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Elderly home care scheme is likely to be means-tested

Out-of-pocket payments vital to maintaining schemes, says report


Minister for Older People Helen McEntee. Photo: Tom Burke

Minister for Older People Helen McEntee. Photo: Tom Burke

Minister for Older People Helen McEntee. Photo: Tom Burke

Older people are likely to undergo a means test and pay a significant out-of-pocket payment towards home care under the first statutory scheme to be introduced here.

The public will be able to say how much they can pay and what they want from a scheme which would guarantee a minimum level of home care.

A report into the review by the Health Research Board is being published by Minister for Older People Helen McEntee today.

However, the report reveals how statutory schemes, which support older people to live out their lives in their own homes, are under growing pressure in other countries. They are having to charge more for the service.

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The analysis by the Health Research Board comes in the wake of ongoing dissatisfaction with the lottery faced by thousands of older people who cannot get a HSE home care package and are ending up in nursing homes.

More than 5,200 elderly are on waiting lists for a home care package, home help or some other form of support to allow them remain their own homes.

Currently all HSE home care packages are provided free, without a means test, after an older person's needs are assessed.

But the demands for these packages are growing as the population ages and many elderly are left struggling.

Today's report, commissioned as a first step in the process by the Department of Health, provides a stark insight into the cost of statutory home care schemes in Scotland, Germany, the Netherlands and Sweden.

The report reveals:

  • People in Germany and the Netherlands are paying compulsory long-term care insurance and are also liable for means-adjusted co-payments.
  • In Scotland the threshold for access to professional home care has been raised and only people with the highest level of needs are cared for.
  • People are given personal budgets to control costs.

The report said that the needs of the older person, rather than ability to pay, is an underlying principle in all countries and they have a formal system of assessing this.

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However, "Scotland and Sweden have a long standing rights-oriented home care services sector which is increasingly rationed by stricter eligibility criteria."

Ireland will also have to foot the bill for the regulation of home care services which currently are not subject to any inspection for quality and safety.

The minister told the Irish Independent: "My priority is to ensure that our older people get the best care possible.

"For many that is long-term nursing home care, but for others that care can be provided in their own homes, surrounded by the people and communities that they love.

"Unfortunately, as a country, the only statutory scheme we have in place at present to care for our elderly is the Nursing Homes Support Scheme, 'a Fair Deal'. I am determined to change this and to establish a new statutory homecare scheme.

"Homecare is an increasingly important part of the supports we offer to older people.

"It is estimated that about 20pc of the over 65 population receive some form of community-based support service annually from the State.

"The publication of the findings of the review by the Health Research Board is an important step in the process, currently underway in the Department of Health.

"Work is under way to determine what type of home care scheme is best in relation to both regulation and funding.

"I am committed to progressing this, as a priority. The development of the scheme is complex. We need to get it right."

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