NHI calls for immediate linkage between population and long-term healthcare as applied to politics

Thursday September 21, 2023

NHI calls for immediate linkage between population and long-term healthcare as applied to politics

21st September 2023: Nursing Homes Ireland is calling on Government to protect long-term residential care services for our ageing population by applying the same principles it applies to the political system to ensure proportional provision is in place. In tandem, it has called for it to prioritise bringing into effect a long-standing recommendation to Government for a framework to bring key stakeholders around the table to identity strategies to ensure and sustain provision of quality long-term residential care. The call is being made at the organisation’s Annual Conference in Lyrath Estate in Co Kilkenny, taking place Thursday 21^st September, against a backdrop of further closures of nursing homes with another 18 over the calendar year, indicative of an unprecedented crisis in older person care.

Tadhg Daly, NHI CEO, states: “It’s logical that our Constitution stipulates constituency reviews are necessary to accord political representation with population demographics. Yet there’s no such logic or stipulation whereby long-term residential care services will be provided in accordance with population need. We have the fastest growing older population in Europe, and multiple nursing homes have been closing their doors in quick succession. Forty-one private and voluntary nursing homes, representing around one-in-ten, have closed their doors the past four years. At our conference last year, we reminded Government we were in the midst of an unprecedented emergency for nursing home care and more nursing homes were anticipating closure in the weeks and months ahead. Since September 2022, 18 nursing homes have closed their doors, leading to 592 residents having the very upsetting experience of having to move home. By not affording long-term residential care the same status as that given to the political system, the continued reduction in nursing homes and nursing home beds will continue. The statutory entitlement to access nursing home care will be completely undermined when the care is unavailable to those requiring it, given communities won’t have nursing homes in place and bed availability is likely to be compromised.”

He pointed to NESC (National Economic Social Council) recommendation to Government in 2012, ten years ago, for actors within long-term care to be engaged on a strategic basis to meet the challenges of providing long-term residential care.

“Ten years ago, the National Economic and Social Council recommended to Government stakeholders, including nursing homes, HIQA, as regulator, and the NTPF, as the body responsible for the purchase of care, be part of a forum that would examine and address the challenges presenting in the provision of nursing home care. Ten years on we’ve seen nursing homes isolated during the initial period of Covid19 and providers now closing their doors within communities, never to return, and there is no forum or framework in place to plan for our nursing home and extended long-term residential care needs. We’ve already become aware hospitals have experienced challenges in discharging patients back into the community via nursing home care because of the closure of nursing homes, exacerbating a long-standing crisis in our hospital emergency departments. Over 40 communities have lost nursing home care options the past four years and further are to follow. Given the Government’s continued failure to introduce an appropriate support mechanism to address the very considerable increase in costs, nursing homes are continuing to squeeze and more will move from survival mode to closure in the months ahead. No forum exists whereby the challenges, policy, planning and actions necessary to ensure long-term residential care issues and requirements are addressed.”

NHI is calling for the same principle to be afforded to healthcare and long-term residential care as per the political system, whereby population demographics are tallied and a framework is adopted and implemented to ensure appropriate provision is in effect. Demographic assessments should also be applied within healthcare to assess population healthcare service needs, with NHI warning many communities are being abandoned given the extent of nursing home closures. There is requirement for Government to lead in ensuring we have in effect policy and a framework to ensure requirement for services is provided based on population need and the services come into effect. NHI also called for an end to the discrimination applied in the funding of nursing home care between HSE and private / voluntary nursing home providers. Fees applied under Fair Deal by the NTPF are, on average, €744 more, per resident, per week for resident care in HSE nursing homes than those applied for resident care in private and voluntary nursing homes.

Mr Daly added: “We’ve the Department of Health and the ESRI projecting around 10,000 additional long-term care beds will be required in the next ten years. Yet HIQA reported a reduction in nursing homes and bed capacity in 2022. Giving it the same status as the political requirement to match representation with demographics, coupled with appropriate resourcing, can recognise, stipulate and address the need to ensure long-term residential care provision matches with population growth. Our over 85 population, who are most dependent on nursing home care, is set to double within 20 years. NESC’s recommendation has been sitting on a shelf in Government buildings. There is now compelling and urgent requirement to bring stakeholders together to be proactive in bringing into effect a framework to address the underlying crisis presenting for the sector and the need for long-term residential care across Ireland.”

Speakers at the NHI Annual Conference, hosted in the Lyrath Estate in Co Kilkenny, are to include Bernard Gloster, HSE CEO; Deputy Colm Burke, Fine Gael Health Spokesperson; Dr Chris Luke, retired consultant; Kieran Little, PwC partner who will speak on the report Challenges for Nursing Homes in the Provision of Older Persons Care.

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

 Note for Editor

1. Over the past four years, 41 private and voluntary nursing homes with 1,224 beds have closed their doors.

1. Article 16 of the Constitution sets out clearly and distinctly the overarching requirements that apply to the membership of Dáil Éireann. In addition, and complementary to the constitutional provisions of Article 16.2, Part II of the Electoral Act 1997 provides for a constituency review following each Census of Population.

1. NESC (The National Economic and Social Council),  Quality and Standards in Human Services in Ireland: Residential Care for Older People, July 2012. The report identified the contradiction in how nursing home care in Ireland is funded and regulatory requirements. Extract: “These problems raise the important issue of the combined effect of the decisions of the main actors in the standards framework, particularly the providers, HIQA and the Department of Health. Regularly sharing key information is likely to support a type of ‘fourth loop learning’, thereby strategic issues beyond the remit of only the regulator are identified and planned for (see Section 1.3 for a definition of triple loop learning). It could therefore be useful to establish a problem-solving group of those influencing the provision of long-term care (e.g. providers, the Department of Health, and HIQA) to examine and address the challenges of providing sufficient quality long-term care in an equitable and sustainable way.”