THE UNEXPECTED revelation that the Fair Deal nursing home support scheme has already exceeded its funding target for 2011 is a worrying development.
The system was set up under the previous government to replace the system, whereby older people were given a subvention towards part of their private nursing home costs. It had become increasingly difficult for many to bridge the gap between the subvention and the cost of residential care. Under Fair Deal, a maximum 15 per cent of the value of a person’s home plus a portion of their pension is transferred to the exchequer in return for a nursing home bed.
Now, with the scheme under review by Minister for Health James Reilly, and notwithstanding his announcement that €100 million earmarked to fund nursing home beds under the scheme had been diverted by the Health Service Executive (HSE) to pay for drugs and therapies, many older people are concerned about their future. A nightmare scenario, in which they may be faced with joining a waiting list until a nursing home resident vacates their bed or dies, cannot be discounted pending the outcome of the ongoing review.
From a health service perspective, the scheme’s suspension heralds some uncomfortable scenarios that are likely to materialise later in the year when any temporary boost to funding comes to an end. As the recent TILDA study into the lives of older people illustrated, the Republic’s community care services remain significantly under-developed. They are in no position to take up the slack from an under-funded Fair Deal and the prospect of an increasing cohort of patients, who are fit for discharge from acute hospitals, being unable to access private nursing home care and having to remain in a hospital bed is not one health service managers will want to contemplate.
However the issue also flags broader areas of concern. How could some €100 million out of €1 billion we were assured had been ring-fenced for nursing home beds be diverted by the HSE for occupational therapy and other treatments? The Minister must establish whether this represents unofficial policy within the executive to move around large tranches of funds as monetary pressure builds up steam.
As long as the HSE continues to refuse final approval to nursing home applicants, the stress on older people and their families will continue. They entered Fair Deal in good faith; the State cannot now renege on its part of the bargain.