The Government has sidestepped the potentially explosive issue of increasing charges for people in long-term residential care. However, it remains to be seen how sustainable the Fair Deal nursing home scheme is in the long run, given demographic pressures.
The review of the scheme has forecast that the number of people it would have to support will rise by about 9,000, to 33,000, by 2024.
Over that period the number of people older than 65 will rise by about 200,000, to 802,000, while those older than 85 will increase by nearly 30,000, to just under 96,000.
The cost of long-term residential care is financed by a combination of direct State support under the Fair Deal scheme, costing nearly €1 billion a year, and contributions from residents based on their means, whether this be pensions, other income or assets. The average contribution amounts to about 25 per cent of the cost of care.
Minister of State for Social Care Kathleen Lynch immediately indicated that the Government had decided not to adopt any of the options set out in the review for increased contributions to pay for future long-term care. Instead, the Government would seek to generate efficiencies from administrative reforms.
Additional cost of €49m
The
Department of Health
said that, by 2018, it was projected that the number of people benefiting from the Fair Deal scheme would grow by up to 1,126, at an additional exchequer cost of €49 million over the three-year period.
However, the review also made clear that after that point the numbers covered were expected to accelerate.
Meanwhile, private nursing homes operating the Fair Deal scheme are pressing for reforms in the funding model to recognise what they see as the true cost of care. Such a review might look at allocating funds based on a resident’s needs, rather than a simple capitation payment.
The cost of the scheme is not the only problem facing the Government in the area of long-term care. Private investment in the nursing home sector is certainly not running at the levels of the past, while the State sector is facing challenges in some areas in meeting standards set by the regulatory body Hiqa.
The review pointed out that while the average weekly cost in a public facility was nearly €1,400, the figure for a private or voluntary centre was just under €900 at the end of last year. While it was likely that residents in public units might have higher care needs, the review said costs in these centres “appear to be in excess of what applies in private centres”.
