Fair Deal – fairly good but fairly slow

WITH the Nursing Home Support Scheme, better known at the Fair Deal, nine months old, there still remains some doubt over how it operates, who should apply (and when) and how quickly those applications are being processed.
The Health Service Executive (HSE) has confirmed that of the approximate 12,800 applications they have received so far, 7,800 have been processed. That means 5,000 have not. This means that over the first nine months of its operation, only 60% of applications have been processed. The most significant piece of information is that it is taking up to six months for some of the applications to go through the system.
So, if you are considering applying to the Nursing Home Support Scheme, you should do so right away, as you may be waiting some time to find out if you have been successful.
It is not all bad news though. HSE figures also indicate that very few applications, fewer than 1% in fact, are being rejected. This figure is at zero for anyone who is already in receipt of a subvention as they have, technically, already been assessed as requiring nursing home care – the first hurdle in the application process.
Nonetheless, this still leaves the Fair Deal falling some way short of removing the financial worries that older people face when it is necessary for them to move to live in a nursing home. While the odds are strongly in their favour, there will still remain, until the claim is processed, a doubt as to whether they will be accepted.
In fairness to the HSE, the process of making an application is straightforward enough and their website contains a comprehensive set of frequently asked questions. These cover issues like how to make an application on behalf of a third party whose mental capacity may be diminished, to the precise breakdown of how the charges against a person’s property will apply. We in Nursing Homes Ireland have also published a Guide to Choosing a Nursing Home, including information on the Fair Deal. The NHI guide is available on www.nhi.ie or call 01 4292570 for a postal copy.
However, some aspects of the scheme are not widely realised and are worth considering.
The first element to be aware of is that the scheme replaces the existing Nursing Home Subvention Scheme. Individuals already in receipt of subvention may retain their existing arrangements or may opt to transfer to the new scheme if they so wish. However, if you do not already have a subvention, or are coming to a nursing home for the first time, the Fair Deal is your only option.
Whether you are making an application for yourself or a relative, there is one other major element of the Fair Deal that you should factor in. It does not cover every expense that a person in a nursing home might incur. Exempted from the scheme are “luxuries” like hairdressing and newspapers. More significantly and potentially much more expensive, a whole range of therapies, ophthalmic, dental and social programmes are also excluded. 
Given that the Fair Deal takes 80% of a person’s regular income as well as up to 15% of the value of their home, this can have a huge impact on personal budgets. Where the nursing home resident’s only income is a pension – the amount left over for discretionary spending could be very small indeed.
The final point that may concern some people is whether the funding for the scheme will run out and what happens then. A cynic might point out that the slow rate of processing of the applications will have the happy outcome of ensuring this does not happen. The evidence from nursing home operators is that the process of getting paid, even once the applications are approved, is tortuously slow. In fact, the HSE, in its latest monthly performance report has stated that it has spent more than anticipated on the Fair Deal so far. It has also stated that its figures still indicate that there is enough money in the kitty for the full year. Everyone involved in the sector hopes that this will be the case. 

Tadhg Daly is chief executive of
Nursing Homes Ireland