THE SO-CALLED “fair deal” scheme for nursing home care has finally been introduced, nearly two years behind schedule. However, rather than putting an end to the confusion and anxiety that affects older people when faced with the prospect of high nursing home charges, the manner of its implementation by the Health Service Executive (HSE) has perpetuated those concerns. And it is hard to distinguish the “fair, equitable, transparent and progressive system” promised by the Minister for Health, Mary Harney.
The HSE appears determined to close many public nursing homes and to encourage clients to move to the private sector. That is the logic behind its costing of public services, where the total care costs tend to be higher for public nursing homes than for those in the private sector. The methodology used in that exercise is open to question, particularly as private homes were asked to engage in a competitive tendering process.
There are other concerns. Before citizens can become eligible for the new scheme they have to undergo a rigorous financial assessment, as well as a care needs assessment to determine whether they require long-term care at all. If successful, they may be placed on a waiting list because the HSE will be given a limited budget. The Department of Health acknowledges that such people may have to wait until funding becomes available. Does that mean these people or their families will have to bear the full cost of emergency nursing home care, without previous subventions?
Private nursing homes were asked by the National Treatment Purchase Fund to quote for services on a bed-and-board basis. Patients will have to pay 80 per cent of their incomes for this, along with deferred charges on their estates. All other medical requirements and services will have to be paid for separately out of remaining income, or by their families. The fact that these details are emerging two years after the legislation was published indicates a degree of confusion and penny-pinching that reflects badly on the system. Old people have traditionally been treated shabbily in this State. Little appears to have changed.
Some € 55 million was provided to fund an estimated 9,000 private nursing home places this year. But there may be 13,000 applicants. And the budget for next year has yet to be agreed. Such last minute administrative ambiguity is unacceptable. People who need nursing home care are confused and worried. They deserve a better deal.