Abandonment of the interests of an aging population by successive governments has not been confined to pensions. Public nursing homes, community based facilities and care packages for people who wish to live at home have all been neglected in favour of acute hospital services. They represent failures of political nerve and a reactive, rather than a proactive, response to health service reforms.
Sufficient investment has not been made in upgrading and refurbishing public nursing homes, leading to threats by the Health Information and Quality Authority (Hiqa) to withhold registration from some institutions. At the same time, the private nursing home sector has been campaigning for an increase in State funding on the basis that its services are more competitive. The sector has drifted since former minister for health James Reilly announced in 2011 that up to two-thirds of public nursing home beds might close. Saving money was the priority then, as was evident from a penny-pinching approach to the Fair Deal nursing home scheme. To defuse criticism, a commitment was made to keep elderly people in their homes for as long as possible by providing attractive homecare and residential community packages. Little has happened.
In response to this developing situation, Fianna Fáil has proposed to confer statutory healthcare rights on people who wish to live in their own homes, rather than in nursing homes, if they qualify under a Fair Deal assessment. A Private Members' Bill is due to be published in September. The scheme has obvious attractions because it would probably reduce the very large number of 'low dependency' residents in nursing homes and cut costs. But it may also, for the first time, introduce a system of charges for homecare services now funded by the Health Service Executive. The Because of the vulnerability of elderly clients, service providers should be bound by statutory regulations. A single, countrywide system of assessment and entitlement should also apply.