The Reality

The Reality


“The  Fair Deal has to be fair for everyone and I need to acknowledge that it’s not always fair for the providers of nursing home care… You’ve been asked to make big changes. Changes that I’ll absolutely stand over. Changes in relation to HIQA guidelines and regulations. But changes that have been stressful and changes that have come at a cost and you haven’t been remunerated for that cost.”

Minister for Health Simon Harris address to nursing home representatives, NHI Annual Conference 2019, 14th November 2019.







‘Smaller nursing homes are closing voluntarily due to concerns over their financial viability.’

HIQA’s 2018 & 2017 Overview reports.


Dementia Services Information and Development Centre

“The complex and high dependency needs of persons with dementia in specialist care units now need to be more realistically reflected in fairer resource allocation, in recognition of the skill mix of staff employed in specialist care units, their training needs and the level of care expected to be delivered to residents with dementia.”

Dementia Services Information & Development Centre, An Irish National Survey of Dementia in Long- Term Residential Care (2015).



Fair Deal Department of Health commissioned analysis

“Pricing model operates in an ad hoc manner, lacks rationale, consistency and fairness, only applies to the private sector, and in the long run is unsustainable.”

Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities (2015).


“It is untenable that the State quality regulator can assess differentiated dependency levels and in doing so impose costs on nursing homes, while the State price regulator claims it is unable to reflect the same factor in its pricing decisions.”

DKM Economic Consultants, Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities (2015). The report was commissioned by the Department of Health




“The challenge we have is to build in more flexibility, tiers and levels into the payments to nursing homes based on the level of care.”

Minister for Older People Jim Daly, Seanad Éireann, 12th November 2019.