Cash crisis for Fair Deal as nursing home demand soars

Warning that new applications must not be put off

Alan Kelly: Asked if cash concerns were behind delay. Photo: Gareth Chaney/Collins
Minister Alan Kelly, pictured right: Asked if cash concerns were behind delay. Photo: Gareth Chaney/Collins

From Bill Heaney in Dublin

Scotland is not alone in its concern about funding provision for care of the elderly.

Fear is mounting over the rising cost of funding the Fair Deal for nursing home care here in the Republic of Ireland, as demand for the scheme soars.

State spending on the scheme is expected to hit €1 billion this year – and the HSE [Department of Health] has acknowledged it is monitoring it on a “week-by-week basis”.

Over 23,200 people in a population of around four million are  availing of the Fair Deal, which is above expectations, and its budget was increased by €24.3m to €985.8m this year.

If Fair Deal exceeds its allocated budget, it is expected the Minister for Older People, Jim Daly, will be forced to seek emergency extra funding from the Department of Health.

Mr Daly said demand for the scheme was “outside of expectations in the year so far” and he has requested more data.  In response to queries from the Irish Independent, the HSE last night confirmed that it “is currently experiencing increased demand for the Fair Deal scheme”.

It added: “Activity levels are being monitored on a weekly basis and the HSE is in ongoing contact with the Department of Health.”

It comes as farmers take to the streets today, saying the lack of fairness in the scheme for them is costing them up to €40,000 a year in nursing home fees.

Alan Kelly TD is greatly concerned about funding Fair Deal and warned over timelines being “pushed out”.

“I am concerned at year-to-date spending compared to the total allocation and I believe this is causing real issues as [to] how Fair Deal is being administered,” said the Labour TD.

Mr Kelly warned that any fresh applications to the Fair Deal scheme must not be delayed in the face of rising costs.

He also questioned whether concern over cash flow was contributing to delay of promised reforms of the scheme that would benefit farmers and small businesses.

Figures from Minister Daly show that the Fair Deal scheme was expected to support an average of 23,042 people in 2019. With this in mind, the budget for 2019 is €985.8m, which is an increase of €24.3m over its 2018 budget.

But he said the latest available HSE performance reports indicated there were already 23,228 people supported in the scheme at the end of February this year.

Mr Daly said: “The HSE have noted that the number of residents in nursing homes who are supported by the NHSS to be ahead of forecast for the year to date.

“The Department of Health is engaging with the HSE and will continue to do so over the next few weeks to fully assess the situation, including a detailed analysis and validation of this data and to understand if specific trends can be identified.

“This will help to inform a view on the scheme activity and financial projections for the remainder of 2019.”

The Fair Deal scheme offers support for people who require long-term residential care.

Participants contribute to the cost of their care according to their means – while the State pays the balance.

The aim is that nursing home care is accessible and affordable for everyone.

Under the Fair Deal Scheme the State can only claim 22.5pc of the value of the family home, under a three-year cap on the asset.

However, farm families and small businesses owners face 7.5pc of the value of their land being used annually to pay nursing home fees.

There is no cap on this, meaning an entire farm could have to be sold to pay the bills.

Hundreds of farmers are protesting outside the Department of Health in Dublin today (Tuesday) over the slow progress introducing the three-year cap on farm assets.

IFA Farm Family and Social Affairs Chair Caroline Farrell said it was now nearly nine months since Cabinet approved the proposal to introduce a three-year cap on farm and small businesses assets, where a family successor commits to continue to farm the asset for a period of six years.

“In the time since Cabinet approved the proposal, it has cost individual farm families an estimated €40,000 in nursing home costs. That is the equivalent of losing four acres of their farm enterprise,” she said.

The minister has said that his department is working on the development of draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.

“However, subject to legal advice, I expect to bring the Heads of Bill to Government in May. The changes to the scheme will come into effect in 2019 subject to the legislative process,” he said.

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