PAC focus on public nursing home costs welcomed


Nursing Homes Ireland has today, 23rd November, welcomed a commitment by the Oireachtas Public Accounts Committee to examine the cost of public nursing home care in Ireland.


The commitment to examine the costs arises from NHI correspondence to the committee following publication in October by the HSE of the cost of care in its own operated nursing homes, following a five year delay. The published costs highlighted a glaring chasm and discriminatory practice between what the State will spend for care in its own nursing homes and what it will pay for citizens’ care in private and voluntary counterparts.


The published costs revealed the average fee payable to HSE nursing homes is 53% above those payable to private and voluntary counterparts. In some instances the HSE pays its nursing homes up to seven times the amount payable to private and voluntary nursing homes. The published costs revealed massive inequity in fees payable at county level.


The Chairman of the Public Accounts Committee, Deputy Seán Fleming, told its meeting on 17th November: “We will move on with the remainder of our correspondence. Category C is correspondence from or relating to private individuals and any other correspondence. Items 153 C(i) and (ii) concern an e-mail attaching a letter from Nursing Homes Ireland regarding the discrepancies in the fair deal fees paid to HSE nursing homes by comparison with their voluntary and private counterparts. I propose that we write to the HSE for a response in the first instance. However, the cost of nursing home care, the HSE, the private sector and how they interrelate, are certainly issues we will want to discuss as part of our work programme. We will certainly come back to that in our work programme for the new year.”


Tadhg Daly, NHI CEO stated: “We welcome this commitment by PAC Chair Deputy Sean Fleming for this very important issue within health spend to be examined by his Committee.  Private and voluntary nursing homes are abused by the State in its role as the monopoly and dominant purchaser of care. The HSE fees are deciphered without negotiation within a non-transparent or accountable process. The glaring anomalies in spend for nursing home care are blatantly evident when you compare the fees payable to HSE providers as opposed to their private and voluntary counterparts.


“This sector of health spend requires PAC examination with regard to how taxpayer finances are being spent. Only last week Dáil Éireann was informed that €22.75m will be spent by the State to deliver 130 beds in Co Donegal. Excluding site cost, this amounts to a staggering spend of €175,000 per bed.


“There is so little transparency that we don’t even know if the HSE fees reflect the real costs of their providing nursing home care.  Independent research says the fees payable to private and voluntary nursing homes are not reflective of the true costs they are incurring to provide this specialist care. A shocking finding within the DKM Economic Consultants Analysis presented to the Department of Health last year informed it is untenable that HIQA can assess differentiated dependency levels and in doing so impose costs on nursing homes, while the State price regulator, namely the NTPF, claims it is unable to reflect the same factor in its pricing decisions. How can the Department of Health and HSE stand over this practice and on the other hand justify the enormous gulf in fees payable to its own operated nursing homes?”


Tadhg Daly, NHI CEO is available for further comment. Contact Michael McGlynn, NHI Communications & Research Executive at 01 4699806 / 4699800 or 087 9082970.  


The HSE nursing home costs, published October 2016, can be accessed here.

The most recently published private and voluntary nursing home costs, published this month, can be accessed here


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