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THERE HAVE BEEN calls for an investigation into the running of nursing homes in Ireland after new figures showed a significant cost difference between private and public providers.
Figures released by the HSE show a significant discrepancy in the weekly costs of providing long-term residential care for elderly people.
The figures list the weekly costs per person at state, private and voluntary-run nursing homes in Ireland under the Nursing Homes Support Scheme (NHSS – also known as Fair Deal).
This is the scheme of financial support for people who need long-term residential care when they get old.
The figures show that costs of public nursing homes (ie, state-owned and run by the HSE) are significantly higher than the costs of either private or voluntary care providers.
The highest is at St Vincent’s Care Centre in Westmeath, which has a weekly cost of €2,399 per resident. This is up to three times as much as the amount payable in some public nursing homes.
Taking all the individual centres into account, the average fee payable in HSE nursing homes is nationally 60% above that of private or voluntary nursing homes.
This figure has grown from 53% when the costs were last published by the HSE in October 2016.
Calls for investigation
On the back of these numbers, the representative body Nursing Homes Ireland has called for a full investigation by the Dáil Public Accounts Committee.
“Somebody needs to shout stop and question how public funds are being utilised within State nursing homes,” said Tadhg Daly, CEO of NHI.
We are calling upon the Public Accounts Committee to fulfil its previous commitment to examine the cost of care within HSE nursing homes and seek to provide some transparency and answers to very serious questions with regard to this element of public spending.
Daly said that the Fair Deal scheme accounts for €1 billion of the current health spend and that more accountability was needed.
The costs listed for nursing homes are the amount needed for the care of each person, but not what the person pays. That cost is determined by a financial assessment to see what they are able to pay, with the state making up the balance.
The cost to the person receiving care is the same whether they are staying in a private, voluntary or state-run facility.
HSE response
In a statement, the HSE acknowledged that there was a discrepancy between the running costs at different facilities and put it down to a number of factors.
One reason was the need to reduce the number of beds allowed at different centres to bring them in line with Hiqa standards.
It also said that the current layout of many centres affected staffing levels, and that the area of some centres in rural areas that were not viable for private operators made them more costly.
It also said it had higher ratios of nursing staff to patients and that many centres had to rely on agency staffing due to a recruitment moratorium that was in place for a number of years.
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Everything the government does is more expensive than the private sector
@Alfred Pennyworth: maybe we should privatize the government !
@zippo: Power to the people.
@Alfred Pennyworth:
Is this any wonder?
Last year the OECD criticised SAfrica for paying its public sector workers 30% more on average than private sector average, saying it was “unsustainable in the economy in the long term”. In Ireland it’s now 40% more for public sector, from parity ten years ago.
When the next recession comes it’ll be higher taxes, not cuts in the public sector as should happen. Unions say ‘jump’, governemnt says ‘how high?’
Non stop corruption. Politicians and their cronies slurping at the trough. Retiring with pensions that are the envy of ex presidents of the United States. Arresting every politician in Dail Eireann and their over privileged yokels in every state body would be a good start. Get rid of the troughs for the boys and clean up the country.
I wouldn’t leave a dog in some private nursing homes, never mind a vulnerable elderly person!
@Del Bear: some public nursing homes aren’t great either.
@Del Bear: Unfortunately both my mother and father have recently experienced the level of care in both private and public nursing homes. Overall very positive experience of the private sector, but I will never forgive the staff of the public home attached to a large hospital in West Dublin for their treatment of my mother. I had to be there every evening to ensure she was fed and received her medications. In the space of 14 days I had to chase down nurses a number of times to get her medication as they missed the whole ward on a number of occasions. Despite not been able to fed herself her meals were left on the tray in front of her. Residents were bulked up on fortified drinks. Was only there for 2 weeks, but she deteriorated rapidly. Bed sores, mouth infections from lack of oral hygiene. left slumped in a chair. Since getting her into a local private home she has responded to proper care and attention in a dramatic fashion. I haven’t had time to chae up on a complaint as both my parents developed rapid onset dementia at the same time. They lived beside me so a lot of the care and organising was down to me. My father, who got agitated with the condition, was reportedly assaulted by his carer in the same West Dublin hospital, yet nearly 24 months later we are still waiting on report. I could write a book about the inhumane treatment in the PUBLIC care system. From our local district nurse, to county elderly care team and the hosp[ital and public care homes. Disgraceful and savage treatment. My parents had family to fight their corner, and even at that it was a nightmare. But I have seen many elderly dumped in these places with no family and they are treated no better than animals. My local care home is private, and is expertly run. Really caring, fantastic staff, despite many of them on poor pay.
@Eddie: I’m sorry you had that experience. It was the exact opposite for us. I can’t speak highly enough about the HSE nursing home my mother spent many years in. I’ve less kind words about the private one.
@Eddie: I’d echo the comments by the above poster. My Grandmother spent her last few years in a public care hospital/ home and the service there was amazing. The staff were phenomenal, and actually cared about their charges. So for that reason I was going to say I could understand why it cost more to run publicly, than privately. As private operators would be providing service to turn profit. But maybe mine was an isolated example.
@Cien Allura: I think its down to the luck of the draw in a Geographical sense. I have heard great things about the HSE run home in Maynooth. Maybe we are just very fortunate in having a very well run private home, called Parke House, in my local town.
We really need some detail on costs or more detailed comparisons. I am wondering if there is something being missed, could part of the reason be that HSE nursing homes deal with more high dependency cases, disabled, dementia, etc, while private ones tend to take easier cases? That would surely skew the average figures.
@Squiddley Diddley: you are spot on. No choosing for the public’s plus what extras do the privates charge for?. You can’t fully and fairly compare.
It is all down to the usual – unaccoutable civil/public servants who never face any really sanction for continued inefficiency, ineptitude and incompetence.
It is interesting to note how in a low inflation economy for the last number of years we see health insurance rising annually and the excuse given is rising costs – what costs and what has been done to reduce these identified cost excuses?
There a lot of questions to be answered:
Do we have details of costs breakdowns – for example, staff costs for each grade (cleaner to doctor), ratio of care staff to admin in both environment, medical and sundry supplies costed like for like?
How much is being spent on agency staff?
What economies of scales are being purchased nationally ( If any)?
We really need to start sacking some senior civil servants in this country – and hold the rest of them to the same accountability,
@Tom Purcell: You do realise that health insurance is a private sector economy yes?
So can we have an answer , how much does it cost to employ a fully qualified nurse in private nursing home and how much does it cost to employ a fully qualified nurse in Public nursing home? and that’s just one of many questions.
In general,aren’t the patient’s in public nursing homes more dependent on care than those in private care..the same private homes that cherry pick patient’s for acceptance.more dependent means more expensive care..plus hse care staff nurses and assistants are paid properly.ie premium rates for night/weekend work etc..considering what they do still probably not paid enough..as opposed to hca in private homes on little above minimum wage..with nothing for unsociable hrs..
I think I’m gonna just hope I die before I ever need to be in a nursing home. My grandfather who had dementia ended up in hospital with malnutrition as he wasn’t being fed in his (private) nursing home. My mother-in-law used to go for respite once a year for a week in a well known Cork hospice and was also not fed properly (chicken nuggets landed in front of her when it had been explained she could only eat soft food) and more worryingly, was not given her medication. It seems that no amount of money buys good care.
Is it down to cost effectivness or cost cutting, you get the service you pay for, I would hate to think people are suffering because of cost cutting.
Are they comparing like with like? As in, are there as many high dependency patients in private nursing homes?
My mother had dementia and spent time in both private and public nursing homes. I am so glad she ended her days in a HSE nursing home because the quality of care she received was so much better. In the private nursing home, they had a minimum staff and only one nurse on the premises. They didn’t have time to keep a close eye on their patients either. When she moved to a HSE home, there were more staff on hand and an extra nurse. She was washed more often, they ensured she was fed, they had the time to monitor her. It’s depressing that care is being outsourced to profit based entities. God help us all if we end up in these places.
Well I would prefer to be put down humanely the put into a private nursing home.
I don’t doubt there is far more inefficiency and multi layered management in the public system but to be fair I suspect there are more high dependency (less profitable) patients in the public system.
Sher of course, if something is cheaper, then it must be better. Delegating the status success in the delivery of care to the most vulnerable, to an accountant, is just off the wall stupid. These are elderly people, not passengers aboard ‘Ryanair’ nursing homes. When something is cheaper, something is being traded off, it’s that simple. Anyone who advocates penny pinching when it comes to care, would want to work in a private run care home for a while and see what the effects of that are, cause it’s not positive. This oversimplifying nonsense from the media is the problem with todays society. Everyone is an expert all of a sudden.
* “Status of success”…
@Himalaya Joe:
lets be clear the level of care is not a question here its the cost and I would prefer to be employed in the HSE operated one , do you want to know why? and that will answer your the cost question.
@conriel: Oh but the level of care is very much the issue here! When it comes to private providers of care, the term “you get what you pay for” is extremely accurate!
@Himalaya Joe: or like most public services the taxpayer is a cash cow to be milked. Let’s see the staff costs, benchmarks, comparisons. Do HIQA guidelines re bed numbers only apply to public run homes now? That seems like a lame and poorly researched excuse for starters. Let PAC do its job.
@Sean @114: yes Sean the biggest cow being the welfare budget.
It’s probably much nicer and much better paid to work in a HSE run nursing home as well.
Who can afford that? Do you have to leave the title deeds to your home next to the d.n.r notice on your bed?
misses gunderberg time for bed let’s unstrap ye from that chair and maybe I’ll bring ye t the toilet after me tea brake no singing now ye know how it makes PJ across the hall howl like a lurcher giving birth to a hairbrush.no there’s no fire blanket in your room t night it’s in PJ’s room this week yea I know the managment are cutting corners so as t make yer pension stretch t Marietta bikkies on a Wednesday seeing as they already got yer house…I know Iknow workin for 60yrs means nothing t Leo Vader darths nephew anyway if he gets his way old whiners will loose the vote because the future is gonna be full of 60–80 yer olds
With I pads and evidence of corner cutting and elderly abuse…missus gunderberg have got a few euro coins for the lackey meter so we can charge PJ’s motor chair..
Is it the same as schools with the state funded ones owned by charitable organisations?
My mother has dementia. Thankfully she is in a nice nursing home, locally run, near us. It’s waaay too expensive but we all chip in. The hse home she was in previously was horrendous, I still feel sick just driving past. Staff couldnt wait for a reason to strap patients in, and once they did that poor person stayed in that chair every minute of every day. Tiny tv up high, on mute, no interaction at all. And I once saw a staff member being a b*ll*x to a patient- til he realized I was there.
@Kath Noonan: did you report your observations?. Was the person strapped in a falls risk?. What was the employee doing when you say being a boll1x?. Details……
No accountability. Spend spend spend, shur the taxpayer will cough up.
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