Posted by Nursing Homes Ireland Submission for Budget 2024
Introduction
Nursing Homes Ireland is the representative organisation for the private and voluntary
nursing homes sector.
This sector, and the care our Members provide, are intrinsic to healthcare delivery in
Ireland.
Having high quality nursing home care available to those who need it is an essential part
of a well-functioning health service which delivers the care people need in a way that is
affordable, accessible, and of the highest standard.
………….
The private and voluntary nursing home sector, through its 420 homes:
- is providing care in a ‘home from home’ for 27,500+ persons.
- Accounts for 80% of all long-term care beds in the country
- Provides direct full and part-time employment to 35,000+ persons.
- Provides diverse, wide-ranging employment that includes nurses, carers, caterers,
admin staff, and ancillary workers. The 420 private and voluntary nursing homes
also play a lead role engaging local health and social care professionals including
GPs, therapists, dieticians, physiotherapists. - Contributes in excess of €220 million annually to the exchequer through direct
taxation. - is the most appropriate care setting for older persons assessed as requiring long
term care. - provides care in local communities throughout Ireland, in line with Sláintecare.
- reduces pressure on acute hospitals and the health budget, with private and
voluntary home care costing 1/8 of the cost of an acute hospital stay.
The 35,000 persons directly employed by the private and voluntary nursing home sector
contribute significantly to the exchequer on an annual basis through direct taxation paid.
Nursing homes are the largest single employer in many communities throughout Ireland.
Hundreds of millions are also paid directly by the sector on an annual basis to the State
through payment of commercial rates, water charges, VAT and other associated
contributions to economy offered by service providers who operate on a round-the-clock
basis.
Nursing homes provide more appropriate care for individuals whose specialist care needs
would otherwise have to be met in an acute hospital setting.
Significantly the costs of providing this care in an acute hospital are a multiple of between
five and eight times the cost of providing nursing home care.
These dedicated health settings within our local communities fulfil a critical and key role
for thousands across the country in healthcare delivery and job facilitation………..
Introduction
This pre-Budget submission is presented amidst a continuing and severe crisis for the
private and voluntary nursing home sector throughout Ireland. This ongoing crisis arises
from escalating costs that are not sufficiently acknowledged or covered by the fees
provided under the Fair Deal Scheme (Nursing Homes Support Scheme), which is
administered by the State.
Without immediate and urgent action by the Government, this ongoing crisis, will manifest
in:
- People requiring the 24/7 clinical, health and social care provide by nursing homes
being denied timely access to it, which presents severe implications for people
requiring such care. - People having to avail of this specialised care far removed from their local
communities. - The loss of vital step-down services for acute hospitals, resulting in extended
delays in the discharge of patients back into the community. - Impact on already overstretched acute hospitals/A&E, with patients being treated
on trolleys in many parts of our country.
Much like the rest of society, the nursing home sector is not alone in feeling the pressures
of inflationary costs. However, as such costs are not being recognised under the Fair Deal
Scheme, nursing homes are uniquely affected by increased cost of care including any
statutory imposed costs.
We are seeing nursing homes being forced to shut due to such impacting costs, as they are
no longer able to afford the costs given the fact that homes are locked into fees under the
Fair Deal. Since 2017, over 70 nursing homes have been forced to close, with an alarming
1,800 beds lost with residents having to move from what is their home.
Make no mistake, nursing homes, are homes first and foremost. With closures forced upon
nursing homes, residents are being forced to move to another location, further from family
and friends, at a time in life when they should be content, secure, and not in fear of losing
their home at the end of their lives. We should be celebrating our ageing demographics
and the fact that people are living to older ages. Instead, we must contend with the
alarming possibility in the absence of increased funding under Fair Deal in which our
nursing home and healthcare sector will not be able to provide sustainable, high-quality
care to our older population.
………….
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Conclusion
Without urgent government action, the nursing home sector’s crisis will deepen with
further closures inevitable, affecting residents, families, staff, and the broader healthcare
system.
Implementing these requirements will help ensure sustainable, high-quality care for
Ireland’s ageing population.
- Nursing Homes Ireland requires that all proposed state cost measures undergo a
full Regulatory Impact Assessment (RIA). This should be fully costed and
provided for in NHSS Budget. - To sustain local nursing home services and to stabilise the sector in the coming
years, the private and voluntary nursing homes require an immediate
“Stabilisation Fund” of €265 million. - Nursing Homes Ireland requires that the Government support equal access to
primary care services, equipment & appliances for all older people regardless
of whether they are living at home or in a public, private, or voluntary nursing
home. - Nursing Homes Ireland requires that the role of the Healthcare Assistant to be
recognised as a professional occupation by CORU. Nursing homes must be
properly resourced through the Fair Deal scheme to enable them to appropriately
remunerate such care staff.
The government must prioritise these actions in Budget 2025 to address the immediate
needs and long-term sustainability of nursing homes.
As the national representative voice of private and voluntary nursing homes, we are
available to meet with Ministers and Officials to present and provide further information
and detail if required.
We would welcome any invitation to meet, discuss and deliberate on the requirements
made in this pre-Budget submission
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The Fair Deal is portrayed as if the elderly are provided with full-time care in a nursing home at the cost of the State. This is far from the case. 80% of income of the elderly goes to the nursing home and supposedly 20% to the person. All assets are assessed and inheritances too. The person who receives State pension and has no other other assets can share a room with a person who has a State pension, personal pension, proceeds of assets.
Microsoft Copilot has come to my rescue. Yes Artificial Intelligence. See below:
The Fair Deal Scheme, also known as the Nursing Homes Support Scheme, provides financial support for those needing long-term nursing home care in Ireland. Here are the key details:
How It Works
- Assessment: The Health Service Executive (HSE) assesses your care needs and financial situation to determine eligibility and the amount you need to contribute.
- Payment: You pay a portion of the nursing home costs based on your financial assessment, and the HSE covers the remaining balance12.
Coverage
The scheme covers:
- Accommodation and food
- Nursing and personal care
- Laundry services
- Basic aids and appliances needed for daily living12.
Not Covered
- Short-term care (respite, convalescent, or day-care)
- Extra fees for services like hairdressing, therapies, or activities12.
Application Process
- Apply: Submit an application to the HSE.
- Assessment: Undergo a care needs and financial assessment.
- Approval: If approved, you receive financial support towards your nursing home costs12.
Additional Options
- Nursing Home Loan: If you have assets like property, you can defer payment until after your death using a loan secured against your assets1.
For more detailed information, you can visit the Citizens Information or HSE websites.
Is there anything specific you would like to know more about?
Thankyou AI for this
Who Watches the Watchers? 
I visit a lot of nursing homes and have noticed they are increasingly reliant on foreign staff. While these care assistants are usually very kind and professional, the old people tend to feel disoriented, especially if they have early-stage dementia and have suddenly been placed in a nursing home – it’s too much for them to process in their confusion and distress. Irish people don’t want to work as care assistants because the pay is poor despite the great responsibility and emotional energy needed to do this very important job. People from poor countries are used to poor working conditions, so they accept the low pay and terrible working conditions. The result is a lot of frightened, confused old people effectively living in a “foreign” environment where the staff speak to them in basic English and have no shared cultural references. If you didn’t have dementia going into this kind of environment, you’d soon develop the condition – even if the staff do their best, they cannot provide that familiarity old people crave. And yet there is often no other option for old people who are too vulnerable to live alone.
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