Róisín Shortall urges clarity over nursing home charges issue

Social Democrats co-leader calls for a special sitting of the Oireachtas health committee

Former minister of state in the Department of Health Róisín Shortall has called on the secretary general from the Department of Health to come before the Oireachtas health committee to clarify details about the State’s legal actions in relation to nursing home charges.

Ms Shortall, co-leader of the Social Democrats, told RTÉ Radio’s Morning Ireland that she was minister of state with responsibility for primary care and did not have any role in terms of nursing home care or long-stay care, and had not been briefed about the reported memo.

As reported in today’s Irish Times, department official Shane Corr emailed Taoiseach Leo Varadkar on December 22nd, 2019, copying the Dáil Public Accounts Committee, expressing concern that billions of euro in repayments of long-stay nursing home charges were being put “out of reach” of “largely old and helpless people”.

A protected disclosure made by Mr Corr, published in a Sunday newspaper, revealed a Department of Health 2011 memo purporting to set out a legal strategy to thwart refunds of potentially billions of euro to people wrongly charged for nursing home care over 30 years.


There seemed to be a lot of confusion about the memo, she said, which was why the actual memo should be published. “There’s a number of documents that are critical to this entire issue. And those documents need to be published. And we need to have an opportunity to actually see the facts involved in this,” she said.

Ms Shortall said she was not surprised at the lack of certainty around charges generally and around legal entitlement to healthcare.

“This has been a problem for many, many decades and still remains the case within the health service – the law in relation to entitlement to care. It talks about eligibility that people are eligible for care, but they don’t have a legal entitlement.”

This had always been a grey area, she said. Sláintecare called for clarification on the legal entitlement to public healthcare. “We are very unusual in this country in not having that.”

“What there is, is eligibility. You can be eligible for public services, but that doesn’t necessarily mean that the services are there and that there was an element of that. I think throughout the [2000s] when there was certainly public debate on the issue in relation to who should be entitled to public healthcare in long-term settings and who should be required to pay for them,” she said.

The situation changed throughout the 2000s, said Ms Shortall. Under 1976 regulations, the health service could charge people who did not have medical cards for nursing home care.

“But we know also that, in addition to that, people who had medical cards were also charged, and that needed to be addressed. In 2004, there was a clear direction on that. The government then tried to subsequently legislate to charge everybody, and that was struck down in 2005. They brought in new regulations in 2006 allowing them to charge everybody and that lasted until 2009 when the Fair Deal scheme was introduced, which provided greater certainty in relation to who had to pay and who hadn’t.”

Ms Shortall said the Taoiseach and the subsequent minister for health Simon Harris had to clarify when they were briefed about the memo. “That’s another document that we need to see.”

Ms Shortall called for a special sitting of the Oireachtas health committee at which the secretary general from the Department of Health, Robert Watt, and a representative from the legal section in the department “would come in and brief the health committee on all of the background to this, because there are conflicting reports on what actually happened. The allegations are being made in the Mail and then the Government has a different view on that. So it’s important that we see those documents and that people can make up their own mind.”

The Government of the day had to balance and decide how to treat people fairly and not expose the State to a huge liability, she said. “The potential liability is also contested at the time. You know, it’s reported that that potential liability was in the region of €12 billion that was split between public and private patients.” The total cost ended up being half a billion euro, she said, which again was conflicting information.

“The whole saga goes back decades. And I think it’s important that if we’re going to have a debate, that the full debate and all of the information is made available and the documentation is released. So I think it’s reasonable to leave it until next week. I think it should be early next week for the Dáil debate to take place.”

Vivienne Clarke

Vivienne Clarke is a media monitor and reporter