State should roll back reliance on private nursing homes, says Minister

The State should play a greater role in directly running nursing homes and reverse the current reliance on private providers, Minister of State for Older People Mary Butler has said.

The comments come as a charity supporting older people, Sage Advocacy, has criticised additional charges for services levied on residents in private nursing homes.

Mervyn Taylor, chief executive of Sage Advocacy, said a review of cases it had worked on had found residents were facing growing levels of debt over additional charges. “One resident was charged for gloves to stop them removing their incontinence wear,” he said.

“In another case a resident was faced with notice to quit because their family was unable to pay increased charges. We have also heard that some nursing home residents are being charged for religious services,” he said.

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In some cases residents were being charged over long periods for items that could have been purchased at “a fraction” of the total cost of the charges, the charity said.

This included one case where a resident was being charged €85 a month for four years for an air mattress, which Sage Advocacy said would cost €300 to buy outright.

Currently the vast majority of nursing homes are run by private or voluntary providers, with public facilities run by the Health Service Executive (HSE).

Ms Butler said residents and their families must be made aware of any extra charges from providers and the reasons behind the charges. “My officials are currently reviewing the available evidence in relation to additional nursing home charges and I will consider the policy options,” she said.

She said private nursing homes should not levy extra charges for services that came under the scope of the Fair Deal scheme, where the State pays part of the cost of nursing home care for patients, or were covered by other schemes.

“The policy of privatising care of older people over many years is not a policy that I personally support. My preference has always been – and remains – that the State would be the main provider,” she said.

The Minister of State said she had instructed her officials to “explore all options” to provide more oversight to nursing homes, such as a potential commissioner or Ombudsman for older people.

She said she was aware of the “growing consolidation” of the private nursing home sector by large companies owning groups of homes in recent years. “My policy focus is to reverse this trend and for the State to take a more active role in the provision of residential care for older people in Ireland,” she said.

Tadhg Daly, chief executive of Nursing Homes Ireland, who represent private and voluntary providers, said additional charges were often to pay for “essential” primary care not included in Fair Deal scheme, such as physiotherapy, occupational therapy, specialist equipment and social programmes.

Mr Daly said the representative organisation and others had repeatedly raised concern over this for many years.

Any additional charges for providers to deliver such services were listed in residents’ contract for care agreed with the nursing home, he said.

“There is regulatory requirement for contracts to be clear, unambiguous and to contain full details of the services to be provided to the resident,” he said.

“Securing timely access to such services is vital to meet residents’ healthcare needs and to support them in their day-to-day living,” he said.