will discuss it at Government level, with the Minister of State at the Department of Health, Deputy Mary Butler, and with all of those involved. It is fair to say that the entire situation is changing and evolving. Covid-19 had a huge impact on the nursing home sector. The level of State intervention and supports was both unprecedented and significant. The economics of nursing homes are also changing. We want to advance home care to a greater degree. The length of stays in nursing homes is shortening, which is a good thing in some respects because it means that people are staying at home for longer. However, that then has an impact on the economics. Contracts are being developed between acute hospitals and nursing homes in order to deal with people's recovery after hip operations, convalescence and so on. We need to create a model that is high quality and affirmed by HIQA from that perspective. It must also be economically sustainable and be capable of dealing with the growth in demand. The fact that people are living much longer than they used to also has implications.