Nursing homes funding model is ‘not fit for purpose’
The body representing nursing homes is warning policymakers that changes are required to meet the needs of the country’s aging population, and has increased its lobbying of TDs for measures it wants to be implemented.
Top of its agenda is the overdue publication of a review of the pricing of the nursing home support or Fair Deal scheme.
The HSE-operated Fair Deal scheme, established in 2009, gives financial support to those who need long-term care in a registered nursing home. Applicants undergo a financial assessment — including an analysis of assets and savings — to determine how much they pay towards the costs, while the State picks up the rest.
The National Treatment Purchase Fund (NTPF) has negotiated the maximum prices paid to the nursing homes.
However Nursing Homes Ireland (NHI), which represents more than 360 members in the sector, argues that the current funding model, introduced with the scheme 10 years ago, is not fit for purpose.
It says a 2015 review of the scheme supports this argument.
This review led to the establishment of a steering group chaired by the NTPF which includes representatives from the Department of Health and the Department of Public Expenditure and Reform.
It was due to publish a pricing review of the Fair Deal scheme in 2017, but its findings have yet to be released.
“A cynic would say they’re afraid of what’s in it,” said NHI chief executive Tadhg Daly.
Mr Daly said the greater number of people living longer, combined with the rising complexities of an ever-aging population, bring with them increased demands on nursing homes.
He said the current financial model is unsustainable to meet these demands.
“We should be celebrating the fact that people are living longer, but we must plan to meet those requirements,” he said.
Nursing homes also need to be able to recruit from a wider pool of potential employees, said Mr Daly.
The NHI has said “a severe crisis” is facing the recruitment of healthcare assistants and that there are 1,300 roles that require filling within the sector.
Mr Daly highlighted changes to the Employment Permit Regulations last year which aimed to make it easier for businesses in the horticulture, meat, and dairy sectors to hire workers from outside the European Economic Area.
The pilot scheme will make 800 permits available, but will be subject to conditions.
“We are having huge difficulty attracting staff and are competing with the hospitality industry to bring in workers,” said Mr Daly. “Our members prefer recruiting locally for staff as it is more cost-effective but that can be difficult to attract both the quality and numbers needed.”
A third issue that has seen the NHI increase its lobbying efforts centres around access to GPs.
The NHI argues that the current general medical services contract is not fit for purpose in terms of providing GP care for residents in nursing homes.
It says GPs appear to be “overstretched and under-resourced”, and that a new GMS contract which includes specific reference to services for nursing home residents is needed.
The NHI said its members across the country are engaging with TDs on a “constituency by constituency basis” on the three issues.
