Health Service Executive In Care Home Fees Failure
Ireland’s Health Service Executive (HSE) is failing to abide by rules limiting the fees patients in nursing homes should pay, Ombudsman Emily O’Reilly has revealed. Despite a radical overhaul of how the elderly pay for care, the Office of the Ombudsman found several cases were the HSE was ignoring its own guidelines and at times the law. Under regulations in place since last year, long-stay patients can only be charged on the basis of their own income or pension.
But one elderly man was charged double what he should have been for a nursing home bed after the HSE added his income to his wife`s to see if he was eligible. He ended up paying €120 a week for care, even though his pension only came to €96 a week.
Ms O`Reilly said: “It turned out that the HSE had issued guidelines in relation to charging spouses which were completely inconsistent with the regulations and also with the primary legislation. In other words they were taking into account her income as well as his income whereas under the legislation only the income of the patient should be taken into account.”
Ms O`Reilly said the HSE had looked at the matter and agreed with her findings and the man will be compensated. The Ombudsman is now examining whether it is an isolated case.
Several other cases where the HSE failed to play by the rules were also probed by the Ombudsman.
An elderly woman had to pay for a nursing home bed because HSE officials in the Eastern Region Northern Area ruled she technically owned half a house with her daughter and therefore had to pay fees. The pair hit financial difficulties following the decision with the mother exhausting all her savings to fund her care and her daughter considered selling the family home.
After the Ombudsman`s probe the HSE accepted it should disregard the property and will pay over €200 a week towards the care.
A woman, who had a medical card, was forced to pay for private nursing home care after being moved out of St Colmcille`s Hospital, Loughlinstown to free up beds. Following a review the HSE agreed to cover the cost of the private care.
The Office of the Ombudsman played a key role in efforts to establish that health boards had illegally charged patients in long-stay public care homes. The law was deemed unconstitutional and the Government conceded it would have to refund up to €1 billion to 70,000 patients.
The Health (Charges for In-Patient Services) Regulations was then introduced legalising charges following an assessment of each patient`s income.
The Ombudsman investigates complaints from members of the public who feel they have been unfairly treated by public bodies and according to her annual report there were 2,243 valid complaints during 2005 compared to 2,064 complaints in 2004, a 9% increase.
The Ombudsman`s office also dealt with 9,704 queries from the public last year and between valid and invalid complaints and queries, almost 13,000 people contacted the office last year.
A survey conducted by the office showed 35% of complainants felt better off as a result of having contacted the Ombudsman.
Of the valid complaints received, 42.9% related to civil service departments and offices, 33.3% involved local authorities, 19.9% to the HSE and 3.8% to An Post.