The Government’s View of Aged Care in Ireland

The Government has a plan for aged care. In a time when many of those in the sector are facing extreme hardship and the elderly need more suitable options, our Real Estate team examine whether the plan goes far enough.

What you need to know

• Ireland’s ageing population means that time is running out to find an equitable solution to aged care
• The scale and differing needs mean that there is not one solution and approaches including home care, independent living units and nursing homes should come together as one system
• The need for nursing home beds remains high while the cost of operating those beds is at times unsustainable
• We consider the Programme for Government and its action plans for aged care, including a consideration of the NTPF system.

Introduction

Against the backdrop of an ageing population, struggling nursing home operators, and ongoing legal challenges to the National Treatment Purchase Funds (NTPF) scheme, the Government has published its Programme for Government. One of the overarching goals of the Government concerning the aged care sector is to implement a national action plan that will, among other things, examine and enhance the mix of professional care options. It is envisaged that those options will include home care, community-based care, independent living options and long-term residential care facilities, such as nursing homes. This signals the Government’s intention to utilise as many options as possible when it comes to elder care in Ireland, as opposed to relying on nursing homes as a sole solution.

To achieve this the Government acknowledges the need to explore additional funding for, and greater use of, alternatives to nursing home care such as home care. The Government has identified that it plans to:

• Design a statutory home care scheme to allow people to stay in their own home for as long as possible
• Increase home care hours, and
• Increase the housing adaptation grant

In addition, Independent Living Units, also referred to as ‘ILUs’, provide housing for the elderly who are capable of living independently, but who have health and social care needs and wish to avail of shared services. ILUs serve to keep many elderly living independently for longer and delay their admittance into a nursing home.

The net effect of the Government’s aged care national action plan could be that fewer elderly in Ireland are going into nursing homes. That would in turn mean that the median age of those requiring a bed in a nursing home in Ireland is set to increase.

Nursing homes

The Government has also committed to strengthening the nursing home sector in Ireland by:

1. Increasing funding for the Fair Deal Scheme and ensuring that the waiting list does not exceed four weeks
2. Building more public nursing home beds
3. Publishing the NTPF review of pricing systems in early 2025 and working towards an equitable funding model for the nursing home sector, and
4. Providing a career pathway for healthcare assistants.

Nursing Homes Ireland, the sector’s national representative body, has commented that these express commitments by the Government are a step in the right direction.

Fair Deal Scheme

The Nursing Homes Support Scheme, commonly referred to as the Fair Deal Scheme, has been in place since 2009 as a system of financial support for people who require long-term residential care. The scheme allows participants to contribute what they can to the cost of their care, with the remaining cost being covered by the State.

Pricing systems for nursing home beds under the Fair Deal Scheme

We expect that our clients engaged in the nursing home sector will be particularly interested in the release of the NTPF review of pricing systems.

Approximately 80% of nursing home places funded under the Fair Deal Scheme are in private or voluntary nursing homes that are funded by the Irish State based on prices negotiated with the NTPF. The last review of the pricing system was published by the NTPF in May 2019 – now over five years ago. Inflationary factors over the last number of years have been a huge concern for nursing home operators, while they have struggled to understand the basis for proposed NTPF rates.

Comment

It is encouraging that the Government is committed to working towards an “equitable funding model” for the nursing home sector. Observers have been noting for several years that the current funding levels for nursing homes are inadequate, with one 2023 report finding that 51% of nursing homes are unprofitable. There is also a marked disparity between the average public and private rate across Ireland, with the public rate being as much as €640 per bed higher than the private rate. This will be watched closely by all parties in the hope that a more transparent system will lead to more equitable decisions.

The acknowledgement of the need for additional supports and options for the elderly is important and these other options will form a greater part of our client’s business plans in the near future.

For more information, contact a member of our Healthcare or Real Estate teams.

The content of this article is provided for information purposes only and does not constitute legal or other advice.