The IMO has for many years advocated for access to adequate health services for our elderly population through position papers and submissions. In the Submission to the Department of Health Review of the Nursing Homes Support Scheme the IMO raises a number of issues in relation to care under the Scheme:

• Older people have the right to equal access to and equal resourcing of health care, including long-term community and residential care. Neurodegenerative disease (stroke, dementia etc.) is the most common reason for admission to nursing home care, therefore nursing home care should be an integral part of the health services. Demand for long-term care must be properly assessed and adequate resources-including capital investment, operational funding and manpower-must be provided to meet that demand. 
• In search of value for money, the model of care provision under the Nursing Homes Support Scheme is to shift from public provision to private provision with the closure of between 555 to 898 public beds in 2012 and all new funding is to go to the private system.   Although private nursing homes can manage care for some older people, patients with higher medical need and/or higher dependency levels benefit from more intensive nursing and therapy support provided for in the public sector.There is a clear need to provide a significant increase in the proportion of care in public nursing homes. 
• Older people consistently state a preference to live their lives in their own homes and again demand for community-based care must be properly assessed and adequate resources provided.  The contribution made by carers must be recognised and supported and a review of medical cover for elderly patients living in nursing homes and in the community is urgently required.
• The Government has a duty to care for the most vulnerable citizens including the elderly, those with disabilities and those with mental illness. Given the direct relationship between poverty and both disability and mental Illness, the extension of the Scheme to Disability and Mental Health Services will further accentuate existing health inequalities. The IMO opposes any plan to extend the Nursing Homes Support Scheme to Community-based Services and to other sectors such as Disability Services and Mental health Services.
• To cope with Ireland’s ageing population a fairer and more equitable system of funding long-term care is required.  The principle of solidarity must be applied to the funding of long-term care where the cost is spread over a wider population and access to the service is based on medical need, with minimal bureaucracy.