Subvention rates for older people who cannot afford the full cost of private nursing home care vary dramatically in different health authority areas, new figures show.
In the Dublin area, weekly enhanced subvention rates of up to €520 are paid on behalf of older people and their families, compared to €50 in the mid-west.
Those in receipt of enhanced subvention also vary substantially, ranging from 1,098 in the eastern region to just 32 people in the midlands. The figures were provided to Fine Gael TD Mr Dan Neville, in response to a parliamentary question.
The subvention scheme is aimed at helping older people and their families with the cost of private nursing home care. Such rates vary across the State, from between €600 to €800 a week.
While standard weekly subvention rates of up to €190 are paid by the State on behalf of thousands of older people, health authorities also have discretion to pay an enhanced subvention for those who still cannot afford private nursing home care.
There are no clear rules about who is entitled to get enhanced payments or how much a health authority should pay.
In a statement, a spokesman for the Minister for Health, Ms Harney, said the payments were at the discretion of regional health authorities and were influenced by factors such as differences in nursing home costs.
The spokesman also confirmed the Departments of Health and Social and Family Affairs were working on plans which should result in a system that would be "transparent, less discretionary and more equitable" for those in need of long-term care.
Age Action Ireland, the support group for older people, yesterday said the differences in rates were "astonishing" and highlighted the need for reform.
Mr Paul Murray, head of communications, said: "Few areas cause more grief to older people and their families than the cost of long-stay care. Even allowing for population differences, it is extraordinary that some of the health board areas were only topping up the regular subventions with as little as €50 a week."
The Irish Nursing Homes Organisation said older people and their families who were unable to afford private nursing home care were being penalised on the basis of where they lived.
The group's chief executive, Mr Paul Costello, said: "It's a very bumpy and uneven playing pitch out there. It's also deeply unfair that older people are having to use their non-contributory State pension to try to make up the balance of nursing home costs."
Under the scheme, the subvention is paid to the nursing home proprietor. The amount is based on the dependency level of the older person and the means of the individual or their family.
Unhappy applicants may appeal to the Department of Health and an appeals officer must review the decision. It is also subject to review by the Ombudsman and may be subject to judicial review by the courts.