Fair Deal scheme: Solutions are needed, not just analysis

Many older people and their families will be relieved to learn that nursing home residents under the Fair Deal scheme will not have to pay an increased contribution towards their care.

Kathleen Lynch, the minister of state at the Department of Health with responsibility for older people, confirmed yesterday that current rates would remain. She clarified this after the publication of a review into the scheme, which set out a range of options for the Government in terms of long-term funding.

While Ireland was once regarded as home of the ‘young Europeans’, we now have an ageing population that is likely to add to the cost of an already overstretched health service.

The Nursing Home Support Scheme — commonly known as Fair Deal — is expensive to operate, costing the State up to €1bn each year. The fact is, though, that most older people would prefer to live in their own homes and communities than in a nursing home. According to Ms Lynch, the Government tries to facilitate this as much as possible, but it is questionable whether enough is being done in this regard.

As the review points out, in Denmark, when local authorities were barred from building nursing homes, they went on to develop assisted-living arrangements, which have proved successful.

Closer to home, a modified version of this scheme is working well. The Meath area operates a ‘boarding out’ model of care, whereby older people live with families other than their own, somewhat like the children’s foster-care model.

Perhaps consideration should be given to extend this type of arrangement nationally.

According to Ms Lynch, the Fair Deal scheme is likely to remain “a key component of the provision of care for our older citizens”.

That may well be so, but why is it that there are huge discrepancies between the cost of public and private nursing home care? At the end of 2014, the average weekly cost of care in a public facility was €1,390, compared to €893 in a private or voluntary facility.

While the review of the scheme acknowledges this, it offers little in the way of comprehensively addressing it.

The review highlights the fact that the population of people aged over 80 will increase by 37% up to 2021. In the coming years, it says that an additional 9,000 people will need to be supported by the Fair Deal scheme.

That is bound to increase hugely the cost of caring for those either in care or still living at home. Yet, here again, while it offers sound analysis, it fails to offer any lasting solutions or suggest an appropriate funding model. The fear is that such critical issues will be put on the long finger.

Alone, the charity that provides services for older people in need, expressed disappointment at the scope of the review, arguing that 35% of older people currently in nursing home care could be given the choice to live independently if they had the proper supports.

The future home of ‘old Europeans’ deserve better.