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Proposals to increase nursing home charges are unfair and unjust

Published 03/04/2015

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Age Action would vehemently oppose any move to pass additional nursing home costs on to vulnerable older people or to put a charge on them after their death for any community-based services they need.

The proposals are part of an unpublished review of the Nursing Home Support Scheme for nursing home beds, prepared for the Department of Health and the HSE, the details of which were broadcast by RTE’s Prime Time programme last night.  The report found that options included an increased state investment in the scheme or an increased contribution by those in nursing homes. 

The options for increasing the contribution of nursing home residents included reducing the income disregard threshold for the means testing of a person’s income, increasing the annual charge on a person’s assets from 7.5% to 10%, increasing the number of years on which a person would pay a percentage of the value of their home (currently 7.5% per annum for three years), and increasing the percentage of person’s disposable income which would be contributed for those with incomes above the State Pension (currently a person pays 80% of their disposable income). 

The report also recommends that consideration be given to charging people for their community-based care, with the charge being imposed on their estate after their death.

Age Action warned today that the way in which the Nursing Home Support Scheme (NHSS) charges  the sickest of older people for essential care is fundamentally unfair, in that no other section of society is required to pay from their disposable income, additional assets and a portion of the value of their home towards their care.

“The proposals to increase the level of these charges would add insult to injury and would be opposed by older people and their families,” Age Action Head of Advocacy and Communications, Eamon Timmins said.

The existing charging structure is already causing hardship for older people.  For example, an older person whose only income is the state pension is left with €46 per week after the Fair Deal charges.  The so-called “Fair Deal” only covers basic bed and board, and does not cover other costs such as therapies (eg physiotherapy or chiropody), specialised wheelchairs or equipment, hair cuts, soap, shampoo etc.

“While the entitlement to a public bed exists in other parts of the health system, the introduction of the NHSS in 2009 extinguished the public bed in a nursing home, so that older people who need round-the-clock nursing care are left with the choice of signing up for the Fair Deal or paying the full fee privately,” Mr Timmins explained.

Although the scheme is only in place six years, charges have already been increased once.  “The range of increased charges proposed by the Department of Health’s document suggests a lack of understanding of the inequity of the scheme and that a belief that this inequity can be increased further – that older people who are sick and frail are a resource that can be tapped time and again,” Mr Timmins said.

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Input into the Nursing Home Expert Panel on perspectives and experiences in relation to the COVID-19 pandemic

(17 June) The Alliance of Age Sector NGOs, represented by Age Action, is meeting with the Nursing Home Expert Panel to communicate perspectives and experiences in relation to the COVID-19 pandemic and its effects on nursing homes, with a particular focus on planning the further responses to nursing homes’ needs over the next 18 months.  National Public Health Emergency Team (NPHET), chaired by the Government’s Chief Medical Officer, was established in January. It has been providing direction, guidance, support and expert advice on the development and implementation of Ireland’s strategic response to the pandemic. The Panel is due to report to the Minister for Health by end June 2020 and is has undertaken a public consultation details of which are available here.