As Minister for Mental Health and Older People, I welcome the recent ESRI report: Long-term Residential Care in Ireland: Developments since the onset of the Covid-19 pandemic. The report brings into focus some the challenges facing the long-term residential care sector in Ireland which the Government continues to address to provide short-term stability and long-term growth to this sector.
The ESRI report highlights that long-term residential care (LTRC) supply and care home ownership has changed significantly in recent years and that large nursing home operators are now significant providers of LTRC in Ireland. The report also highlights some of the challenges facing smaller nursing homes, particularly in rural areas, and some of the regional differences that exist in terms of the provision of nursing home beds.
It is acknowledged that the nursing home sector has evolved over the last 30 years from a predominantly State led service to a situation today where approximately 80% of nursing home services are provided by the private sector. I am aware of the investment trends in the Irish residential care market, the growing consolidation of the sector, and the complex investment and ownership structures that now exist. I am also aware of the potential risks and unintended consequences associated with the level of care services currently being provided by the private sector. It is therefore important that all aspects of the nursing home sector are scrutinised over the coming years, and I am committed to ensuring that service delivery and configuration in the sector meet the needs of service users in a sustainable and safe manner.
Long-term residential care is a crucial part of the overall continuum of care and public Community Nursing Units (CNU) play a vital role in the provision of long-term care across the country. The Government is committed to continued investment in healthcare infrastructure which supports the highest quality care for our older population and provides equitable access to this care in every region.
This investment includes the CNU programme, which was launched to ensure that up to 90 of our public Community Nursing Units would be refurbished or replaced to ensure the best quality environments for our older people. As of Q3 2023, 47 projects have reached construction completion. Construction is under way on several more facilities, while the remainder are at various stages of review, appraisal, design, and tender.
A clear indication of the Government’s desire to plan appropriately for the future, in the context of an ageing population, is the update of the 2018 Health Service Capacity Review, which is currently being progressed. This is particularly important given changes in the health and wider operating environment since the original 2018 review was undertaken. This work will forecast future capacity requirements in acute care, primary care, and in social care services for older persons (residential and homecare services) up to 2040.
Government has also approved the creation of Regional Health Areas, requiring significant restructuring of health and social care organisation in Ireland, underpinned by regional population-based planning and resource allocation models. A national framework for health and social care capacity planning, creating the tools and infrastructure to support consistent, data driven, regional planning will be a critical success factor for this work.
High-quality design, planning, and construction is vital in creating safe environments that enable high quality residential care for older people. I have therefore committed to creating new design standards for long-term residential care settings for older people (public, private, and voluntary).
On the 19 December 2023, I announced a public consultation on a Design Guide for Long-Term Residential Care Settings for Older People. The Department of Health, in conjunction with the Health Service Executive (HSE) and the Health Information and Quality Authority (HIQA), is currently seeking the views of the public on a draft Design Guide for Long-Term Residential Care Settings for Older People and the feedback received will inform the final version of the design guide.
