Watchdog to examine records of Fair Deal 'secret meeting'
The Public Accounts Committee and the competition watchdog are to examine records of a secret meeting at which private nursing home operators mooted a boycott of the Fair Deal scheme to boost the fees they are paid by the State.
The records, revealed by this newspaper last weekend, show how nursing home operators had to be warned repeatedly by solicitors that they risked "dawn raids" and an investigation by the competition authority, if they took collective action to increase their funding.
The records were referred to the Competition and Consumer Protection Commission (CCPC) by Fianna Fail TD, Thomas Byrne last week while patients' advocate, Stephen McMahon, lodged a complaint.
The Public Accounts Committee (PAC) has invited Nursing Homes Ireland and the Health Information and Quality Authority (Hiqa) to discuss the documents on Thursday.
Hiqa will be asked whether there was a potential conflict of interest in its chairman, Brian McEnery, attending the meeting. Mr McEnery was at the highly sensitive meeting in his capacity as an accountant to the healthcare sector. He also chairs the agency responsible for regulating the nursing home sector.
Sean Fleming, PAC's chairman, confirmed that Nursing Homes Ireland (NHI), the trade association which organised the controversial meeting, will also appear at a separate session on Thursday. The National Treatment Purchase Fund (NTPF) which sets fees for private nursing homes and which was heavily criticised in the dossier, is expected to appear before the Oireachtas committee at a later date.
The records of the meeting have been anonymously circulated to a number of TDs in recent days, including Thomas Byrne, a solicitor. Mr Byrne said he felt it was his duty to forward the records to the competition authority, given their content and an instruction that they should be "deleted and destroyed". Stephen McMahon, of the Irish Patients' Association, reacting to the Sunday Independent's disclosures, has advocated for transparency about fees charged by nursing homes. The Competition and Consumer Protection Commission (CCPC) confirmed that it received one complaint relating to concern about "potential anti-competitive behaviour in the residential care home sector."
In a statement, the CCPC said: "By their nature, competition complaints such as these are complex and require in depth analysis, before a decision can be made on whether to open an investigation."
The dossier includes an 11-page record of what was said at the meeting, which took place in Dublin on October 23, 2015. The record was taken by Eversheds, who are legal advisors to Nursing Homes Ireland.
There are also two emails, one from Nursing Homes Ireland to Eversheds, conveying an instruction from the board of directors to "delete and destroy" the records.
The records reflect the scale of frustration in the nursing home sector over the price they are paid for residents under the Fair Deal scheme. Operators say the fees paid by the State under Fair Deal do not cover their costs. The funding arrangements have led to some nursing homes passing on extra charges to residents.
The records suggest that Brian McEnery addressed the meeting on the history of the Fair Deal scheme and "spoke of tightening margins and massive staffing issues within the nursing home sector". He referred to the "inconsistency" in the approach of the National Treatment Purchase Fund, and referred to "a number of situations in which he himself is involved in negotiations" where his clients are seeking to expand the bed numbers but the NTPF refused to grant increases. Private nursing home operators mooted a refusal to admit new residents discharged from hospitals and controlling the number of new beds to try to secure a better price for their services. Lawyers present warned that any collective action risked an investigation by the Competition Authority and possible "dawn raids", the records suggest.
In a statement last week, Mary Lou McDonald, deputy leader of Sinn Fein and a member of PAC, said the "alarming matters" raised in the reports added to her "ongoing concerns about nursing home fees and governance matters".