There has been much praise for the fair deal scheme. The scheme is not the problem, but rather the waiting list for applicants. Families have told me that due to budget cuts, people are waiting to get into nursing homes. Processing applications is now taking longer. Previously that was a simple procedure. I understand 2,083 people are on the scheme’s national placement list, with a waiting time for funding approval of 15 weeks from the date of determination. One must ask the reason for that, and why in my constituency the elderly aunt of a constituent was approved on 9 July 2014 and funding was made available on 29 October 2014, a total of 16 weeks later. That is the type of delay people face. It is very disappointing to hear of hundreds of people waiting for funding. It is a serious situation when a person goes into a nursing home and must wait for funds to become available as it leads to financial hardship. The Minister heard about cases where people have had to pay up to €13,000. Payments are no longer backdated, as happened under the nursing home subvention scheme.
We must examine how the crisis could be avoided and what we will do to improve the situation. I am aware that funds were diverted from the fair deal scheme to the community care area and home-based packages. I would like to see both areas funded properly. With a diminished budget, we will have problems retaining beds and we must consider what could be done to improve the situation. Only a few people were approved for the fair deal scheme in County Galway last week. Given that a minimum of an additional 7,600 beds are required for long-term residential care between now and the end of 2021, we must ensure careful planning in the area. Based on population projections, there will be a significant national deficit of long-stay beds by 2016 based on a target of 4% of older persons in long-stay care. We also require carers to provide care. Between 2009 and 2012, approximately 340 new nursing beds were available per annum. That compares to annual increases of approximately 1,000 per annum in the preceding years. We will hear about more cases of older people not getting a bed under the fair deal scheme.
Some people would like to be cared for at home but supports are needed for that also. Nursing homes are a more appropriate and affordable setting than an acute hospital. The cost of providing nursing care in a hospital compared to a nursing home is a multiple of between five and eight times the cost. Nursing homes have raised with me and many colleagues the level of funding they get. The matter should be investigated given that different levels of funding for nursing homes is provided even in the same town. The average cost for a resident in a private nursing home is €750 a week compared to a weekly cost in an acute hospital of in excess of €6,000. One can see the difference in the figures. I hope we will not have a situation any longer whereby people cannot access nursing homes and they remain in acute care which will cost the State more money. In County Galway, 85 people were waiting to access the fair deal scheme in September 2014, an increase of 286% on September 2013. I hope the Minister will plan better for the future in this regard.
I note that Dr. Tony O’Connell, the national director of acute services in the HSE, referred to the fact that the HSE was hampered in freeing up beds because patients fit for discharge cannot leave and no nursing home places are available due to cutbacks. He said it costs hospitals approximately €200 a day to care for patients while the cost drops to €100 once they are in a nursing home.
Many people attacked the fair deal scheme when it was introduced in 2006. It was called a death tax on the elderly. A rate of 5% was applied each year for the first three years adding up to 15% of the cost. The Government increased the rate from 5% to 7.5%, which adds up to 22.5% over three years. That shows we have not really thought out how we will fund the fair deal scheme but we should have a clear policy on it in the future.