Hand holding mobile phone with Nursing Homes Ireland news on it

Deficient Fair Deal underlies crisis in older person care

Thursday May 11, 2023

11th May 2023: Comment from Nursing Homes Ireland CEO Tadhg Daly on The Irish Times report today, Resident’s concern as nursing home operator quits Fair Deal.

“Nursing homes are operating under a deficient Fair Deal pricing scheme. This has been in effect since the inception of Fair Deal, with the escalation in costs exacerbating an already deficient scheme that is now manifesting through a crisis in nursing home care, given the scheme’s failure to provide for the reality of costs. Since Fair Deal came into being in 2009, successive warnings have been presented to Government. Numerous analyses commissioned by and independent of Government have highlighted its disconnect between the reality of resident care costs and fees payable under the scheme. A few months into its being, an Ombudsman examination of Fair Deal found it “remarkable” that the NTPF had been given “a free hand” to decide what elements of care the scheme’s fee would cover. In 2020, the Comptroller and Auditor General’s examination of the scheme found no model in effect to inform how criteria are assessed to determine a fee. The regulator HIQA has highlighted on the long-standing basis the funding model is not matched with residents care needs, is leading to closures, and needs to be addressed. Continued failure of successive Ministers for Health to address the multiple reports and their recommendations, including its own, have now led to a crisis in nursing home care”

“Recently published HSE figures reveal HSE nursing homes are receiving an average fee under Fair Deal that is close to €800 per resident, per week more by comparison with private and voluntary counterparts. This is an acceptance by the State of the true cost of care and represents gross discrimination by the State against residents and staff in private and voluntary nursing home care. State nursing homes, which are not subject to fee negotiation, can allocate funds based on what it assesses as the reality of care costs, while private and voluntary homes are threatened with closure and subjected to it, with Fair Deal dismissive of the reality of resident care costs.”

“We are in the midst of an older person care crisis. Nursing homes are in increasingly precarious financial positions, with their viability increasingly under threat day-by-day. 23 private and voluntary nursing homes have closed the past year-and-a-half, leading to the fact that over 600 nursing home residents have lost what was their home and around 900 staff losing their employment. Communities are losing vital health and social care services that will not be returning. More closures are anticipated in the weeks and months ahead. Our Save Our Nursing Homes campaign continues. Immediate and medium term intervention is required from Government. An immediate fit for purpose stabilisation fund is critical to stem the tide of nursing home closures. The consequences of inaction in this regard are being felt in communities that are losing nursing homes and will continue to be felt. Further nursing home closures and anticipated forced withdrawal from the Fair Deal scheme are inevitable without additional funding under a reformed Fair Deal. Medium term, there are bountiful reports on the table of Government. Act upon them. Bring into effect a truly fair, Fair Deal scheme by ensuring it reflects resident care needs. A transparent, evidence-based pricing mechanism has been identified as a necessity and 14 years on, the time for implementation is long past.”

Tadhg Daly is available to comment on operation of the Fair Deal scheme. Media interviews will be facilitated by Michael McGlynn, NHI Communications and Research Executive, who can be contacted at 087 9082970.