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Nursing Homes Ireland welcomes acknowledgement by Minister for Health on nursing home fees

Friday November 15, 2019

14th November 2019: Nursing Homes Ireland has today welcomed the acknowledgement by Minister for Health Simon Harris that private and voluntary nursing homes have not been appropriately remunerated for a number of years for the provision of nursing home care. Speaking at the NHI Annual Conference, the Minister committed to publish the Fair Deal pricing review in the coming weeks and to meet with the sector to plan future care.

Tadhg Daly, NHI CEO said: “Today’s acknowledgement by the Minister is long overdue. We will be seeking to meet the Minister this month to follow up on his commitments to address Fair Deal fees for private and voluntary nursing homes.”

The Minister’s acknowledgement came as private and voluntary nursing homes overwhelmingly voted no confidence in the NTPF and the Fair Deal negotiation process. The actions of the NTPF and effectiveness of the Fair Deal scheme have come under national scrutiny arising from the current threatened closure of St Joseph’s, Shankill, due to the failure of the Fair Deal fee to meet the costs incurred to meet high dependency care needs of residents. Furthermore, the most recent HIQA Overview report for the nursing home sector, published in August 2019, stated for the second year running small nursing homes are closing their doors due to Fair Deal fees proving not sustainable for providers.

Minister for Health Simon Harris met representatives of NHI and St Joseph’s when he delivered the opening address to nursing home representatives from across the country at today’s annual conference at Citywest Hotel, Co Dublin.

Ahead of the conference, NHI undertook a snapshot survey of nursing home providers. 99 providers informed the survey that revealed there is an overwhelming lack of confidence in the NTPF in carrying out its responsibilities under Fair Deal and in the scheme itself. The organisation asked: “Do you believe the NTPF, during its negotiation process and in determining fees payable for provision of nursing home care, recognises the reality of costs being incurred to provide high-dependency, person-focussed, specialised care?” An overwhelming majority – 97% (96 of 99 providers) – replied “no”.

Furthermore, the providers were asked “Have you confidence in the NTPF Fair Deal Review Process?”. Nursing homes dissatisfied with the fee offered for the provision of care only have recourse to appeal the fee offered internally within the NTPF. Again, an overwhelming majority – 96% (94 of 99 providers) – replied “no”.

Tadhg Daly, Nursing Homes Ireland CEO, said the sector has lost confidence in the NTPF. He said: “The actions of the NTPF and the effectiveness of the Fair Deal scheme have come under scrutiny arising from the threatened closure of St Joseph’s, Shankill. Our survey informs specialist care providers across the country are stating Fair Deal is fundamentally flawed because of the failure by the NTPF to recognise the reality of costs incurred. It should spark huge concern when the independent regulator HIQA goes on record for two successive years to report nursing homes are closing their doors because the fees entailed are not commensurate with costs to provide the specialist care that nursing home residents require. Last week, through St Joseph’s, we were provided with a glaring insight into what is arising within our sector. 25 nursing homes have closed their doors since 2013. In 2015 the Department of Health was disturbingly informed in a report it commissioned fees payable under Fair Deal are not commensurate with costs entailed to ensure regulatory compliance*.

“Nursing homes are being put to the pin of their collar by the NTPF as a monopoly purchaser that offers a flat fee that is ignorant of the reality of costs incurred. Behind the sustained, unreasonable and coercive approach is a failure to appropriately fund the high-dependency, specialised care needs of nursing home residents.  The flat fees being offered are squeezing nursing homes to the extent that smaller providers are being forced to close their doors. Nursing homes in our rural communities in particular are under sustained threat and will have to close their doors like St Joseph’s if the NTPF doesn’t change its tune.”

The absence of independent appeals mechanism intensifies providers lack of faith in the Fair Deal process, as enforced by the survey. Mr Daly said: “Implausibly there is no independent recourse afforded to specialist healthcare providers should they fail to agree a fee with the NTPF. This represents a great injustice within our health services. As evident, from our survey and feedback derived, providers have no confidence in what is effectively a kangaroo court. At our conference we will be reiterating our call to the Minister for the establishment of an independent appeals mechanism and publication of the review of the Fair Deal pricing mechanism that is now over two years delayed.”


Tadhg Daly, NHI CEO, is available for further comment. Contact Michael McGlynn, NHI Communications & Research Executive at 087 9082970.

Pictures are available from Lensman PR Photography. Contact Lensman at 01 8197738.

Note for the Editor

*DKM Economic Consultants, Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities (December 2015, commissioned by Department of Health). “In short, 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.”