€212,000 a year for a resident in most expensive public home
The cost to the taxpayer to pay for a resident in an HSE-funded nursing home can be as high as €212,264 per year, or more than €4,000 a week.
This is in sharp contrast to the spending per patient in privately run care centres. Latest figures show the most expensive private home in the country costs €1,325 per week.
Meanwhile, the cost of looking after the elderly in a publicly paid-for residential setting has risen dramatically in recent years.
One of the main reasons for the increased cost to the taxpayer is that the HSE must pay the going rate to its medical staff and other staff employed in these centres. This includes competitive salary structures and provision for a pension and other benefits, such as maternity leave and sick pay.
The publicly funded Abbeyleix Community Unit, in Co Laois, has the most expensive accommodation costs, running at €4,082 a week. Next on the list is St Brigid's Hospital, in Portlaoise, where the weekly cost is €2,584.
The cheapest State-funded unit is Dublin South East HSE Units, in Clonskeagh, with a weekly bill of €1,691 per patient. However, the overall burden on the public purse is reduced by the amount an individual resident can pay for their care, depending on their financial circumstances.
It is also significant that the weekly cost to the HSE of operating a particular nursing home does not affect the amount charged to a particular individual availing of the State-subsidised Fair Deal scheme. The fees charged under the scheme are the same - regardless of whether a person is resident in a high or lower-cost home - as they are assessed on the basis of individual income and assets.
Under the Nursing Homes Support Scheme, which provides financial support for those who need long-term nursing home care, people make a contribution towards the cost of their care, and the State pays the balance.
A financial assessment of a person's income and assets is carried out to calculate the required contribution, which is based on 80pc of income and 7.5pc of the value of any assets. There is a substantial gap in the cost of accommodating a patient in a publicly-run nursing home compared with a private facility. The privately run St Joseph's Centre, in Shankill, Co Dublin, has a weekly operating cost of €1,325. The most expensive HSE-funded public nursing home is Abbeyleix District Hospital, in Co Laois, costing €4,082 a week. The HSE defended its higher costs on a number of grounds. Owing to the recruitment moratorium over the last number of years, the public residential care sector has relied on the use of agency staff to provide back-up for "safe levels of service". This reliance on outside workers is being "replaced steadily", with staffing requirements being met through more sustainable contract arrangements.
Nursing Homes Ireland CEO Tadhg Daly said fees payable by the HSE to its own nursing homes highlighted a "scandalous practice".
"The right to choose where you wish to avail of nursing home care is inherent within the Fair Deal scheme," he said.
"However, remove the Fair Deal veil and the principle of equality is discarded when it is applied to the funding of nursing home care. How can it be countenanced that the HSE can pay its own nursing homes up to seven times the fees payable to private and voluntary counterparts?"