Social workers have been told not to refer older patients with medical cards to private nursing homes, unless they get written assurances from hospitals that the patients may be entitled to a public nursing home bed.
The Irish Association of Social workers has told members it is concerned they should not be seen to be "colluding" in any way with what they say is an inequitable process which may be unlawful.
John Brennan, of the association, said social workers were under severe pressure to clear acute hospital beds as a result of Minister for Health Mary Harney's plan to reduce waiting times at accident and emergency units.
As a result he said they were being forced to direct older people who are discharged from hospital into private sector homes, even though they may be eligible for a public bed.
The cost of a public nursing home bed is just €120 a week. While State subvention is available for older people in private nursing homes, it is not enough to cover the full cost and leaves many older people or their families still facing shortfalls of up to several hundred euro a week.
The issue of entitlement to public nursing home care is controversial and has potential implications for thousands of elderly patients in private care. A High Court case is pending which involves an 80-year-old medical card holder who says she was forced into private care because of the State's failure to provide adequate public nursing home care.
In the meantime it is understood that the Attorney General has advised Government that medical card holders have an entitlement to a public nursing home bed, qualified by availability of State resources. There is an acute shortage of public nursing home beds, with many older people being told they face a wait of between six or 12 months for a bed.
Age Action Ireland said yesterday it was aware of dozens of cases where older people and their families felt pressurised into taking private nursing home beds.
The group's spokesman Paul Murray said it was unfair that social workers were being forced to try to deal with problems created by a political drive to reduce waiting times in accident and emergency units.
Mr Brennan, who is chairman of the Association of Social Workers' special interest group on ageing, said letters which members should obtain from hospital authorities must state that their decision to take a private bed should be "without prejudice" to the possibility of their entitlement to recover money they pay from the State in future.
"The Government's 10-point A&E plan has put pressure on the entire health and social care system to find immediate quick-fix solutions to clear acute hospital beds . . ."
He added: "This has been an extremely frustrating experience for patients, families and professionals when what is required is appropriate public long term care services."