Deputy Seán Sherlock On Cobh Hospital Crisis

Deputy Seán Sherlock: I should say at the outset that Cobh community hospital is a facility that is very well-regarded by the people of Cobh. I have been asked by my Labour Party colleagues on Cobh Town Council to raise this issue as a matter of urgency because there is a situation whereby the National Treatment Purchase Fund has taken over the fair deal scheme as it relates to Cobh hospital. That will have serious permutations for the cost per patient per week in that it is stated that the possible drop in fees from €1,200 to €800 per bed per week could result in a serious deficit. Obviously a deficit in funding would have an impact on the ability of the patients to remain within the hospital in the first instance, but also severely impact on the hospital’s ability to take in new patients.
It is a 38-bed hospital and there are approximately 40 staff. What goes to the heart of this is the issue whereby care for our older people who are in community-based facilities is being eroded by this Government through a process of stealth. The Government’s model of health care is about rolling back the State and these wonderful community-based facilities so that they may be completely and utterly subsumed into a private nursing home model, thereby rolling back the stakesholdings that communities have within these hospitals which make them the excellent facilities they are. It is all being done under the wonderful guise of HIQA rules and the fact that these institutions are older. Anything that is deemed to be older in this new paradigm we have with this Government is deemed not to be of sufficient standard.
I want to speak for hospitals such as Cobh, the welfare home in Youghal and Nazareth House in Mallow, all of which provide an excellent standard of care, but are now under threat because of the new rules that have come into play through the fair deal scheme and the new punishing HIQA standards. All I want to do here is make the case for Cobh community hospital, in that it is an excellent facility. There is a significant buy-in from the people of Cobh into this hospital. The staff coterie is very loyal to the hospital. The patients there are happy, and I would hope the Government ensures the continuation of this hospital in perpetuity, especially for the older people of Cobh who will use it, hopefully, into the future.

Deputy Seán Connick: I thank Deputy Sherlock for raising this issue which relates to the nursing home support scheme, “a fair deal”. The scheme commenced on 27 October 2009 and the HSE is now processing applications.
The scheme was introduced in order to address the fundamental inequity in the treatment of public and private long-term nursing home residents and in order to alleviate the financial hardship being experienced by long-term residents in private nursing homes. Prior to the introduction of the scheme, many people in long-term nursing home care experienced unaffordable care costs over periods of many years. The result was that many people had to sell or remortgage their houses or had to turn to family and friends in order to find the money to meet their care costs.
A fundamental purpose of the new scheme, therefore, was to offer assurance to one of the most vulnerable groups in society – those in need of long-term nursing home care – that such care will be affordable and will remain affordable for as long as they need it. In order to achieve these objectives of equity and affordability, the new scheme involves a fundamental change in the way in which long-term nursing home care is funded and, consequently, the way in which nursing homes and community hospitals are funded. In the past, many of these facilities were allocated a lump sum annually. In contrast, the new scheme supports the individuals in need of long-term residential care, not the facilities providing the care. This means that funding follows the patients, regardless of whether they choose a public, private or voluntary nursing home, and ensures that these facilities are not being funded for empty beds.
In order to qualify for the scheme, all private nursing homes, including Cobh community hospital, must negotiate and agree a price for the cost of care with the National Treatment Purchase Fund. This is a necessary feature of the scheme due to the commitment by the State to meet the full balance of the cost of care over and above a person’s contribution. As stated above, the nursing homes support scheme only applies to long-term nursing home care. Nursing homes and community hospitals can continue to have separate agreements with the HSE for the provision of other services, for example, day care, respite and convalescence.
Finally, the Government is committed to developing a financially sustainable funding model to support all long-term care services, both community and residential care services. It is envisaged that this work would also encompass short-term residential care such as respite and convalescence care. This commitment by Government was made in the social partnership agreement, Towards 2016, and preliminary work has commenced within the Department of Health and Children on the analysis of funding models.