Hand holding mobile phone with Nursing Homes Ireland news on it

Government sneaks out two-year-old Review at 5pm on Friday of a Bank Holiday Weekend without a Ministerial statement; NHI says Report is a Whitewash

Saturday June 5, 2021

Government plan for ‘review of Varadkar review’ is failing people requiring nursing home care’ and utterly contemptible, ignoring regulator warnings

5th June 2021: Nursing Homes Ireland is to seek an urgent meeting with the Government following the publication at 5pm on the Friday evening of the June Bank Holiday Weekend by the Department of Health of the long-delayed and awaited NTPF Review of Pricing System for Long Term Residential Care Facilities. 

Arising from the original review of Fair Deal published in 2015, a further review was recommended for completion within 18 months to ensure the scheme’s pricing mechanism would address high-level, complex care needs of nursing home residents. Incredibly, the concealed review, which was four years delay, has conjured up the requirement for another review. This is despite HIQA warning within the review that the current model focussed on driving down fees as opposed to encompassing the reality of specialised care costs is threatening the quality of care.

Tadhg Daly, NHI CEO, states: “I can see why the Government sneaked it out on a Holiday Friday evening without a statement as the report is an embarrassment to Tánaiste Leo Varadkar, who commissioned it as Health Minister, and an absolute insult to nursing home care.  It is a complete and utter whitewash and is completely failing people requiring nursing home care who already have been let down by the decision to make the nursing home sector the first to be cut off in Pandemic support measures with the withdrawal of TAPS from June 30th. The Review proves the NTPF is not fit for purpose and has been politicised, with its independence compromised in this report.

“Most recently the Comptroller and Auditor General has joined the likes of HIQA and other independent analyses in highlighting failings in the Fair Deal pricing mechanism to appropriate calculate the true cost of nursing home care. Given four years, the NTPF has now produced a review that is utterly contemptible of nursing home care and its residents. They commissioned Deloitte and Prospectus to undertake an analysis that they ignored and how much did they spend on this absurdity over four years.

“Questions must be asked as to who decided to sneak out a two-year-old review that took four years to complete on a Friday night.  It can only be seen as an attempt to bury the Review but also muddy the waters about the cutting of infection control supports in nursing homes from June 30th.  What was the point of the NTPF commissioning the expensive Deloitte and Prospectus Consultants to undertake a detailed analysis of the effectiveness of the support mechanisms for nursing homes if the NTPF was going to completely ignore its findings and recommendations. One can only conclude the NTPF did this to serve its political masters. The approach adopted was we will kick for touch by recommending another review while the ill-suitability of the pricing mechanism continues to close smaller nursing homes and devalues the care needs of nursing home residents. The Minister for Older People needs to explain what political pressure was put on the NTPF to not just kick the can down the road but into the next decade. No Government who claims to care about older people could stand by this manoeuvre by the NTPF.

“Deloitte and Prospectus presented to the NTPF if a pricing mechanism is to be meaningful there has to be transparency that entails full disclosure with regard to how a fee is set. This is in keeping with Comptroller and Auditor General findings in his examination of the scheme published last August, when he highlighted the NTPF had no mechanism to inform how it determines fees. Deloitte and Prospectus recommend recourse of appeal to an independent third party is required to bring greater transparency to the fee-setting process. And the independent advisors pushed that the complexity of residents and their care requirements has to be reflected in the pricing mechanism.”

“It is incredulous, the regulator HIQA warns within the review the current model of keeping prices down may lead to lower quality services but what emanates from the NTPF and the Department of Health is zero willingness to grasp this.  Had this Report been published in 2019 when it was completed and implemented and resourced rather than kicked down the road, the calamity of Covid-19 in 2020 and 2021 might have been lessened.”

“Despite this Review being ongoing since 2015, the report says the NTPF doesn’t want it to end after four years. It has recommended it assess its own approach to pricing and adding to the preposterousness, it states such assessment will likely take a considerable amount of time to undertake.  The only ones this could suit is a Government suffering from paralysis.  So the review of the pricing mechanism that took two years to publish and the prior four years to complete, two years after the original deadline of 2017 set by then Minister for Health Leo Varadkar,  has effectively recommended another review.  At least hundreds of thousands of Euro have been spent on this ‘independent’ review that the NTPF now plans to ignore. What utter disdain for nursing home residents, staff, providers and wider Irish society.”

“After four years of waiting, the NTPF has utterly failed to deliver and its review marks a backwards step in care of older people. The Oireachtas must take the NTPF to task and ask very serious questions regarding its reasons for not fulfilling the terms of reference that were stipulated by then Minister Varadakar. The ‘recommendations’ advanced by the NTPF bring nothing to the table. The regulator’s credibility and standing is severely harmed, given its warning of a threat to care if the present model remains is disregarded. Why is the NTPF not taking the required urgent action to address the regulator warnings and why is it not taken to task when it choose such an approach. Who is accountable for this review that is contemptuous towards older person care?”

“NHI has stated from the outset that the NTPF, as price setter, should not have been tasked with undertaking the review as they are not independent and are compromised. It has turned out to be the kangaroo court we warned about and money has been spent on a report that borders on farce. Our fears have been realised and it is entirely unacceptable. NHI will now engage with nursing homes across the country to consider our options.”

“If this Government is serious about the care of the older person, it must set about implementing a fit-for-purpose process that will address the issues identified by Deloitte and Prospectus.  It must also treat with urgency support for embedding Covid-19 infection measures within a funding model that recognises the true costs of meeting the care needs of nursing home residents.  And our older people must get more than lip service and must become a true priority for our health services.”


Tadhg Daly, Nursing Homes Ireland CEO, is available for further comment. Media requests will be facilitated by Michael McGlynn, NHI Communications and Research Executive, who can be contacted at or 087 9082970.

Note for the Editor

Smaller nursing homes continue to close as registered providers advise HIQA that they had made a decision to close their nursing home as the financial model underpinning a small nursing home was difficult to sustain, particularly in the context where extensive investment may be required to ensure regulatory compliance into the future. The closure of nursing homes that offer a smaller, homely setting is concerning and if it continues could impact on the choice of setting available to older people and their families in the future. HIQA has stated concerns regarding the closure of smaller nursing homes for three successive years within its overview reports.