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Increase in Fair Deal discrimination escalates as HSE fees are published

Monday May 1, 2023

Average €744 more payable to HSE residents under Fair Deal as cost of care crisis persists for private and voluntary nursing homes

1st May 2023: New HSE figures reveal the level of discrimination applied by the State in the funding of its nursing homes under the Fair Deal scheme is escalating, amidst the cost of care crisis that has led to an unprecedented level of closure of private and voluntary nursing homes. Recently published figures reveal HSE nursing homes receive an average 69% more (€744), per resident, per week, under Fair Deal fees payable by comparison with private and voluntary counterparts. The published fees, for January 2023, inform across every county over the past year, the disparity under the scheme has increased. In three counties – Laois, Longford and Westmeath, HSE nursing home fees for resident care are double those payable to private and voluntary counterparts.

Tadhg Daly, NHI CEO states: “While the funding crisis has led to the closure of over 20 nursing homes the past year, the already considerable gulf in payments to HSE nursing homes has increased. HSE nursing homes now, on average, are receiving close to an average €800 extra funding per resident, per week, for nursing home care. In January 2022, the average difference was over €600 per resident and it is now approaching €800. Fees payable to HSE nursing homes signify the reality of nursing home care costs. There are multiple analyses of Fair Deal finding the fee setting process, which is not applicable to State nursing homes, is not commensurate with the reality of nursing home resident care costs. HSE nursing homes are provided with fees that are commensurate with resident care costs. The chasm in how the State funds its own nursing homes represents discrimination against nursing home residents and those entrusted in meeting their health and social care needs. It is discriminatory use of public funding and private and voluntary nursing homes are forced to close while HSE nursing homes receive multiples in funding.”

A Value for Money Review commissioned by the Department of Health pointed to the discrimination in fees payable prohibiting the capacity of private and voluntary nursing homes to compete with HSE nursing homes in remuneration for healthcare assistant staff. Mr Daly said: “The discrimination being operated under Fair Deal has a direct effect upon the ability of nursing homes to appropriately remunerate and retain staff who are vital to meeting our older population’s health and social care needs. The prejudicial process discriminates against staff in private and voluntary nursing homes. A Fair Deal that is fair to all providers should be underpinned by the principle of equal pay for equal work.”

NHI has called on Government to expedite its continually stated commitment to implement measures to bring stability to the sector, which was recently reiterated within its Sláintecare progress report. Incredibly, the apparent urgency to address the cost of care crisis is resulting in the development of a policy paper on the future direction of the sector being put on hold. Mr Daly states: “A cost of care crisis continues to present for nursing home care in Ireland, with 20 nursing homes closing their doors the past year. It is a crisis that has been acknowledged by Government on a long-standing basis, yet repeated promises to bring into effect a response are still outstanding. It is irresponsible and bitterly disappointing that it has now stalled on implementation of a policy paper to provide the sector with much needed direction. Communities are losing nursing home care services and this will have very detrimental implications and leave health and social care without vital services. The closures will continue until urgent stability and confidence is brought into being by Government. A key learning emerging from Covid19 was the absence of policy and direction to support nursing home care. The failure to push on in bringing into effect systematic reform highlights an unwillingness to implement the recommended fundamental reform in how nursing home care is delivered.”

Tadhg Daly is available for further interview. Interviews will be facilitated by Michael McGlynn, NHI Communications and Research Executive, who can be contacted at 087 9082970. 

Note for Editor 

  • Click here for a breakdown of the average fees payable on a county-by-county basis and nationally.
  • Extract from Sláintecare Progress Report 2022, published 28thMarch, page 61.
    • Deliverable: Develop a policy paper on the future direction of long-term residential care infrastructure and financial sustainability.
    • End of Year Position Status: Significant Delay Deliverable
    • Comment – end of year position: Scoping work has commenced on the development of this paper, however this project is now paused. Immediate sustainability concerns must be addressed as a priority therefore resources have been reallocated accordingly. Any measures to address nursing home closures and other  reductions in capacity in the short term will involve consideration of impacts on long-term sustainability.

National Media Coverage

RTE Morning Ireland & Online: More nursing homes will close without extra funding – expert

Irish Times: Private nursing homes closing due to Fair Deal ‘discrimination’, claims Nursing Homes Ireland

Irish Independent: HSE nursing homes receiving €744 more per Fair Deal resident than private facilities

Irish Examiner: Reduced State funding for private nursing homes linked to closures

BreakingNews.ie: Urgent action needed to prevent closures of private nursing homes