What is Fair Deal?
The Nursing Home Support Scheme was introduced in 2008 to help older people finance their nursing homecare. It's known as the Fair Deal scheme because it's supposed to be a fairer way of financing elder care.
How does it work?
Older people preparing to go into a nursing home contribute a minimum of 20pc of the cost of their care. The State pays the balance. Once you are assessed as ready to go into a nursing home, you can apply. The Health Service Executive will assess your finances, taking into account your income, pensions, assets, property, savings. If you qualify, the HSE decides how much you contribute. If you don't want to have to sell your home to finance your nursing home care, you can apply for the Nursing Home Loan, which will be repaid out of your estate. You can apply to any private, voluntary or public nursing home.
Why is it considered fair?
Because older people would move into a nursing home, knowing that all the costs of their care would be met and they wouldn't necessarily have to sell the home from under them to finance it. The Government promised that under Fair Deal, no older person would be left with less than 20pc of their income, so they would have enough to fund the odd blow-dry or flutter on the 2.35 at Doncaster.
What's the problem?
Money. Private and voluntary nursing homes don't get to set their weekly price for residents who come in under Fair Deal. The National Treatment Purchase Fund does. The NTPF, which sources private care for public patients, sets the price after going through the books of nursing home operators. Nursing home operators say the State is not paying enough.
The State stumps up to cover the basics: bed and board, laundry, nursing home care, etc. But the law also requires nursing homes to ensure quality of life by providing therapies, activities and outings, which cost money. Private operators believe that it is unfair that the State requires nursing homes to provide services to residents that it won't pay for. To compound their grievance, nursing home operators claim another injustice is that HSE-operated public nursing homes can get paid up to three times more per resident than private operators.
What are nursing homes doing about it?
The Government has been reviewing the Fair Deal scheme for more than a year now. But, in the meantime, most nursing homes are passing the additional costs of "activities" and "social programmes" on to Fair Deal residents. The costs vary wildly from €1 a day to €325 per week, as our investigation has shown. Others don't charge at all. And nobody is actually regulating the charges to ensure they are fair. The charges are not hidden - but they are not quite transparent either. Few publish them in brochures or on their websites. Some nursing homes insist on meeting you in person before they will divulge what additional charges they plan on applying.
Where does this leave vulnerable nursing home residents?
Between a rock and a hard place. Elderly residents and their families who were promised a Fair Deal are the ones left to fork out for the gap between what the State pays nursing homes and what nursing homes say is the true cost of the care. Advocacy groups say in some cases this is leaving elderly residents impoverished. The remaining 20pc of their pension they were told they would have to spend is not so protected after all. A Fair Deal, but not for nursing homes and certainly not for the elderly residents they are paid to care for.