A group campaigning on behalf of retired people has claimed that the State has failed to fulfil its obligations for the provision of nursing home care to the elderly population.

Active Retirement Ireland, which has 22,000 members, says it is becoming increasingly alarmed at the direction being pursued by the Minister for Health and the Government on nursing home services.

It says it has three main areas of concern:

*The non-availability, to all intents and purposes, of public nursing home places for older citizens who are entitled by law to them

*There is an ‘inherent and inevitable’ conflict of interest between the provision of care on a profit basis by private nursing homes and the provision of care and appropriate therapies aimed at meeting quality of life standards

*The proposition that the approximately 5% of older persons who need nursing home care should be discriminated against '‘to the point of pauperisation', compared with citizens who require other forms of hospital or institutional care, is ‘unworthy of the State.’

Active Retirement says the entitlement of older persons to public nursing home services derives from Section 52 of the Health Act 1970, as amended, which states that the health authorities 'shall make available inpatient services' to all citizens.

The group says the State's inability to fulfil its obligations goes back to the early 1980s when not only did the provision of new public nursing home places cease, but many existing hospitals and homes which provided care for older persons were closed due to financial retrenchments.

"Not unnaturally, the provision of private nursing homes proliferated, as a result of which there is now no practical alternative for older persons seeking residential care."

Active Retirement claims that as a result of the State's failure to provide public care, older persons cannot access the form of care to which they are entitled and become subject to charges, which can be a hardship and a source of great anxiety.

While the group says it is not claiming that many private nursing homes do not provide satisfactory care, it is doubtful if any aspect of the health service is well-served by a substantial move in the direction of private enterprise, but it is especially unsuitable for dependant older persons who are often unable or in a poor position to articulate problems.

It claims that the 2001 Health Strategy promise to provide 800 community nursing units over a seven year period has not been followed up.

Active Retirement says there has been a considerable history of malfeasance by the State over the past 20 years in the charging of family members and the withholding from residents the weekly allowance from pensions to which they were entitled.

It points out that the policies the State pursued in relation to nursing home charges were pursued in the teeth of advice that the charges were illegal.

The group says the present position is that an older person entering a private nursing home, which is usually the only place available, will face charges of around 600 to 900 euro per week.

Towards this cost, a subvention of up to 200 euro a week may be payable, depending on circumstances.

It claims the subvention levels have not in any way kept pace with the escalating cost of private care and now only cover one-third to one-quarter or less of the cost.

Active Retirement says the subvention arrangements are a 'travesty of the entitlements all older citizens should enjoy.'

A recent interdepartmental advisory group proposed a co-payment system for funding the future cost of elderly care.

Active Retirement claims this recommendation will ‘leave no stone unturned’ in seeking out the assets of older persons including their homes.

This proposed system, it claims, would apply to care in public or private centres alike and the liability of the older person could be set at 80% of assessed income.

This, the group claims, is a far cry from the eligibility enjoyed in theory under the Health Act 1970.

It agrees that there is an anomaly in the distinction between the level of funding obligation placed on a resident in a public nursing home, such few as there are, as against private care.

"Active Retirement Ireland concurs that there is an anomaly but considers that the anomaly the Minister for Health should be addressing is that by which citizens are first of all deprived of a service they are entitled to and then required to pay relatively huge charges for use of the only alternative available."

It says it is concerned about policy decisions to be taken by the Government in relation to the future of elderly care over the next few weeks and says there has been no consultation made with representative organisations on changes.

Active Retirement says all older persons and all citizens should demand that the Government make no decisions which would adversely affect older persons’ rights without making clear what the decisions being contemplated are, and that there be widespread consultations on any changes to be made.