David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:

notes that: - the majority of long-term residential nursing home care is delivered by the private and voluntary sectors;

- since 2020, there have been 31 private and voluntary nursing home closures which have resulted in a loss of 915 beds;

- increasingly, nursing homes are considering leaving the Fair Deal Scheme and contend it is not providing sustainable funding;

- a significant number of nursing homes reported an operating loss in 2022, and are raising concerns about the viability of the sector;

- nursing home capacity, where under-utilised for long-term care, can be used for "step-down" transitional care;

- according to the PwC report, commissioned by Nursing Homes Ireland, entitled "Challenges for Nursing Homes in the Provision of Older Persons Care - Private and Voluntary Nursing Home Sector", the nursing home operational cost for care per resident has increased by 36 per cent, and new bed development costs have increased by more than 45 per cent per bed since 2017;

- as the population grows and ages, with the number of people aged over 85 set to double in the next two decades, and as more care is delivered in the home, the health profile of nursing home residents will tend to be older and more complex; and

- nursing homes face significant difficulties in recruiting and retaining experienced staff; recognises that: - immediate action is needed in the short-term to halt further nursing home closures;

- a medium- and long-term plan is needed to ensure the sustainability of the sector and develop public capacity; and

- the promised Commission on Care has yet to be established, despite being central to developing a sustainable plan to ensure a viable residential care sector for those who need it, and reorientate care into the home for those who prefer it; and calls on the Government to: - deliver and fund a collective pay agreement for workers in the nursing home and home care sectors, to ensure a living wage and proper remuneration;

- review public funding arrangements for long-term nursing home care, to provide better pay and conditions for workers, quality of care for residents, and maintain viability in the sector;

- reform the pricing mechanism to enable the Fair Deal Scheme rates to be based on resource allocation that is reflective of a resident's individual care needs;

- directly fund hospitals to contractually purchase bed space for fixed periods in local nursing homes where capacity is available; and

- establish the Commission on Care.

I welcome to the Visitors Gallery members of Nursing Homes Ireland, including the CEO, Tadhg Daly, and many of his members, Shane Scanlan from The Alliance – A Support Network for Nursing Homes, staff members of nursing homes from across the State and, crucially, family members of relatives in nursing homes who, unfortunately, are facing the threat of closure because of the lack of sustainability and lack of viability of the sector. Our motion was tabled to send a very strong message and very strong signal to the Government that action is needed and that inaction is not something that can be accepted or is acceptable. Residents of nursing homes, their families and providers need urgent action from the Minister of State with responsibility for older people, Deputy Butler, but also the Minister for Health, Deputy Donnelly.

Since 2020, 34 private and voluntary nursing homes have closed their doors with a loss of more than 1,002 beds. The loss of 1,002 beds is bad enough but the Minister has to accept that the loss for people who lived in those homes, the people who cared for them and the people who own and manage them is also enormous. I can tell the Minister that the stress of closure and the threat of closure for both residents in nursing homes and their families is intolerable. We need to send a very clear message to the sector that we want to support it, we will support it and there will be sustainability in the sector. We would all accept, as do those who run nursing homes and provide nursing home care, that we also need to make sure we have adequate home care supports. In the first instance, we have to ensure people are cared for in the home. We still have not seen the statutory home care scheme that was promised or the commission on care that was to be established as part of the programme for Government. Of course, there is a lot to do in the home care sector and we need more investment in that area.

There are people who will need to be in nursing homes. Some of my family members were in nursing homes. My grandparents were in private nursing homes and they received the very best of care. They were in nursing homes because they had dementia and other illnesses which meant they simply could not be cared for in the home.

What we are hearing all of the time from home care providers and from nursing home providers is that there is lack of capacity. The nursing home providers whom I have met over recent years have told me that we have been building up to this crisis over that time, yet we have seen no action from the Government. I do not know how many times the Minister has visited private nursing homes or voluntary nursing homes. I do not know how many meetings he has had with Nursing Homes Ireland and the representative groups. I do not know how many residents he has met in recent years. I can tell him all of the people, providers, residents, staff and family members I have met are crying out for help. They are telling the Minister that the service is unsustainable. It is not just the service providers who are saying this. A report from PwC was published recently that clearly set out the challenges in this sector. Time and again, there were HIQA reports that identified problems in the sector. We have known for some time that we have to review the fair deal scheme, we know we have to review the pricing mechanism and we know that reports are telling us that costs have gone up by 30%, including energy costs, food costs and staffing costs. All of that has to be paid for and all of that is putting a huge financial strain on those private and voluntary nursing home providers, but they are not getting support from the Government. I have to relay to the Minister that they are telling me they are not being supported and they do not hear anything from the Minister.

I want to finish my contribution by reading into the record one story of a family who contacted me. It reads:

My mother's name is Joan. She is 90 years of age. Joan has advanced dementia or Alzheimer's. She married in 1962 and reared five children with my dad. She has worked hard in the home all her life, caring for her family. She previously cared for her father when he was widowed.

Joan's daughter told me:

She cared for her mother who died from cancer when she was young. She cared for my sister and father at home before they died. Now there is time for her to receive care. The care she is receiving is phenomenal. The staff work extremely hard. They know Joan's personality now. They know her likes and dislikes, how to get around her, her interests and her habits. My eyes have been opened to the tremendous work the carers and the staff do. They are inspirational. I am angry having to write this down about my mother because of an action by Government and I am begging you to act to ensure that her nursing home is not closed.

The responsibility does lie with the two Ministers I am looking over at. They have to act. They should not go into the summer recess without taking any decision here or we will see more homes close. That would be intolerable. The political leadership has to come from the Minister of State, Deputy Butler and the Minister, Deputy Donnelly.

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