Nursing home owners warn against ‘scapegoating’ over Covid-19 deaths

NHI conference hears calls for increased funding and better preparation for an ageing population

Nursing home owners have warned against unfair blaming of their sector over deaths that occurred in residential care during the Covid-19 pandemic.

There is “an element of scapegoating” of nursing homes, particularly private homes, over deaths that occurred in residential care settings during the pandemic, according to Nursing Homes Ireland chief executive Tadgh Daly.

He was responding to an Irish Times report that up to 30 care homes could face criminal investigation depending on the outcome of a Garda inquiry into a test case involving the death of a woman in one home in 2021.

While declining to comment on any ongoing investigation, Mr Daly said the sector was “forgotten” at the time the pandemic started in 2020, when “no one knew what they were facing”.


Speaking at the Nursing Homes Ireland annual conference in Kilkenny, Mr Daly called for significantly improved State funding of nursing homes and warned that Ireland was poorly prepared for the projected increase in older people in the population.

“Our members are at the mercy of State-sponsored inflation. We’re not like a hotel that can increase its charges, we are on a fixed tariff,” he said. Private nursing homes have long maintained they receive much lower rates of support per resident than HSE-run nursing homes.

HSE chief executive Bernard Gloster said it was the “provider of last resort” and pointed out that in recent days the HSE had stepped in to take over the running of a private nursing home. Negotiations on the tariff paid to individual private nursing homes are in many cases taking place yearly, rather than at longer intervals, he also pointed out.

About 60 per cent of private homes have been given increases in support, in some cases amounting to 6-7 per cent, he added.

Mr Daly acknowledged some progress had been made but added: “the change has not been rapid enough and it is coming off a low base”.

“They’re trying to buy care on the cheap and there are consequences from that. We’ve seen it already in closure and, inevitably, there will be more, unless support is increased.”

Comprehensive geriatric assessment will be carried out on all patients transferring from hospital to nursing homes, starting in the coming weeks, Mr Gloster told the conference. Teams from the integrated care programme for older persons will carry out about 55 such assessments a week.

Residents of nursing homes should have the same access to specialist services as those living at home, he emphasised.

The number of over-65s in the population is set to double by 2050 – going from 14 per cent to 25 per cent – Karen Greene, deputy chief nursing officer at the Department of Health, told the conference.

By then there will be just 2.1 workers for every dependent person, compared with a ratio of 4.2 workers to dependents at present.

Voices from the conference

Mary Burke, director of care, Killure Bridge nursing home in Waterford

“The challenge for us is recruitment, trying to retain good-quality staff. We recruit them, invest in them and then they leave us for the HSE.

“We need to make working in our nursing homes more attractive.

“Unfortunately, our pay rates don’t match those of the HSE due to the funding we receive. If the National Treatment Purchase Fund increases our funding, we can then give that back to the staff. The only reason they leave us is for the extra money.

“We do recruit from overseas but there are huge additional costs involved – the average healthcare assistant recruited from overseas will cost €5,000, a nurse will cost €9,000-10,000. That’s a big challenge.”

Brian Fahey, owner of Killimor retirement home in Galway

“Our uppermost challenge is financial viability. Despite the fact we have invested heavily in the past four years – to the tune of €7 million just prior to Covid – we’re experiencing very high demand. We offer a very good service, but we cannot fund the cost of that. It’s becoming less and less viable for us to continue, despite the state-of-the-art services that we offer.

“In our area, HSE nursing homes receive about €2,000 per week per resident and our home receives about €1,000 yet we provide exactly the same service, under the same regulations, to the same standards.

“It’s a myth that HSE nursing homes have patients with more complex needs. The facts don’t bear it out, in many cases our dependence levels are higher. Sometimes we take patients who were not accepted by the public system because it couldn’t meet their needs.”

Ciaran Larmour, managing director of Glas Care Group, which runs three nursing homes in Dublin

“Funding is hugely important. We want to provide the best care we can to our residents but it gets harder and harder to do that when the funding is so tight.

“We’d love to be able to pay our staff much more but the funding increases we get don’t allow that.

Ciaran Larmour, managing director of Glas Care Group, which runs three nursing homes in Dublin. Photo by Paul Cullen Sept 21st, 2023

“Support from Government has waned since Covid ended. We aren’t up for contract negotiations with the NTPF (National Treatment Purchase Fund) until next year so we are bearing all the cost increases that have happened recently.

“It’s brilliant that people are able to stay at home longer but when they do come into the nursing home, they tend to be higher dependency and that takes more care.

“It is true that inflation has eased but the increases are still there and we haven’t been given the funding for them.

“We’re a small group in society, taking care of a vulnerable cohort. It’s a good service; we could make it better with improved funding.”

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times