Cost of ‘Fair Deal’ scheme could rise significantly, department warns

Budget 2018 paper says spending on programme covering 23,000 ‘sustainable’ so far

The cost of the “Fair Deal” nursing homes scheme has been sustainable for the exchequer so far but funding requirements could increase significantly in the future, the Department of Public Expenditure has warned.

In a paper published as part of the Budget 2018 documentation it said exchequer spending on the scheme – which covers about 23,000 people – increased by about €34 million over the last three years to €917 million this year.

The paper said that “per-client” costs had been increasing, but within reasonable levels. It said part of this increase had been offset by clients paying more towards their own care. It said as a result the exchequer bill had “not been increasing beyond what is affordable”.

However, the Department of Public Expenditure warned there were upward cost pressures that were already affecting exchequer expenditure on the scheme – which is known technically as the Nursing Homes Support Scheme (NHSS) – in the first half of 2017.

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“If these cost pressures are to materialise further the funding requirements for the scheme might increase substantially.”

The paper said that in addition there were a number of developments within the scheme “that might jeopardise its sustainability going forward”.

“These developments include:

*the review of the price of care in private nursing homes negotiated by the National Treatment Purchase Fund which is due to be to be carried out

*the maintenance of income contributions in line with the scheme

*the response to additional charges incurred by private nursing homes on NHSS clients.

“For the scheme to stay financially sustainable it is important to keep track of ongoing trends in the scheme and properly cost all changes that are being considered,” the paper concludes.

Martin Wall

Martin Wall

Martin Wall is the former Washington Correspondent of The Irish Times. He was previously industry correspondent