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How the private sector can help build capacity for growing eldercare demand

Private nursing homes need parity with the financial provision made for public sector nursing homes if Ireland is to best support its ageing population, says the largest Irish independent provider of care services to the elderly

As the population ages, there is a need for a collaborative public and private healthcare approach.
As the population ages, there is a need for a collaborative public and private healthcare approach.
Wed May 03 2023 - 05:00

Michele McCormack, chief executive officer of Mowlam Healthcare Services, will be dispelling some myths at this year’s Future Health Summit.

She will address delegates as part of the event’s Care of the Elderly session. Her presentation will, she hopes, put some misconceptions about healthcare provision to bed.

“I hope to dispel some myths about the private sector with regard to the capabilities within the sector the patient outcomes and specifically those concerns about what motivates the private sector, that it’s all about the bottom line,” she says.

Private equity firm

“Yes the business has to be about the bottom line but we are all healthcare professionals working within that sector.”

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Nothing spells that out clearer than McCormack’s own CV.

She started her healthcare career as a teenager working as a nurse’s aide in Harold’s Cross Hospice and having trained and worked as a nurse in St Vincent’s, ended up as chief operating officer at both the Mater hospital and Blackrock Clinic.

She left it in November 2021 to join Mowlam Healthcare Services, the largest Irish independent provider of dementia, nursing home, respite, re-enablement and palliative care.

Set up in 2002 and bought by private equity firm Cardinal Capital Group in 2020, it has 27 nursing homes countrywide, with five more under development, plus a growing number of specialist Memory Care dementia centres.

She believes misconceptions about the private healthcare sector need to be addressed, and quickly, if Ireland is to best support its ageing population.

“We are all well aware that the Irish healthcare system as a whole does not have the supply to meet existing demand before the ageing population is even factored in,” says McCormack.

In 2022 CSO figures indicated that 768,000 people, or 15 per cent of the population, are aged over 65. That represented a 20 per cent increase in over-65s in just six years.

Changing profile

In addition to the capacity challenges, there is a changing profile of residents who have more complex needs.

“The number of people with dementia in Ireland is expected to increase from 55,000 to 113,000 by 2036,” she explains.

But with 29 nursing homes ceasing to provide care between 2018 and 2021 alone, she believes the Government needs to rethink its funding model.

“Private nursing homes need parity with the financial provision made for public sector nursing homes,” says McCormack.

The Department of Health’s recent value-for-money review found HSE nursing homes were provided with fees that were, on average, over €600 per resident per week more than the private equivalents.

She is clear about where the problem lies. “We need to rethink Fair Deal. It just does not work,” she says. “And it is not just nursing homes saying that. The Comptroller and Auditor General, the ESRI, the Oireachtas Public Accounts Committee, the Office of the Ombudsman, the Dementia Services Information and Development Centre, and Sage Advocacy have all said the Fair Deal Scheme is not fit for purpose.”

In addition to residential long-term care, the demand for inpatient and community-based rehabilitation, re-enablement, step-down and community-based supported care outstrips both current and projected demand.

“Additional capacity for defined pathways is required to support and deliver on key national clinical programmes, including stroke, national clinical programme for older people, trauma strategy and neuro-rehabilitation strategy,” she explains.

In addition to inpatient healthcare facilities nationwide, Mowlam Healthcare provides inpatient re-enablement, step-down, convalescence, respite and independent living units. It operates a continuum-of-care model, designed to support people who need additional care, or specialised services, at all levels of post-acute clinical complexity.

Multidisciplinary care

The company already has a demonstrable collaborative relationship with the HSE and a track record in delivering post-acute rehabilitation and re-enablement services.

It operates Mount Carmel Community Hospital, a 94-bed step-down re-enablement and rehabilitation inpatient unit on behalf of the HSE.

It also provides community-based multidisciplinary care, working in partnership with Healthcare Direct, a multiservice provider of allied healthcare services including physiotherapy, occupational therapy, speech and language therapy, and dietetics.

“As the population ages and there is an increased demand on inpatient and community-based services, there is a need for a collaborative public and private approach to the delivery of healthcare,” says McCormack.

Under the Department of Health’s National Clinical Programmes, more and more services will require delivery in community-based settings.

“The strategy and vision are there from the HSE, but it needs partners to realise it,” she adds. “We see ourselves as the obvious partner with which to do it.”