Fair Deal crisis was flagged in April

THE emerging crisis in funding for nursing home care, which Health Minister Dr James Reilly said he learned of just last week, was flagged by Department of Health officials in an April briefing document prepared for him.

The document, published on April 1, said that while the Health Service Executive (HSE) was allocated €6 million in additional funding for the Fair Deal Programme in 2011, “it has now indicated that the additional funding has been fully utilised to deal with new applicants under the scheme” and that it was “at the point where it cannot accept any new applicants unless existing capacity becomes available”.

Two reports compiled by the HSE in January and February, and subsequently signed off by Department of Health officials, also flagged the funding problem.

The January HSE performance monitoring report was concerned that funds would not last to the end of the year if the rate at which applications were being processed continued.

The following month, the HSE warned that the continued growth of the scheme during 2011 would be dependent on using more public nursing home beds — not covered by Fair Deal — and “utilising vacated capacity”: in other words, if a nursing home resident died, an new applicant could be approved.

Both of these warnings were flagged to health officials in February and March, and reflected in the April briefing document.

However, Dr Reilly reiterated yesterday he only became aware late last week of the crisis, and described it as “a legacy issue”.

“I was deeply disturbed last week, towards the end of last week, to hear of budgetary problems in relation to Fair Deal,” the minister said.

Last night, Dr Reilly’s spokesman said the attention of the minister was brought to the crisis “exactly when he says it was” and that the warning flagged in the briefing document had been “actively queried” by the older person’s unit within the department earlier in the year, following the HSE reports. He also queried the HSE’s February claim that the scheme had reached its limit on the basis that the HSE accepted a further 571 applicants in March.

Consultant geriatrician Prof Des O’Neill said the funding crisis was “completely foreseeable” and that a number of geriatric advocacy groups had warned the department it was unworkable when the scheme was being hatched. This was largely because it required substantial frontloading of funds from the state, which the state cannot now afford, and because of the huge number of applicants.

More than 22,600 people are catered for in long-term care under Fair Deal, which has a budget of €1.011m for 2011.