NHI Budget 2015 statement: Crisis in elderly care will spiral out of control



No Fair Deal for older persons in Budget 2015




Trebling of numbers awaiting nursing home care in 2014 & 100 person increase every two weeks  


14th October 2014


Nursing Homes Ireland has said the fact that there is no increase in the Fair Deal Budget indicates a Government that is out of touch with older people and one that accepts it is ok to have 2,100 elderly patients on an ever-growing waiting list. 


In fact as the Budget was being read out the Department of Health released to NHI today, 14th October, a new list that shows 100 additional persons have joined the Fair Deal payment waiting list in just two weeks and the significant rise in numbers are indicative of a major crisis in care of the older person.  No specific commitment has been made to increase Fair Deal 2015 Budget as the Department of Health confirmed to NHI 2,114 people are now awaiting Fair Deal payment.


The Department commitment of €25m in the Budget to address the escalating crisis of persons delayed discharge within acute hospitals is acknowledgement of crisis in this respect. However, disappointingly there is no specific commitment to utilise it to support the vast majority of persons delayed discharge who are requiring access nursing home care [75% of such persons according to HSE Performance Assurance Report July 2014]. NHI looks forward to engagement with the Department and HSE to discuss implementation of funding.


Tadhg Daly, NHI CEO stated: “Older persons are already waiting months in acute hospitals unnecessarily arising from failure to adequately resource Fair Deal and deplorably we will now be looking at a six month waiting period and maybe beyond for Fair Deal financial support approval in 2015.   


“NHI warned a year ago that we were facing a crisis in older person care and the chaos has escalated significantly in recent months. It is incredulous and defies logic to see no firm commitment to increase the resourcing of the Fair Deal scheme. It is very disappointing and surprising that the Government hasn’t got a grip on this issue in the 2015 Budget.  Only last week in Dáil Éireann the Minister had to express dissatisfaction with the extraordinarily high numbers – 700 persons – delayed discharged within our acute hospitals and for a number of months the HSE has highlighted the continuing upward trend in such numbers since beginning of year. At end of July 75% of such persons were awaiting long-term nursing care.  


“Last year the Department of Health predicted there would only be 900 waiting on Fair Deal funding at end of this year. Today 2,114 are awaiting Fair Deal funding and the number is rising by 100 every two weeks. The reality is some elderly people will never get to experience nursing home care and this is a tragedy for them and their families. Since beginning of the year numbers awaiting Fair Deal payment approval have more than trebled and waiting period has increased five-fold. People are now waiting an extraordinary and distressing period for Fair Deal financial support - four months. Today’s rejection of the requirement to appropriately resource Fair Deal is negligent and Minister Varadkar has been let down by his Government colleagues on this. It will inevitably lead to distress, angst and deterioration in health amongst older persons and deny them timely access to appropriate healthcare.


“It defies logic and economics. The HSE has highlighted the negative impact delayed discharges are having upon our acute hospital sector and the Department of Health warned Minister Varadkar upon his appointment that there was a need for funding for 1,000 additional places per year. Nursing home care plays a vital role within a proper functioning health service and the failure to heed the present crisis and adequately resource Fair Deal for year 2015 beggars belief and will have serious knock-on effect for health services and health spend.”


Irish Daily Mail, 15th October: €25m won't solve waiting list problem 

Irish Independent, 16th October: More than 2,100 waiting for place in nursing home

Irish Examiner, 15th October: Bed blockers still a problem


Tadhg Daly, NHI CEO is available for further interview. For further information contact Michael McGlynn, NHI Communications & Research Officer at 01 4292570 or 087 9082970.




  • Minister Varadkar, Dáil Éireann, 9th October: “The situation is far from satisfactory and I will not pretend otherwise. There are roughly 700 delayed discharges in acute hospitals at the moment. Most of these are elderly patients who have been discharged by a consultant and are ready either to go home or go to a nursing home but cannot do so.”
  • The Department of Health briefings provided to Minister Varadkar upon his appointment (published by Department in September) stated: “On balance it would appear that a minimum of an additional 7,600 beds (over 1,000 beds per year) will be required between now and 2021.” It also states: “In monetary terms, it is estimated that these [older person demographic pressures] equate to an additional funding requirement of the order of €200m per annum over the coming years.”
  • The HSE Performance Assurance Report July 2014 states: “During 2014 there has been a continuous increase in the number of people admitted as patients to hospital emergency departments. In addition the number of people referred for ‘elective’ procedures and out patient appointments has increased month on month, resulting in an increase in the demand for acute patient beds. The availability of acute hospital beds is constrained in that a significant number of patients who are deemed medically fit for discharge are awaiting alternative care arrangements in the community in the form of long term nursing home care, respite or transitional care. The number of patients ready for discharge to other community settings at the end of July was 664. The level of additional funding required to enable these discharge is not currently available. This has resulted in increased waiting lists as the required acute capacity is not available to deal with the number of people requiring procedures. Both acute hospitals and social care elderly services are working collaboratively to address the emerging issues” It informed on 31st July 688 person were delayed discharged and 74.7% were awaiting long-term nursing care.  


  • In February of this year, there were 654 waiting, with 29 days to get financial approval.
  • In April, there were 913 waiting and 6 weeks for financial approval.
  • In May it was 1,265 and 7 to 8 weeks approval times.
  • In June it was 1,465 with 12 weeks for financial approval.
  • In September it was 1,753 and 14 weeks for financial approval.
  • Figures issued last week highlight 2,007 waiting and 15 weeks at least for financial approval.
  • Figures provided to NHI by Department of Health today, 14th October, state 2,114 people are awaiting Fair Deal funding and the waiting period is 15 for funding approval is 15 weeks.






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