ASSESSING FAIR DEAL
Analysis highlights extent of Fair Deal reductions as requirement for nursing home care grows The Department of Health projects 7,600 nursing home beds will be required to meet ageing population’s long-term residential care requirements by year 2021 and CSO is forecasting the population aged 85+ - those most dependent upon the specialist care provided by nursing homes – will increase by 46% to same year. Michael McGlynn, NHI Communications & Research Officer, assesses resource allocation to support nursing home care through the Fair Deal budget, looking at annual spend allocation since the scheme came into effect. It highlights a marked decrease in allocation of State resources to support nursing home care and by consequence fewer persons availing of it. Fair Deal and the requirement for nursing home care has been generating considerable headlines in recent months. Ministers in the Department of Health Leo Varadkar and Kathleen Lynch have publicly pronounced requirement for the scheme to be demand-led to ensure it can meet the growing requirement for nursing home care. The HSE Service Plan 2015 provided for an additional €10 million in funding – year-on-year-basis – to fund the scheme and has projected an additional 300 persons will be supported by Fair Deal by end of 2015 by comparison with year 2014 (to put into context, numbers projected to be supported by Fair Deal in 2014 service plan was 939 fewer by comparison with 2013 target). €948.8m has been allocated for Fair Deal for year 2015 and it is projected 22,361 persons will be supported by the scheme by year end. The following takes a more detailed look at Fair Deal budget allocation, actual spend and numbers supported by the scheme, based upon analysis of HSE and Department of Health figures. When looking at the resourcing of Fair Deal and support levels, it is important to consider the wider context. In Dáil Éireann 21st January, Minister Lynch stated the population aged 80 years+, “which has the greatest need in terms of utilisation of health services is growing by some 4% annually”. Approximately one in five persons aged 85+ require nursing home care and the CSO has projected that cohort of population will grow by 46% to year 2021*. The Department of Health briefing papers to Minister for Health Leo Varadkar upon his appointment warned 7,600 nursing home beds will be required to meet older population healthcare requirements to year 2021. An analysis follows.
P However, there was a significant shortfall in actual numbers
2010/2011
2014
P In Dáil Éireann 25th February this year, Minister Lynch
P The allocated spend for Fair Deal in 2014 in HSE Service
outlined budget allocation for Fair Deal scheme years 2010 The 2015 allocated – 2014. Spend for year 2010 was €979m.T spend by comparison with allocation for 2010 represents a decrease in spend of €30m euro. Budget allocation for 2011 was €963m. T he 2015 allocation represents €14m decrease by comparison with allocation four years previously. 2012
supported by Fair Deal. 22,871 persons were in Fair Deal payment and also ‘approved but not in payment’ at year end 2012 (HSE Performance Report December 2012). Comparing number to be supported by year end 2015 (22,361 persons), 510 fewer persons will be supported. P Looking at the spend in 2012 by comparison with planned
spend for 2015, if we are to take a ballpark figure that spend for nursing home care in a private nursing home is circa €52,000 per annum (€1,000 per week – actual average is €885). T his year’s spend would present a reduction of approx. 880 persons being supported by the scheme when you consider it with that for 2012. 2013 P Allocated spend for Fair Deal 2013 was €997.4m and this
was revised to €974.2m in the Revised Estimates. Spend allocation for year 2015 is €25.4m less. P The HSE Service Plan 2013 targeted 22,761 persons to be
supported by Fair Deal year end. T he 2015 target is for 400 fewer persons to be supported. 22,065 persons were in Fair Deal payment year end 2012. P At year-end 2013, 23,775 persons were Fair Deal supported and
also ‘approved but not in payment’. If HSE 2015 target is met 1,414 fewer persons will be Fair Deal approved by comparison with the numbers at end of year 24 months previously. 23,007 persons were in Fair Deal payment year end 2013.
Plan and within Revised Estimates Budget was €938m. 2015’s allocated spend represents a €10m increase. P HSE Service Plan targeted support for 22,061 persons
(actual numbers supported yet to be published) and 2015 target is to support 300 additional persons. 22, 360 persons were in Fair Deal payment year end 2014. *CSO: Population & Labour Force Projections 2011 – 2046.
P In 2012, the HSE Service Plan allocated €1.046 million
spend for the Fair Deal scheme. By comparison with the spend allocated for 2015 - €948.8m, this represents a €97.2m planned spend reduction this year. However, the actual 2012 spend was revised to €994.7m in the Revised Estimates Budget. So the comparison with 2015 shows a €45.9m reduction for year 2015. P The 2012 Service Plan projected 23,611 persons would be
supported by Fair Deal by year end 2012. The number projected for support by year end 2015 is a decrease of 1,250 persons by comparison.
T able 1: Numbers Num mbers in F air Deal payment paym ment 2014 23,200 23,000 23,000 22,800 22,600 22,400 22,200 22,000
22,959 2 2,959 22,781 2 2,781 22,553 2 2,553 22,380 2 2,380
22,360 2 2,360 22,254 2 2,254
22,162 2 2,162 2 22,162 2,162 22,038 2 2,038
21,961 2 1,961 2 21,926 1,926
21,800 ,8 21,600 21,400
T able 2. Numbers in Fair Deal payment year ends
19 — NHI NEWS
22,016 2 2,016