Ireland: More Illegal Charges Revealed

A new controversy has arisen over nursing home charges, with the news that health authorities in recent months have illegally taken into account the income of spouses in calculating the amounts payable by patients in long-stay care. The HSE and Department of Health have admitted that guidelines on charges brought in last year did not tally with relevant legislation. Fine Gael health spokesman Dr Liam Twomey expressed serious concern about the Ombudsman’s report of more illegal charges.

He said there is a lack of clarity about legal entitlements to health services and it is elderly patients who seem to suffer the most because of this.
“It is absolutely disgraceful to along with legislation to hear that HSE guidelines allowed the income of a spouse of a long-stay public nursing home patient to be taken into account when assessing the fee. It is difficult to believe that the guidelines were not brought into line with the regulations introduced along with legislation to legalise nursing home charges and, as a result, an illegal practice was perpetuated,” Dr Twomey said.
Dr Twomey said the Ombudsman’s report raises concerns too about the level of such illegal charges which may yet come to the surface. And it is possible that once again, elderly people have been ripped off by the state.
He also warned that the Government may be facing a further illegal charges timebomb as the courts may in the future decide that elderly patients, eligible for public nursing home care who have had to go to private homes due to lack of public capacity may be entitled to free care.
Dr Twomey said he believed many of these problems have arisen from the absence of long-promised legislation on legal entitlements to health services.
“The Tanaiste should say when she is going to publish the legislation that would make these entitlements clear.”
The HSE in response to the revelation said the guidelines were introduced last year ‘on an interim basis.’ The full set of guidelines will be introduced as planned on August 1.
It said legislation last year enabled the HSE to recommence the raising of charges for long-stay care.
“The HSE established an Expert Group to develop a set of national guidelines to deal with the provisions of the legislation.”
It said it subsequently developed an interim set of guidelines that would be applied until a full set was complete. The interim guidelines were based on current entitlement assessment approaches such as that taken in assessing medical card applications, which feature ‘a double income assessment element.’
The HSE said where potential anomalies arose during the interim phase of the guidelines, provision would be made to address these once the full set of guidelines was introduced. They also said retrospection will now take place where repayments are required and these will be made on an immediate basis.
“We anticipate that his will only involve a relatively small number of individuals,” the HSE said.