What is Fair Deal?

Sunday Independent (Ireland) - - Special Ivestigation -

THE Nurs­ing Home Sup­port Scheme was in­tro­duced in 2008 to help older peo­ple fi­nance their nurs­ing home­care. It’s known as the Fair Deal scheme be­cause it’s sup­posed to be a fairer way of fi­nanc­ing el­der care.

HOW DOES IT WORK? Older peo­ple pre­par­ing to go into a nurs­ing home con­trib­ute a min­i­mum of 20pc of the cost of their care. The State pays the bal­ance. Once you are as­sessed as ready to go into a nurs­ing home, you can ap­ply. The Health Ser­vice Ex­ec­u­tive will as­sess your fi­nances, tak­ing into ac­count your in­come, pen­sions, as­sets, prop­erty, sav­ings. If you qual­ify, the HSE de­cides how much you con­trib­ute. If you don’t want to have to sell your home to fi­nance your nurs­ing home care, you can ap­ply for the Nurs­ing Home Loan, which will be re­paid out of your es­tate. You can ap­ply to any pri­vate, vol­un­tary or public nurs­ing home.

WHY IS IT CON­SID­ERED FAIR? Be­cause older peo­ple would move into a nurs­ing home, know­ing that all the costs of their care would be met and they wouldn’t nec­es­sar­ily have to sell the home from un­der them to fi­nance it. The Gov­ern­ment promised that un­der Fair Deal, no older per­son would be left with less than 20pc of their in­come, so they would have enough to fund the odd blowdry or flut­ter on the 2.35 at Don­caster.

WHAT’S THE PROB­LEM? Money. Pri­vate and vol­un­tary nurs­ing homes don’t get to set their weekly price for res­i­dents who come in un­der Fair Deal. The Na­tional Treat­ment Pur­chase Fund does. The NTPF, which sources pri­vate care for public pa­tients, sets the price af­ter go­ing through the books of nurs­ing home op­er­a­tors. Nurs­ing home op­er­a­tors say the State is not pay­ing enough.

HOW COME? The State stumps up to cover the ba­sics: bed and board, laun­dry, nurs­ing home care, etc. But the law also re­quires nurs­ing homes to en­sure qual­ity of life by pro­vid­ing ther­a­pies, ac­tiv­i­ties and out­ings, which cost money. Pri­vate op­er­a­tors be­lieve that it is un­fair that the State re­quires nurs­ing homes to pro­vide ser­vices to res­i­dents that it won’t pay for. To com­pound their griev­ance, nurs­ing home op­er­a­tors claim another in­jus­tice is that HSE-op­er­ated public nurs­ing homes can get paid up to three times more per res­i­dent than pri­vate op­er­a­tors.

WHAT ARE NURS­ING HOMES DO­ING ABOUT IT? The Gov­ern­ment has been re­view­ing the Fair Deal scheme for more than a year now. But, in the mean­time, most nurs­ing homes are pass­ing the ad­di­tional costs of “ac­tiv­i­ties” and “so­cial pro­grammes” on to Fair Deal res­i­dents. The costs vary wildly from €1 a day to €325 per week, as our in­ves­ti­ga­tion has shown. Others don’t charge at all. And no­body is ac­tu­ally reg­u­lat­ing the charges to en­sure they are fair. The charges are not hid­den — but they are not quite trans­par­ent ei­ther. Few pub­lish them in brochures or on their web­sites. Some nurs­ing homes in­sist on meet­ing you in per­son be­fore they will di­vulge what ad­di­tional charges they plan on ap­ply­ing.

WHERE DOES THIS LEAVE VUL­NER­A­BLE NURS­ING HOME RES­I­DENTS? Between a rock and a hard place. El­derly res­i­dents and their fam­i­lies who were promised a Fair Deal are the ones left to fork out for the gap between what the State pays nurs­ing homes and what nurs­ing homes say is the true cost of the care. Ad­vo­cacy groups say in some cases this is leav­ing el­derly res­i­dents im­pov­er­ished. The re­main­ing 20pc of their pen­sion they were told they would have to spend is not so pro­tected af­ter all. A Fair Deal, but not for nurs­ing homes and cer­tainly not for the el­derly res­i­dents they are paid to care for.

Maeve Shee­han

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