More than 300 legal actions taken against State over nursing home fees

Legal actions relating to the State’s scheme for repaying nursing home fees that were wrongly charged were taken in more than 300 cases of patients who had spent time in private nursing homes, the Dáil’s Public Accounts Committee (PAC) has been told.

Meanwhile, the PAC heard a suggestion that thousands of people with disabilities who were living in Section 38 and 39 care facilities were also eligible for compensation.

The committee’s examination of the controversy over nursing home charges came during a meeting with the HSE’s interim chief executive Stephen Mulvany.

Comptroller and Auditor General (C&AG) Seamus McCarthy outlined how some €486 million had been spent on the Health Repayment Scheme (HRS) by the end of 2021.

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He said more than 20,300 payments had been made in relation to long-stay charges improperly imposed on residents of public nursing homes between 1976 and 2005.

By 2021 most of the claims considered to be valid under the scheme had been paid, he said.

Some claims received by the HSE were deemed ineligible because they related to people who were residents of private nursing homes.

Mr Mulvany said more than €450 million was directly paid to patients or their families found to be eligible under the HRS.

He said to be eligible people had to either be a medical card holder in public nursing home or in a publicly funded bed in a private home.

Fianna Fáil TD Cormac Devlin noted that a C&AG report covering the year 2009 examined appeals and legal actions arising from the HRS and there had been 306 cases involving patients who had spent time in private nursing facilities.

He asked Mr Mulvany how many of these cases are still active and how many had been settled.

Mr Mulvany said the HSE is not currently managing these cases - the handling of which came under the remit of the Department of Health from 2013 - but the most up-to-date number he had seen for the number of cases was 329.

Department of Health official John O’Grady said he did not have information with him at the meeting but suggested he could respond in writing.

Separately Sinn Féin TD Matt Carthy suggested that there was a third group who were eligible under the HRS - people with disabilities living in Section 38 and 39 care facilities.

He said these people were initially deemed not to be eligible but HSE financial statements from more than a decade ago outline how the HSE appeals officer found that they were.

Mr Carthy said the HSE and the Department of Health initiated a High Court appeal against its own appeals officer’s decision which was later dropped.

He outlined how the provision to make repayments for the group of people with disabilities was recorded in HSE financial statements including 2012 and 2013.

Mr Carthy said a 2011 memo for government ministers estimated that additional funding of €20 million would be needed to cover around 500 appeals that had been made in relation to cases involving people living in Section 38 and 39 homes.

He suggested that there are “thousands” more people who had not appealed the initial HRS refusal of an application based on HSE advice that they were ineligible.

Mr Carthy based this estimate on a worst case scenario of a potentially €360 million cost to the State if all of the cases were to materialise.

He asked Mr Mulvany if contact had been made for eligible people who applied for the HRS - but didn’t appeal a decision that they were ineligible for the scheme - and if provision was ever made to provide payments to them.

Mr Mulvany said he did not have that information at the meeting.

He said the emphasis of the HRS as set out in legislation was “on older persons typically”.

Mr Mulvany added: “What was clearly raised along the way was I’m sure an entirely valid question as to whether people in a similar situation - albeit in a disability service - should be entitled or not. I don’t have any more detail than that.”

He said he was not confirming a figure of up to 10,000 people being eligible saying this was an assertion Mr Carthy was making and “I don’t have the details”.

Mr Carthy later listed questions he had on the matter and Mr Mulvany said the HSE would work on providing answers in the coming weeks. He also said there were “certain ascertains of things as facts” made by Mr Carthy “which we wouldn’t accept”.