Nursing homes call for €191m to avert more closures

State funding lags behind rising costs with national minimum wage rise set to take further toll, private sector homes say

Nursing homes say they need a €191 million bailout in Budget 2024 to avoid further closures in the sector. And they warn that a proposed 12 per cent rise in the national minimum wage will create an additional funding shortfall of between €28 million and €32 million across the sector.

Nursing Homes Ireland, the industry body for private sector care homes, says increased funding for people in long-term care via Fair Deal has been running at less than half the rate of rising costs since the end of 2017.

“The extreme disparity between the reality of care home costs and fees payable under Fair Deal has led to the closure of 34 private and voluntary nursing homes in the past three years,” the group says in a pre-budget submission. This has led to the loss of 1,000 long-term beds, it says, at a time when Ireland’s demographics mean that demand for nursing home places is already increasing.

Fair Deal is the system of State subvention of private long-term care costs. On average, private sector nursing homes receive €1,079 per week per resident, with those residents also contributing 80 per cent of their income and 7.5 per cent annually of the value of any savings and investments above a certain threshold towards the cost of their care.

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The subvention has risen by about 15 per cent since the end of 2017 but, according to Nursing Homes Ireland, the “reality is over the past five years, the cost of caring for a nursing home resident has risen by 36 per cent, led by increases in all costs including for example energy, staffing and food costs”.

The industry body’s chief executive, Tadhg Daly, says Budget 2024 “represents a pivotal opportunity for Government to address this crisis in health and social care”. He says a €191 million injection into the sector will equate to €201 per week per resident, closing the funding gap that has arisen in recent years.

And, noting that salaries account for about 60 per cent of turnover in the sector, it says that “State-imposed inflation” via any national minimum wage increase “must be acknowledged and specifically remunerated and provided for within the fees payable for the provision of care under Fair Deal”.

The Nursing Homes Ireland submission estimates the proposed 12.4 per cent rise in the national minimum wage next year will add about €30 million to bills in the private care sector.

It comes as several nursing homes, particularly in Dublin, have started levying additional top-up fees on private residents in receipt of Fair Deal funding.

“In June, the Government did not oppose an opposition motion calling for immediate, short-term action to stem nursing home closures. Support for this motion now needs to come into effect,” Mr Daly said. “Unless action is taken now, more nursing homes will close and more residents will lose their homes, causing great upset and trauma. More staff will lose their jobs, more communities will lose vital services and the health service will lose critical capacity for older person care.”

Nursing Home Ireland says its 400-plus members provide care to more than 25,000 people across the State at around an eighth of the cost of an acute hospital stay.

The group has long-standing concerns that Government funding of private sector care beds is €744 less per week than it pays for long-stay beds in public nursing homes run by the Health Service Executive.

It is also calling for more fundamental reform of Fair Deal which, it says, currently fixes rates for two years based primarily on historical financial data. “This means that the rates that many homes are receiving… are badly misaligned with their costs of providing care which are increasing rapidly,” Mr Daly said.

Dominic Coyle

Dominic Coyle

Dominic Coyle is Deputy Business Editor of The Irish Times