Leading economist Moore McDowell has warned Government failure to ensure the Fair Deal scheme moves beyond its short-term budgetary concerns will have significant knock-on effect for Ireland’s healthcare services and Irish society. He stated the forthcoming review of Fair Deal must remove the current framework of price capping to ensure the private and voluntary nursing home sector can address the significant growth in demand for long-term residential care. Failure to do so will have very serious implications for acute hospital services and our wider health sector, he warnedMr McDowell was speaking ahead of Nursing Homes Ireland (NHI) Annual Conference 2012, at which he will present: Market Analysis: Preparing For an Era of Major Change. Mr McDowell is currently undertaking an NHI commissioned study on the economic and policy environment for the nursing home sector that aims to provide the most comprehensive analysis ever undertaken of the sector. Mr McDowell warned of the consequences for Irish society of persisting with the present framework. “The nursing home sector is critical to a well-functioning health service. If the sector is not enabled to meet the huge growth in demand in the years ahead, this will have a serious impact upon our acute hospital services and health system. Persisting with the current framework will lead to large numbers relying upon acute hospital services to meet their care requirements and unable to access the specialist healthcare nursing homes provide in community settings throughout Ireland.” He stated: “We know that demand for long term care will rise dramatically over the next 10-15 years*. The State has signaled its intent to reduce its provision and we know therefore that the required increased supply can only come from an expanded private and voluntary sector.” “What is required for a market driven response to an environment that is undergoing significant change? The forthcoming review of the Fair Deal presents an opportunity to address the considerable challenges of increasing the capacity in the nursing home sector to meet the significant growth in demand. At present Fair Deal reflects a preoccupation with short term budgetary concerns rather than efficient operations of the long-term care market and negates against nursing homes increasing capacity to meet significant growing demand for long-term residential care,” he added. “The ability of the private and voluntary nursing home sector to finance development is the key to meeting increased growth in demand for long-term residential care. The current Fair Deal structure, designed to ensure equitable access to care, must be changed. I would recommend that, in tandem with the issue of the overall structure of payment for long-term care, the current framework of price capping must go.” “The market has two components: price setting through the NTPF negotiation of maximum fees and setting service quality standards, through HIQA’s inspection of the sector. These operate independently and are incompatible with an efficient market solution to the supply problem. Price setting, fixing and capping is not compatible with a market driven supply response to demand changes and is not necessary in a competitive market. The present framework for supporting the provision of long-term residential care is dysfunctional and the financial squeeze being brought to bear upon the private and voluntary nursing home sector is not sustainable. The principle of co-payment, already accepted, will have to become an instrument of finance rather than a matter of equity,” Mr McDowell concluded. Tadhg Daly, Nursing Homes Ireland CEO stated: “The review of Fair Deal and continued reduction in capacity of public sector nursing homes means we are now at a defining moment in the provision of long-term care for older persons. The recent progress in addressing the trolley count and delays in emergency departments, including the initiatives of the Special Delivery Unit, will be negated overnight if the increased capacity required in the nursing home sector is not addressed. As Mr McDowell has outlined, persons requiring nursing home care will be inappropriately admitted to acute hospital, and remain there, due to a failure to adequately address long-term care provision.”Ombudsman Emily O’Reilly will speak on Leadership and Advocacy Challenges for the Private Nursing Home Sector. She will speak on the recent historic development of the passing of the Ombudsman Amendment Act 2012, which will extend her jurisdiction to 140 additional public bodies, including HIQA and the NTPF.Ms O’Reilly addressing delegates stated: "The responsibility on your shoulders is both challenging and onerous. The achievement of those objectives, will take hard work, high ethical standards, and an uncompromising commitment to the highest levels of care for our older people.” Ms O’Reilly welcomed NHI’s stated commitment to ensure that residents are provided with the highest quality care and services. She acknowledged NHI’s stated goal of ensuring that everyone who chooses a nursing home for the next step in their lives experiences a safe, happy, caring and fulfilling environment. * CARDI projects the number of persons requiring nursing home care will increase by at least 12,270 by 2021 (Future Demand for Long Term Care in Ireland, 2012). The ESRI projects an additional 13,324 long-term residential care places will be required to meet demand up to 2021 (Projecting the Impact of Demographic Change on the Demand for and Delivery of Healthcare in Ireland, 2012).