Time to move away from state funding model that favours institutional care – amend Fair Deal

Ivana Bacik TD
05 May 2021

Speaking following the publication today by the Ombudsman of ‘Wasted Lives: Time for a better future for younger people in nursing homes’, which investigates the practice of housing people under the age of 65 in nursing homes, Labour Seanad Group Leader and Spokesperson for Children, Disability, Equality and Integration Senator Ivana Bacik has called for immediate steps to be taken to move Ireland away from a funding model that prioritises institutional care.

Senator Bacik said:

“The findings of the Ombudsman’s report today are shocking. That there is in excess of 1,300 people under the age of 65 living in nursing homes, when other settings would clearly be more appropriate, is scandalous. The findings of the Ombudsman must be acted on immediately to ensure that the preferences and needs of younger residents are respected, as stipulated in the Assisted Decision Making (Capacity) Act 2015. I urge the Government to take immediate steps to facilitate a transition to more appropriate settings for those affected.

“However any conversation about this regressive practice must take place in the context of a wider discussion about Ireland’s broken care model. The State’s default preference for institutional care is archaic and not in the spirit of the UN Convention on the Rights of Persons with Disabilities (UNCRPD), which Ireland ratified in 2018. The care sector in Ireland is organised on a piecemeal basis, through a patchwork of local authorities, charitable and voluntary organisations and State agencies. This is not a system that can guarantee the highest standards of care – as has become tragically evident with the many Covid outbreaks in nursing homes during the pandemic. We must question why there is a bias or a preference given to institutional care in Ireland, when most people would want to be supported to stay within their home.  

“The need to move away from a funding model that favours institutional care is clear. It was particularly harrowing to hear the Ombudsman say that many people have been forgotten, rather than ignored, once placed in institutional care. So long as the system is poorly structured, individuals working within it will struggle to improve conditions for people in their care.

“At present, we are in a situation where the Government is signing up to important protocols, such as the UNCPRD, without sufficient State capacity to implement them. The result is a disjointed care sector, where State policy is constantly contradicted by State practices. An exemplar of this is the Fair Deal scheme. The stated aim of this Government is to move away from institutional care settings for older people and for people who cannot live independently at home; yet, the statutory Government scheme in place only enables funding to be drawn down in order to pay for care in a nursing home.

“Labour is proposing that the Government changes the Fair Deal scheme so as to enable people to draw down funds to pay for at-home care and supports, as an alternative to care in a nursing home where that is more appropriate. Many people – young and old – don’t want to go to a nursing home but the State is giving them no other option. This change must be made to prevent some people from being forced into an inappropriate congregated setting, while leaving others scrambling to cover the cost of private at-home care or having to give up work to care for a loved one.

“Building support for people to be cared for at home requires systemic changes. We have an ageing population so the time to act is now. Ireland can become a more equal society with high quality care structures and public services – if we choose to take the necessary steps to achieve that change.”

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