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NHI accuses HSE of trying to once again bury cost of public nursing home care

Thursday February 27, 2020

Nursing Homes Ireland has tonight, 27th February, accused the HSE of trying to bury the amount it pays pubic nursing homes by releasing the figures late in the evening on a busy news day where virus issues dominate.  NHI has also questioned the legality of the HSE’s actions by using money outside Fair Deal, separate to wage budgets, to top up the fees payable to public nursing homes under the scheme.  It has demanded the Government immediately publish the long-overdue review of the Fair Deal pricing mechanism, now approaching three years past its date for completion and continuing to be covered up by the Department of Health.

Tonight the HSE revealed it has again increased the national average fee payable to its nursing homes. Private and voluntary nursing homes were paid fees 66% below those payable to HSE counterparts when the fees were last published in June last year.

In the growing inequality of treatment between public and private and voluntary homes, the HSE has revealed it is paying wage increases to staff in its nursing homes from another budget outside of Fair Deal.  This budget is not open to private and voluntary homes to do the same.  Despite there being a statutory requirement to bring before the Houses of the Oireachtas the cost components for each of its nursing homes, including pay, the HSE is openly flouting this statutory requirement.  It has given no explanation as to why elements of pay are being funded separately from the Fair Deal Budget in the HSE nursing homes.  This raises serious legal issues as to the reality of HSE costs that have not been presented before the Oireachtas.

Tadhg Daly, Nursing Homes Ireland CEO states: “The HSE continues to utilise the €1 billion Fair Deal budget to increase payments to its nursing homes minus accountability. As the Fair Deal budget comes under huge strain and older people have faced weeks waiting to avail of its financial support, the HSE uses the budget to pay its nursing homes much greater fees than those payable to private and voluntary counterparts operating beside them. The Oireachtas Public Accounts Committee has expressed strong concerns regarding the value provided by the HSE in its utilisation of the Fair Deal budget. Yet instead of the gross disparity being addressed, State discrimination in the operation of the scheme is growing.”

“The Fair Deal scheme is fundamentally flawed, with no recourse for private sector and voluntary providers to independently appeal the fee set by the NTPF under the Scheme. Providers seeking fair fees to provide specialised care are dismayed that fees under the Scheme are not commensurate with the reality of costs incurred. As it stands, Fair Deal is leading to the closure of private and voluntary nursing homes and placing unsustainable cost pressures upon nursing home providers.  We are insisting that the next Government introduces a commitment to the introduction of an independent appeal process for nursing home providers under the Nursing Home Support Scheme (Fair Deal). This is a very legitimate and fair ask for private and voluntary providers within a scheme that is inherently unfair.

“From what budget are pay increases being met? There are serious questions to be asked of the HSE with regard to how it is funding nursing home care in its homes. Are operational and administrative costs entailed within the published fees or funded from a budget separate to Fair Deal?  It is important a new Public Accounts Committee is appointed soon to question the HSE increasing its own payments to its nursing homes without any oversight from anyone.”



Tadhg Daly, Nursing Homes Ireland CEO, is available for interview.  Contact Michael McGlynn, Nursing Homes Ireland Communications and Research Executive at 01 4699806 or 087 9082970.