What started out as an admirable attempt to deal with runaway care costs has simply heaped more misery on taxpayers
'Fair Deal' was an admirable attempt to deal with the runaway costs of care for patients and their families, while also addressing the inclination of some to avoid their responsibilities.
But the evidence in a sobering new report from the Comptroller and Auditor General (C&AG) is that it has now become an Unfair Deal for all taxpayers, who must meet total costs that have burgeoned far past the €1billion mark.
Root-and-branch reform is clearly called for, but the whole concept of how we care for the dependent and infirm is now called into question as a result of the pandemic – with individuals and families alike now more determined than ever to prioritise home-care solutions as long as possible.
Almost 550 nursing homes are involved in providing care under Fair Deal. Four out of five are privately run or are operated by voluntary bodies.
The remainder are public nursing homes, operated by or on behalf of the HSE. And the weekly average cost of these is now 62pc higher than in the private sector.
Understandably, private providers last night seized on the evidence of padded prices in State-run homes to call for greater equity, which the cynical might see as a greater slice of the cake for themselves.
But there is no doubt, on reading and decoding the report, that the C&AG can’t fathom any system at all within Fair Deal to ensure that the Exchequer gets value for money.
And the public will be alarmed to read that a major review was completed into Fair Deal five years ago – and then buried. The obvious deduction is that its findings cannot have made for pleasant reading.
The gross figures in the new report are horrendous, as is the absence of training for negotiators, who apparently do not have the rigour or the powers to prevent themselves being bamboozled.
The National Treatment Purchase Fund, which has been a success in buying care in Northern Ireland and Britain for those on waiting lists, certainly inherited a flawed approach – Fair Deal was rushed in without proper interrogation of what made up the cost of care.
With no distinction allowed between different scales of need, every resident was amalgamated into a common denominator… but it seems that, without transparency, annual pleas for increases have been allowed to go through on the nod.
The sector has certainly suffered, but the Covid crisis means that an opportunity for top-to-bottom reform and wholesale right-sizing cannot now be squandered.