Marian Harkin (Sligo-Leitrim, Independent) | Oireachtas source

We are facing a crisis in the nursing home sector because 16 private nursing homes have already closed this year and 450 beds are gone. Unfortunately, too many owners are at their wits' end in reassessing their current financial position.

The escalation in the cost of energy and the cost of living is certainly a factor, but the underlying cause is the fact that the fair deal funding model is not fit for purpose. This is not something we are only discovering now. It has been flagged time and again in many different reports. There were two from HIQA, one from the Comptroller and Auditor General, one from the Department of Health and one from the Ombudsman.

HIQA's latest report states:

HIQA believes that the closure of small nursing homes should be considered in the context of the loss of a particular model of care and not just in terms of bed numbers. Smaller nursing homes that are embedded in the local community offer person-centred care in a very homely environment. Their closure sometimes means that older people in need of residential care have to travel further in order to receive care. This has a knock-on effect for residents, particularly in terms of visitors, social activities and links to their preferred GP or pharmacy.

The fair deal model is structured in such a way that private nursing homes receive in the region of €600 less per person per week, which is an incredible difference. In January 2022, the average fee payable under fair deal for a HSE nursing home was €1,674 per person per week and €1,047 per person per week for private and voluntary nursing homes .

When I raised this with the Tánaiste previously, he suggested that public nursing homes often deal with people who have more complex care needs. While this may have some validity in a restricted number of cases, it is not the universal situation and cannot explain the considerable difference in payments between private and public nursing homes. An urgent review of the pricing model is needed.

It is also important to remember that nursing homes are a vital link in our health services at all times but especially now when our acute healthcare system is under such pressure. It makes no sense that we are allowing nursing homes to close when our acute hospitals have ever-lengthening waiting lists and people waiting on trolleys and in emergency departments. The Taoiseach can fix this almost overnight. He should put in place a sustainable fair deal model because nursing homes are a vital link in the healthcare chain and that chain is at breaking point.

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