<b>:</b> There are 26,700 residents in private nursing homes and 5,600 residents in public nursing homes. The enhanced community care programme and the chronic disease management programme were agreements between GPs, the HSE and the Department, but GPs are not paid under these programmes for dealing with residents in public and private nursing homes. As a result, private nursing homes face a significant problem in getting GPs to provide care in these nursing homes. As a result, some of these nursing homes are physically paying GPs to provide care for medical card patients. This is about keeping people in nursing homes and out of hospitals. The only way to do this is by having a comprehensive medical card programme provided by GPs in each of these nursing homes for the residents there who are entitled to it.

What efforts are being made by the Department to engage with GPs to make sure we can have that scheme put in place for all residents in all public and private nursing homes?

I am going to deal with this issue because it is an issue of such importance to Deputy Burke. He has raised it with me on a number of occasions in addition to raising it with the Minister for Health. As he knows at the moment the capitation fees that are paid to GPs in respect of nursing home residents are the highest paid in respect of any patient recognising the complexity of health needs that I know Deputy Burke will understand probably better than I do. I know this is a difficult issue because we need to find ways in which we can meet the care needs of nursing home residents but we also know the demands on GPs at the moment and the challenges they are already facing. The Deputy has raised this issue with me and the Minister of Health today. We will look to see if any steps can be taken which are affordable and sensible that will better meet the needs the Deputy is referring to. He is right because if we do not meet these needs, the health needs of patients only grow and the functioning of nursing homes becomes more difficult.