The ongoing crisis in accident and emergency departments throughout the State is due, in part, to the occupation of acute hospital beds by people whose acute treatment has been completed.
In the Dublin area alone, there are almost 450 such patients awaiting placement in nursing homes or step-down facilities. Most are aged over 65 and are among the 5 per cent of Irish people who occupy long-stay beds at any one time.
According to Paul Murray, head of communications with Age Action Ireland, in the eight years between 1995 and 2003 the number of private nursing home beds in the State has increased by more than 40 per cent.
At the same time, nursing home interests have indicated that some private nursing homes have occupancy levels as low as 80 per cent.
"A big test of Mary Harney's stewardship will be how she deals with the frail elderly, many of whom end up in long-stay care," Murray says.
"The sector is in flux, some private nursing homes' interests want an end to capital allowances [ones that have already accrued]. Because of elderly occupancy rates, subventions are inadequate causing much distress to older people and their families, and there is little confidence in nursing home inspection," he says.
There are 26,000 nursing home beds in the State, almost 56 per cent of them privately owned. Prices vary, from about €425 to more than €1,000 per week. The maximum State subvention - which is means tested - is in the region of €680 per week, so a significant shortfall can arise.
"Of all the calls to Age Action, the most anguished often revolve around subvention as families try to grapple with health board bureaucracy, acute hospitals and social workers.
"Hopefully, the inter-departmental group on the needs of older people, and the National Economic and Social Forum advisory group on the care of the elderly, will help focus minds," Murray adds.