The cost of providing nursing homes and home help for the elderly will jump by nearly 60 per cent over the next decade, the Department of Social and Family Affairs has been warned. Mark Hennessy, Political Correspondent, reports.
In a major report for the department, Mercer Consulting said the burden on the State could rise because of the fall in the birth rate and the increase in the number of women in the labour force.
"The provision of informal care by family members can no longer be presumed upon," said the report, "Study to Examine the Future Financing of Long-Term Care in Ireland".
"For informal care to continue to be the bedrock of home-care provision, more extensive support for family-care carers will be needed."
Health boards and private care companies could be encouraged to hire older people interested in part-time work after their formal retirement to work in nursing homes and to offer home help.
In a bid to cut down the numbers needing "unnecessary recourse" to nursing-home care, pensioners should have a statutory entitlement to home help, the Minister was told.
Currently, 17,000 elderly are in residential care in the State, while another 31,000 receive some form of care at home.
Though it would be "difficult" to raise extra tax to pay for long-term care, the report said the public "may be willing to pay additional social insurance contributions".
In addition, the existing health levy and taxes raised on alcohol and cigarettes could be directed by the Department of Social and Family Affairs to pay for long-term care.
However, it said pensioners should continue to pay social insurance contributions "since the need for long-term care typically does not arise for a number of years after retirement".
Residential care costs will jump from €277 million in 2001 to €421 million by 2011 in 2001 spending terms, while the overall cost of care will rise from €513 million to €779 million by 2011. By 2021, the Government will have to find €1,184 million (in 2001 figures).
The arguments for the Government financing long-term care seem compelling, the consultants found, though they warned that it would be "prudent" for individuals to make their own preparations.
"It seems unlikely that private insurance can be harnessed to provide a substantive proportion of long-term financing," said the 200-page report.
Extra money for nursing-home care should "not occur at the expense of resources for the alternative of home care", which should be encouraged wherever possible.
Vouchers should be offered to those needing care so that they have "complete flexibility" to purchase services or else offered a choice between services or cash.
Care staff from each health board should create individually tailored packages for each person in negotiation with the health board and independent companies.
So far, there are few independently offered home-care services "though this is likely to emerge as significant additional funding becomes available and as individual beneficiaries begin to exercise choice.
"There is scope to stimulate this effect by encouraging, or even requiring, the health boards to use independent providers to deliver a proportion of their own service obligations."
The report said: "Labour shortages have been cited as a potential barrier to expanding the supply of home-care services. However, labour market pressures are likely to have eased as a result of the recent economic slowdown."
Meanwhile, the Department should plan so that every housing estate has homes which could be used to care for OAPs in the community.
