The Government will re-examine regulations governing the subvention paid to patients in private nursing homes in the light of recent comments by the Ombudsman, according to Junior Minister Dr Tom Moffat.
Dr Moffat, Minister of State for Health with responsibility for older people, told The Irish Times that the regulations were introduced "in good faith". He was speaking after presenting International Standards (ISO) certificates to nine nursing homes at the annual seminar of the Irish Registered Nursing Homes Association.
Last week the Ombudsman, Mr Kevin Murphy, criticised the regulations, which were brought in without legislation. The regulations, applied by health boards, take into account the means of the children of dependent elderly people when deciding the level of subvention for residents of private nursing homes. The subvention averages £73 a week per patient, and goes as high as £120 a week. Nursing home care costs between £320 and £400 a week, and the balance is made up by the resident's pension and by the family.
Ms Eileen Gallagher, an executive member and former chairwoman of the IRNHA, said the regulations were discriminatory against the residents of private nursing homes, compared with people in health board homes. Fifty-three per cent of the elderly in residential care are in private homes.
"The average subvention is £73 a week. That works out at 35-40 pence an hour for 24-hour care. It is just not realistic. Patients are assessed on the basis of their means. If the children are working that is also assessed and taken off the subvention. So the patient and the family still have to come up with about £200 a week after the maximum subvention and pension.
"The State is paying between £320 and £460 a week per patient in its own homes, and there is no assessment of people going into health board homes. They can have a home or a farm and continue to keep them and pass them on to their children, while the full cost of their care is met and they receive £15 a week `comfort money'."
Dr Moffat said: "Most people are generous with regard to their elderly and don't mind. We're in an evolving situation. When anything is introduced initially there are teething problems. If people feel there should be statutory arrangements we would look at that. We are open to improvements in the way forward, which will involve a mixture of the public and the private."
Ms Gallagher said there was a crisis among private nursing homes, arising from the unrealistic levels of subvention from the State and the lack of staff. New units planned by the Eastern Health Board would make it even more difficult to recruit staff.
Nursing homes were obliged by law to have a qualified nurse on duty at all times, but because they could not be obtained on a full-time basis, the homes had to use agency nurses, who were prohibitively expensive and offered no continuity of care. Even the health board homes were heavily dependent on agency nurses. She said they had been asking An Bord Altranais for years to introduce a special category of gerontology nurses, similar to those for children's and psychiatric nursing, but there was no consideration of future needs.