Rónán Mullen (Independent) | Oireachtas source

I welcome the Minister of State. I also welcome the departing students and visitors from the Gallery because it struck me as I was listening that we are talking about a society that cares for everybody and includes people at all stages at life. People at the other end of life need nursing home care for various reasons. It is not always possible for families to care for elderly loved ones at home. Care needs can be complex and so on. We have a duty as a society to make sure we work to honour the dignity of the nursing home cohort in our population.

On my way to and from Dublin every week, I pass through the small village of Brideswell in south Roscommon. There is, or I should say was, a nursing home there called Tearmainn Bhríde, the closure of which was announced during the year. I think it was one of about 16 closures that have occurred this year. I was reading what the Curley family had to say when they were giving that very unfortunate news. They pointed out that they had plans to extend to a 60-bed more modern facility but they could not find a financial partner. We should think about the consequences of that for the people involved. The family in question would have been working very hard to find suitable alternative accommodation for the population in their nursing home for whom, I am sure, they cared very much. The reality is that the disturbance and the upheaval for people at a time of life when this is the last thing that should be happening to them is very much to be regretted.We must think of the consequences of that for the people involved who worked hard to find suitable alternative accommodation for their population in the nursing home for whom I am sure they cared very much. The reality is that the disturbance and upheaval for people at a time of life when that is the last thing that should be happening to them is greatly to be regretted. We think of the consequence of having to move from a nursing home in the local area to maybe a big town such as Athlone or Roscommon, which are near enough still but far enough to mean visitors will be fewer or the visits less frequent. That is before we talk about the job losses in the community and so on. We have a vested interest not just for the people in the nursing homes but for our communities, particularly in rural areas, to look out for those smaller family-run nursing homes.

We live in a time when there is an understandable push towards centres of excellence in all sorts of areas including medicine. It can make sense to have a larger congregated setting for certain things but the human touch must never be forgotten. Many of the family-run nursing homes have been exemplary in the care and individual attention they give to the people living in them.

I have been in touch with Tadhg Daly of Nursing Homes Ireland, NHI, who was very honest in his briefing. He told me there is nothing wrong with seeking to make a profit running a nursing home. Nursing homes are a business and that is how his members get things done. They give employment and so on, he said. Mr. Daly rightly pointed to the discrimination between funding of public beds within the nursing home sector and the funding of long-term care beds. In 2019, there were 23,000 long-term care beds of which about 4,600, or approximately 16%, were public beds. As I understand it, around 30% of the funding was going to the public bed sector. Calculating the spend per person, those occupying a public bed were being funded to the tune of €692 week more compared with the funding of beds in the private setting. One of the arguments that has been made about that in the past has been that there were more complex care needs involved for people in the public beds. This point is refuted by NHI. It cites the Department of Health value for money report. It states:

It has long been assumed that public nursing homes have a larger cohort of higher dependency/high complexity residents than their private sector counterparts. This assumption is based on anecdotal evidence only as there is no single assessment tool used to determine the individual care needs of residents in nursing homes. The study, undertaken as part of this Review attempted to test this assumption, found no discernible difference in care needs between the sectors.

That is the Department of Health’s own value for money report. Why, then, are 16% of the beds getting 30% of the public spend? The argument has been made that sometimes there are extra services available in public nursing home facilities. These extra services, as I understand it, are funded from the community care budget. In fact, the differential in terms of funding available is to the disadvantage of the private sector because private facilities have to pay the capital costs and commercial rates, whereas public facilities do not. They may also be dealing with bank repayments and loans. I cited the example of Brideswell where the inability to get a financial partner for the purposes of developing Tearmainn Bhríde for the future led to the closure of the home. There is a real issue. The question must be asked. There is no doubt as to the Minister’s personal goodwill but must we not ask why the Government appears to neglect smaller private nursing homes at the expense of larger public-funded homes?