ESRI report on nursing homes

Nursing homes should be run in the best interests of those who need them

Sir, – Further to “Elderly in rural areas face beds shortage as small nursing homes close” (News, January 9th), it’s not just private providers that are building large facilities. The HSE is doing the same.

Donegal has the lowest rate in the country of patients in long term care, which is facilitated by a culture of generous families looking after their elderly relatives and by mainly HSE-provided home care. Unfortunately the lack of home carers in recent years is making the provision of home care increasingly difficult. There are a significant number of small community hospitals embedded in the community in Donegal, making visiting and local involvement much easier. The trend of building bigger units on the basis of economies of scale is not in the interests of the elderly, their spouses or families and fills me with dread. The hint is in the name: home not hotel. – Yours, etc,

Prof KEN MULPETER, FRCPI

Consultant in Geriatrics

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and Internal Medicine,

Letterkenny University Hospital,

Letterkenny,

Co Donegal.

Sir, – The demise of small rural nursing homes often owned and led by nurses has been evident long before the pandemic, as stated by the ESRI’s recent study.

Since 2005 as a direct result of two major pressures, the introduction of the new nursing home regulations overseen by the Health Information and Quality Authority (post-the Leas Cross scandal) that placed major demands to upgrade and refurbish homes, with no offer of any financial support or gain, and the continued underfunding of private nursing home beds vis-à-vis public beds linked to a disparity in the allocation of the “Fair Deal” scheme by the National Treatment Purchasing, such as higher fees in the east than in the western and southern regions. Sadly this has made stand-alone small rural homes with less than 40 beds economically unviable and has driven the development of super-sized homes (mini-hospitals) with 80-plus beds owned by opaque corporate bodies and equity funds. – Yours, etc,

MICHAEL STOREY,

Glencar,

Sligo.

Sir, – The ESRI report on nursing home care should act as a warning on the dangers for Irish society of a for-profit care model. The ESRI report indicates that 14 medium to large private operators now dominate the Irish nursing home market. The report says that international experience shows that private dominance of nursing home provision “often creates an environment where profit motives can supersede quality”.

The report warns that cost of nursing home care in this State may increase in the next years due to the “dominance of private supply”.

Under governments dominated by Fianna Fáil and Fine Gael, private ownership of nursing homes has increased from 20 per cent of the total supply to 80 per cent in the space of 25 years.

Nursing homes should be run in the best interests of those who need them, not in the best interests of a smaller and smaller number of big companies who are out to maximise profit. The privatisation of the sector overseen by Fianna Fáil and Fine Gael needs to be put sharply into reverse. Those who advocate for a publicly owned not-for-profit nursing home sector will be strongly boosted by the release of this new report. – Yours, etc,

MICK BARRY TD,

Cork North-Central,

People Before

Profit–Solidarity,

Leinster House,

Dublin 2.