27 Jun 2022

HSE nursing homes in Co Leitrim paid 35% more than private counterparts

HSE nursing homes in Co Leitrim paid 35% more than private counterparts

HSE nursing homes in Co Leitrim are being paid 35% more than their private and voluntary counterparts, new figures published by the HSE reveal. Last Wednesday, after a five year delay, the HSE published the updated costs for nursing home care within its operated nursing homes. These revealed the three HSE nursing homes operating in Co Leitrim have an average fee payable by the State of €1,098 per week, per resident. The HSE nursing home with the highest cost of care was St Patrick’s Community Hospital at €1,499.  The two private and voluntary nursing homes have an average fee payable of €815 per week, according to the most recently published cost of care figures released for such nursing homes, released 15th September.

Nationally, private and voluntary nursing homes are forced by the State to provide care for half the amount that the HSE pays for its own homes, the figures reveal.  Nursing Homes Ireland stated it has taken five years to prise this data out of the HSE.  NHI said it is no surprise it has taken the State so long to publish as it has been operating a system that discriminates against the private and voluntary sector. 

The publication of the costings has laid bare the true cost of nursing home care and the implications of the failure to address this glaring inequity must be addressed by Government, NHI has warned.  Failure to do so threatens the sustainability of the private and voluntary nursing home sector and the vital services provided.

NHI has called on the State to immediately engage with the private and voluntary nursing home sector to provide for the true costs incurred of meeting the high dependency care needs of residents in private and voluntary nursing homes.  NHI demands an equitable system be established for the financing of nursing home care under the Fair Deal, whether HSE, private or voluntary.

It has also called upon the Public Accounts Committee to investigate the level of spending by the State within its own operated nursing homes. There is no requirement for the HSE to negotiate payments for each of its nursing homes. Yet private and voluntary nursing homes are being coerced into accepting fees that do not reflect the true costs of providing nursing home care.

 The long-withheld HSE data, which is accompanied by a litany of HSE-justified vindications for the higher costs, shows it pays its own nursing homes on average 53 per cent more than is paid to private and voluntary operators under the Fair Deal scheme and that State costs have jumped by an average 13 per cent since 2011.  Incredulously the HSE pays one of its own nursing homes €4,082 a week. 

 “The State is discriminating in a scandalous way against private and voluntary providers,” said Tadhg Daly, NHI CEO.  “The State is operating a two-tier funding system and has fought for five years not to disclose these figures.  It is unacceptable that private and voluntary providers are forced to provide care for fees way below those paid to the HSE counterparts.  It is a case of one law for HSE operated nursing homes and a completely different one for the private and voluntary providers who are squeezed into accepting fees that are not reflective of the true cost of providing care.  Reform of the National Treatment Purchase Fund’s fee setting system for private and voluntary operators has to come now on foot of these outrageous inequities in the State scheme. The cost pressures are unrelenting and not being recognised in Fair Deal fees in the private and voluntary sector while the HSE just raids the budget, pays itself and increases its own fees by an average of 13% with no ‘negotiation’ or accountability applied.

“There is no justifying such enormous anomalies. HSE fees are devoid of accountability and transparency. There is no negotiation or requirement to justify the fees they pay themselves. Private and voluntary nursing homes are under intense, unjustifiable pressure because of the State pinning them against the wall when it comes to the negotiation of fees. No independent appeals mechanism is available if a private and voluntary nursing home deems a fee unacceptable. The State continues to abuse its dominant position within the sector, adopting a ‘take it or leave it’ approach during the fee negotiation process under the Fair Deal.”

“So while the HSE increases its own fees by on average 13 per cent on already inflated figures, it forces the private and voluntary sector to accept unsustainable fees. The published public figures highlight a rotten inequality in respect of fees payable for care provision within Ireland’s nursing home sector.  The State is operating an upstairs/downstairs system of payments.  Private and voluntary nursing homes are the majority providers of nursing home care but are expected to do it at half the fees provided to State nursing homes. The sustainability of private and voluntary nursing homes is threatened by fees that are not recognising true costs incurred. Equality in fees payable must become an immediate priority within the Fair Deal. The buck has been passed in this regard by successive Ministers over a number of years and it now must be prioritised. The long-awaited publication of the figures must hasten the review of the Fair Deal pricing mechanism and bring into effect a fair pricing model that provides fees to private and voluntary providers that are reflective of the true costs of providing the high dependency care that nursing homes are delivering in our communities. Arising from publication of the costs, we are calling for immediate increases in private and voluntary nursing home fees under the Fair Deal and engagement with the Department of Health and HSE surrounding this critical issue. “

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