Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

If someone applies for the fair deal nursing home scheme, the first payment will not be received until 13 March 2015. That leaves three categories of people, one of which is those who are in nursing homes. The families of these people must find a minimum of €13,000 to fund the nursing home stay between now and when the payment kicks in. The other group of people involves those who, according to HSE medical staff, can only be cared for in a private or public nursing home and are remaining in their homes because families cannot afford to put them into nursing homes. It is leading to two problems, one of which is the potential risk of neglect to the person, through no fault of the family, by remaining at home when the person needs to be in a nursing home. The second is that many of the people will end up back in hospital with preventable conditions.

I know an elderly person in my own constituency who had to be taken from a private nursing home because the family could not afford it. That person was admitted into an acute hospital pending approval of an application to the fair deal scheme.

A third cohort consists of more than 700 people who are fit to be discharged from hospital but must remain there. This is effectively taking 250,000 hospital bed nights out of the system. The only way to effectively tackle the congestion is to ring-fence the €25 million announced in the budget specifically for that purpose. That should be ring-fenced to treat older people before they need to go into hospital, and for those who end up in hospital, it should be used to get them well and out of hospital as soon as possible. The way to do this is threefold. We must increase long-term care capacity in the form of long-stay beds and the community care model by extending the fair deal scheme to include community supports. We need to reduce the number of older people attending our emergency departments by opening medical assessment units and urgent care centres in smaller hospitals, as well as maximising the use of technology for remote consultation. We also need to increase the rate of discharge into long-term care and the provision of short-term beds. This will unlock the capacity problem within our acute hospital system.

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