Fair Deal scheme treats all people the same and it doesn’t matter if they are in public or private care
Mr McCárthaigh points to what he sees as a concern in the report that the state is withdrawing from direct provision of nursing home care. This view fundamentally misunderstands the purpose and workings of the Nursing Homes Support Scheme (Fair Deal).
The purpose of Fair Deal is to equalise state support for people in public and private nursing homecare and to ensure that such care is affordable for all who need it.
Fair Deal addresses, for the first time, an historical anomaly and inequality whereby the one-third of people in public care had 90% of their care costs met by the state, while the two-thirds of people in private care had, on average, only 40% of their costs met by the state.
The scheme also treats people the same regardless of whether they choose public or private nursing home care.
Under the scheme, people undergo a care needs assessment to determine if they require nursing home care or if their care needs can be met in the community in accordance with the preferences of most older people.
They also undergo a financial assessment to determine their ability to meet their care costs. On foot of these assessments, the state then meets the full balance of cost between the person’s contribution to care and the cost of their chosen nursing home.
With more than 12,000 people being supported by Fair Deal already, the demand by patients and their families for such a scheme is obvious. Further to protect the interests of patients, Fair Deal is underpinned by a rigorous new regime of quality standards introduced in 2009 for all nursing homes, public and private. This is the first time standards have applied to public nursing homes.
The extent of state support for a system of nursing home care that meets the key principles of equity, affordability and patient choice is evidenced by the investment of a total budget of €979 million, including €152m to support Fair Deal since its introduction in 2009. Notwithstanding the current financial challenges the necessary resources will be protected for the scheme next year.
Your article contends that “no information is available on the number of people who were refused financial subvention”. This is incorrect. The figures have previously been stated publicly in replies to parliamentary questions (PQs).
A PQ answered on November 11 stated that approximately 200 applications have been refused under the scheme for specific reasons.
It is also stated that the Ombudsman highlights concerns that under-65s have difficulties availing of the scheme. The fact is there is no age limit to Fair Deal. It is available to anyone who is assessed as needing long-term nursing home care regardless of whether they are over or under 65.
Seán MacCárthaigh characterises as another problem of Fair Deal that it excludes many basic services such as physiotherapy and chiropody. In determining the services covered by Fair Deal, it was considered very important that the care recipient, and the taxpayer, would be protected and would not end up paying for the same services twice. For this reason, medications, services and aids that are already prescribed for individuals under existing schemes (Medical Card Scheme or the Drugs Payment Scheme) are not included in the services covered by Fair Deal.
However, a person can continue to receive goods or services under the medical card scheme regardless of whether they are in a private nursing home or elsewhere.
If a person doesn’t have a medical card, under Fair Deal they are allowed deduct health expenses from their income during the assessment of means process.
I hope this clarifies some of the issues raised and reassures anyone who may be concerned. Further information on the scheme is available at http://www.dohc.ie/issues/fair_deal/
Roisín Heuston
Press and Communications Office
Department of Health & Children
Hawkins House
Dublin 2
CONNECT WITH US TODAY
Be the first to know the latest news and updates
