Nursing homes should enter market with ‘eyes open’, says HSE chief, ruling out blanket bailouts

Nursing home operators should enter the Irish market “with their eyes open”, the chief executive of the Health Service Executive (HSE) has said.
Bernard Gloster said individuals and companies entering the sector knew the rates that were paid and were aware of the projected income levels. His comments to the Joint Oireachtas Committee on Health came as the nursing home sector maintained that nearly 80 facilities had closed down over a period of roughly six years.
The representative body, Nursing Homes Ireland (NHI), said most of these closures had occurred in rural areas, “deepening concerns over the availability of local care”.
Mr Gloster said the HSE was the “funder of last resort” when private nursing homes got into trouble. However, he said the State could not go in, take over, or buy every private nursing home that failed. He said that would create “perverse incentives”.
He said at any time the HSE “would be worried about five, six or seven nursing homes where it might have to intervene”.
Mr Gloster told People Before Profit-Solidarity TD Gino Kenny that the HSE had had to intervene in relation to several privately-operated nursing homes in recent years.
The HSE chief suggested some nursing home operators might take out significant loans against the business and then find that they could not sustain these borrowings. “What happens when they get into trouble is that you start to see an erosion of quality. They can’t fund the staff or the maintenance on the premises. And you start to see a deterioration. Hiqa [the health and social care regulator] will only tolerate a certain level, particularly where something is disimproving. And it is in those circumstances that we have to go in and take over.”
He said the closure of nursing homes caused “dreadful distress” to residents and their families.
NHI said 77 nursing homes had closed down since 2018 due to increased operational costs and pressures of operating under the Fair Deal scheme for covering the cost of long-term residential care. “Last year alone 10 homes were forced to shut, with a further seven this year, contributing to the loss of more than 2,600 beds.”
NHI chief executive Tadhg Daly said: “This is not just a healthcare issue; it is a challenge for society as a whole. Our ageing population is increasing rapidly, and we should be celebrating this fact. However, if we don’t act now the consequences will be profound.”
The organisation said research it had commissioned revealed that nearly six in 10 people in Ireland were either very or extremely concerned that their loved ones may be unable to secure nursing home care in their local community.