Fair Deal scheme and nursing homes

A predictable crisis

Sir, – Another day, another privately owned nursing home leaves the Fair Deal scheme (“Appeal for help as nursing home exits fair deal scheme”, News, May 30th). This was predictable and was predicted.

HSE nursing homes are paid from the Fair Deal scheme about €800 per resident per week more than is paid on behalf of the HSE to private facilities (“‘Tidal wave’ of nursing homes may leave Fair Deal scheme”, News, May 12th). That’s of the order of €40,000 per resident per annum.

Why? You quoted a HSE spokeswoman. HSE-run facilities have more staff per resident, they are paid more and they have greater leave entitlements.

Let’s think about that.


Either the private facilities are understaffed or the public nursing homes are overstaffed. One assumes that private nursing homes would not be allowed to participate in the Fair Deal scheme if they were not adequately staffed.

This leads one to the conclusion that HSE facilities have more staff than is necessary for the safe delivery of care.

The lower rates of pay in the private sector must be what those in the public sector who set the payments to private operators consider to be a fair rate for the job.

But they pay their own staff significantly more and give them longer paid leave. The public and private facilities compete for staff in the same labour market. Which would you choose if you were looking for a job?

A few years ago the HSE offered as another justification for the substantially higher payments made to its own facilities the fact that many of its buildings are old and inefficient while private facilities are purpose-built as nursing homes.

The only sense I could make of this was that private operators were paid less because they provided superior facilities.

Kafka would have made something of this nonsense. – Yours, etc,



Dublin 6.