Unholy row over extra charges is not going away
For many elderly people, their religion is the meaning of life. For nursing home residents who can no longer regularly visit a church, a visit from a priest can provide deep consolation.
They may have previously been daily Mass-goers and feel a sense of spiritual deprivation.
There is a long tradition in Ireland of making a donation to a priest who comes to a person's home to deliver sacraments and it is given in grateful appreciation.
However, many will see the practice of some nursing homes of including a Mass fee among their top-up charges imposed on residents as a step too far.
The mandatory nature of these additional fees, covering a range of areas from therapies to social activities in several cases, is causing distress to residents and their families.
Private nursing home owners continue to argue that the Fair Deal fees they are paid do not cover the costs of these extras and the mark-ups are necessary.
What is becoming increasingly clear is that the Department of Health and the HSE have turned a blind eye for too long.
When the issue of the Mass fee was raised by Dublin Independent Councillor Christy Burke, he was told that private nursing homes do not have to provide any information on fees to the HSE.
This is despite the HSE being allocated €1bn to administer the Fair Deal nursing home scheme.
Clearly, the HSE has been aware of these types of top-up charges and one official remarked that €20 is one of the lesser amounts imposed.
Fr Martin Long of the Catholic press office emphasised that when it comes to donations to priests for services ranging from weddings to funerals to giving sacraments or saying Mass, the amount - if any - that a person contributes is supposed to be voluntary.
Visiting parishioners in their homes is a pastoral duty that priests who are under severe pressure in many parts of the country, due to lack of vocations, diligently perform.
It is surely one area where a donation should be left to the discretion of the individual.
It has been left to the media and the organisation Age Action to be the main drivers for change in these very unpopular nursing home charges.
Thankfully, some action is now being taken.
The drawing up of a formal contract covering these charges, including possible increases, is now being worked on by the Competition and Consumer Protection Commission in conjunction with Hiqa.
The Department of Health has said there needs to be transparency around the charges.
The review of the Fair Deal scheme, which is under way and due to be completed in the coming months, is expected to include recommendations for change.
How far these can go, without new legislation, remains to be seen.
However, there needs to be a thorough investigation of just what the nursing homes are charging, how they justify the fees and also what they are charging for.
That means nursing homes need to open their books to the HSE and Department of Health.
There is too much public concern about the charges to make it untenable that the HSE should stand aside and say nursing homes are private profit-making organisations.
While the HSE does not impose these mark-up fees on residents in its own nursing homes, it has its own practices to answer for which diminish the older person's quality of life.
We have come a long way in terms of nursing home standards since the Leas Cross scandal, but there are still shortcomings.
The nursing home charges controversy is one such failing that is not going to go away.
It has already been ignored for too long.