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Dr Michael Harty, who has apologised for attending the controversial Oireachtas Golf Society dinner in Clifden. Photograph by John Kelly

disparity in Fair Deal funding for nursing homes

THE glaring disparity between public subvention provided to public and private nursing homes came under the spotlight this week as some residential care facilities request more personal protective equipment (PPE) to cope with the Covid-19 pandemic over the coming weeks.

In a week when a local lobby group issued a public appeal for people to donate PPE, a huge gap has emerged in terms of state funding provided to different local nursing home operators.

According to figures obtained by the Clare Champion, some public nursing homed are getting almost twice as much public subvention under the Nursing Homes Support Scheme (Fair Deal) compared with their private counterparts.

Under the NHSS, the cost of care in Clare’s public nursing homes is €1,607 in St Joseph’s Community Hospital, Ennis; €1,650 in Raheen Community Nursing Unit; Ennistymon Community Unit €1,481 and Regina House Community Nursing Unit, Kilrush, €1,422.

This compared to €830 for a single or shared room in St Dominic Savio Nursing Home, Liscannor; €885 in Athlunkard Nursing Home, Westbury; €970 in Carrigoran House Nursing Home; €910 in Kilrush Nursing Home; €870 in Riverdale House Nursing Home, Blackwater, Ardnacrusha; €910 in Ennis Road Care Facility, Meelick; €870 in Sancta Maria Nursing Home, Cratloe; €920 in Cahercalla Community Hospital, Ennis; €975 in Ennis Nursing Home, Ennis; €940 in the Lakes Nursing Home, Killaloe; €825 in Kilrush District Hospital and €905 in St Theresa’s Nursing Home.

Dr Michael Harty said the majority of patients in nursing homes were availing of the Fair Deal Scheme and about 20% were paying from their own resources but would probably have to participate in this scheme when their assets run out.

“Community nursing homes and small family run nursing homes are put to the pin of their collar to make ends meet. I always took issue with the fact the government was franchising out the care of our elderly population to the private system.

“I always felt the public system was retracting from long term residential care, which was first signalled by former Health Minister Mary Harney who put in place a lot of tax incentives and grants for the building of private nursing homes in 2005, 2006 and 2007,” he said.

“If a nursing home doesn’t have a lot of resources they are going to have great difficulty meeting demand for the purchase of PPE.

“Everyone in a nursing home is a public patient. They have a medical card, are over 70 and are dependent on the state for their medical services.

“All these patients should be treated equally but that hasn’t been the case. Nursing Homes Ireland has been left to their own devices to try and deal with this crisis and belatedly the HSE realised there was a crisis in nursing homes and are now only upping their game with testing and other supports,” he said.

He recalled there was a major upgrading of Regina House, which was government funded while community nursing homes in Clare have to achieve from fundraising and their own resources to bolster the subvention they receive from the Fair Deal scheme.

The Clare Champion has learned that fees under the Fair Deal scheme are set by the National Purchase Treatment Fund every three years with no independent appeals process.

Nursing home operators in Clare have confirmed the fees provided under the Fair Deal Scheme has an impact on how much expenditure they can afford on costs such as staffing and purchases such as badly needed personal protective equipment.

Nursing Homes Ireland chief executive officer, Tadgh Daly states private and voluntary nursing homes are seeking fair fees to provide specialised care and are dismayed that fees under the Scheme are not commensurate with the reality of costs or those given to HSE homes.

“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 between public and private sector fees.”

“The State is effectively applying mass discrimination against older people supported by Fair Deal in private and voluntary nursing homes. The HSE is paying its nursing homes fees that are multiples those payable to private and voluntary counterparts. Private and voluntary nursing homes have had to close their doors due to fees payable under Fair Deal not being sustainable and are operating under unnecessarily severe financial pressure.

The national HSE stated the cost of care for private nursing Homes is set by the National Treatment Purchase Fund and the HSE has no involvement in that process.

It noted the Department of Health is currently undertaking a review of the cost of care at Nursing Homes and the outcome of that report will be issued in the near future.

The HSE publishes the cost of providing care in public residential services for older people and the the most recent publication was on February 27th 2020.

The Department of Health hadn’t responded to queries at the time of going to press.

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