The owner of a Belfast nursing home has said the high cost of hiring agency staff is "killing the health service" here.
Dr Alistair Lynas has owned Victoria Private Nursing Home in Windsor Park for 30 years and said the reality of paying agency staff bills is threatening the long-term viability of his business.
He spoke out after this paper revealed that the current cost of hiring temporary care staff in Northern Ireland is £640,000 a day. This represents a surge of 160% since 2015 with an expected overall cost of £230m for 2019.
On one occasion last year, over £1,600 was paid out for a single agency shift in the South Eastern Trust.
In other cases trusts paid up to £155 an hour to plug gaps in their workforce.
Former health minister Edwin Poots has branded the costs difficult to justify and has called for a cap on the "rip-off" fees agencies can charge.
Dr Lynas said: "We had a good, profitable business at the start but now the wages bill is totally out of line. I'm quite happy to pay ordinary fees to the nurses, but if one takes sick you can't pay £40 or £50 an hour for cover - it's impossible.
"It's killing the health service. Another thing that people don't understand is that if your mother is in a home she probably knows the same nurse who looks after her every day.
"If another nurse comes in off the street they won't know your mother, so the standard of care obviously goes down. Something has to be done about it, agency fees are just killing us."
He added: "It's just not sustainable and it's a real shame that some perfectly good homes will have to consider an option of possibly closing.
"We simply can't go on the way we are unless we get bigger care packages or the agency fees are capped. We're not the only ones facing problems. I know of at least one other home that is on its knees."
Last November, Victoria Care Home's manager Helen Chambers said the private nursing sector was facing an unprecedented funding crisis.
She said getting cover for a Saturday shift cost £744, for which the home receives £672.
"Someone needs to tell me how those figures add up, because I certainly can't make it work," she said at the time.
Dr Lynas said the situation had not changed since then.
Four years ago, former health secretary Jeremy Hunt announced measures to end excessive charges, but they were never introduced in Northern Ireland.
Mr Poots said this week that a cap was also needed here "because the system is being ripped off by agencies who are making extreme profits".
The latest Department of Health figures also showed there are currently 7,000 vacancies here, including a shortage of 3,000 nurses and midwives.