State could face €500m bill for nursing home upgrades

It could cost in the region of €500 million over a number of years to upgrade or rebuild 11 public nursing homes, Minister of State at the Department of Health Kathleen Lynch has estimated.

The State will have to invest significant sums to refurbish or replace a number of publicly run residential facilities to meet new Hiqa standards scheduled to come into effect from this year. Otherwise some existing units could be prevented from accepting any further admissions.

Ms Lynch said: “[The 11 public residential facilities] need to be upgraded. If we don’t do anything, we’re going to have serious problems ... These homes are generally on substantial sites which the HSE owns, so the availability of land isn’t an issue.”

She is also in talks with Minister for Public Expenditure Brendan Howlin about funds. The option of public-private partnerships (PPP) was also being examined.

Discussions

An internal health service paper, obtained by The Irish Times, maintains that last November as part of discussions on the Government’s next capital programme, the Department of Health identified community nursing units – publicly operated nursing homes – as “an area of particular need”. The paper states that funding for 1,500 community care unit beds at a cost of €255 million was requested.

The Department of Health declined to comment on the application for funding.

Ms Lynch told The Irish Times: “If we go down this [PPP] route, we could have the option of increasing bed capacity. But there are potential pitfalls ... They can be expensive and we’re not flush with money. The key thing is that these nursing homes will be where we need them.”

The Government’s new capital programme is expected to be finalised in the weeks ahead. Official documents show that the health service has been highlighting the requirement for significant capital investment in healthcare facilities for some time.

The internal paper drawn up in mid-February for senior health officials says more than €60 million was allocated to upgrade long-term residential facilities over the past five years and a further €122 million was “indented” in the capital plan to run up to 2018.

However, it warned that a significant investment was required over the coming three years “to ensure there are no further long-stay bed reductions in the public system and to achieve compliance with the standards”.

The paper suggested that while units may not be closed down, Hiqa could place “conditions”, and prevent any further admissions. It also said that in July 2013 the former minister for health James Reilly had sought funding of about €200 million for capital projects that could be progressed immediately, as well as a further €200 million for other priority facilities.

“In March 2014, a more prioritised list of investments, focusing only on the most urgent needs at a cost of €204 million, was identified,” the internal paper states.