Sir, – I refer to the letter "Fears for future of dementia centre", (Colin Lang, December 9th) and your coverage regarding threatened closure of St Joseph's Shankill, Dublin.
Incredibly the State has persistently ignored independent analysis of nursing home care that informs the funding model; and resourcing of nursing homes does not match the cost of delivering the specialised care that nursing homes provide.
In 2015, the Dementia Services Information & Development Centre research report, An Irish National Survey of Dementia in Long-Term Residential Care, found the private nursing home sector is “the main provider of specialist long-term care to persons with dementia”. It recommended “The complex and high dependency needs of persons with dementia in specialist care units now need to be more realistically reflected in fairer resource allocation, in recognition of the skill mix of staff employed in specialist care units, their training needs and the level of care expected to be delivered to residents with dementia”.
Yet, to the detriment of nursing home residents with complex and high-dependency care needs, no action was undertaken by the State.
Also in 2015, the Department of Health published a report it commissioned DKM Economic Consultants to undertake to assess the effectiveness of Fair Deal.
Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities stated, “It is untenable that the State quality regulator can assess differentiated dependency levels and in doing so impose costs on nursing homes, while the State price regulator claims it is unable to reflect the same factor in its pricing decisions”.
It described Fair Deal as operating in an ad hoc manner, lacking rationale, consistency and fairness, and being unsustainable.
The State has turned a blind eye to these deep-seated issues. It tasked the NTPF, the commissioners of nursing home care under Fair Deal, with reviewing the effectiveness of the Fair Deal pricing mechanism.
This review has been two-and-a-half-years delayed.
While the State procrastinates, the regulator Hiqa has reported for two consecutive years nursing homes are closing their doors because Fair Deal fees are not recognising the reality of costs incurred.
As the letter presents, private and voluntary nursing homes are “simply asking to be paid what the HSE pays itself.” Is this really too much to ask?
The discrimination against residents in private and voluntary nursing homes must stop.
Time for the Minister and Government to bring accountability to the NTPF. Time for fairness and equality in the allocation of resources for all nursing home residents. – Yours, etc,
TADHG DALY,
CEO,
Nursing Homes Ireland,
Dublin 24.