Long-term care system profile: Ireland

The Long-Term Care (LTC) system in Ireland relies heavily on unpaid family care and shares many similarities with systems in Southern Europe. The formal care sector is a mixture of public and private provision and financing, with the majority of care funded by the State but privately provided. The most dominant feature of this system is the Nursing Home Support Scheme (NHSS, commonly called the ‘Fair Deal’ scheme), which provides, on a statutory basis, financial support for those who need residential care. There is currently no statutory entitlement for home-based or community-based care. However, a more sophisticated system of integrated home- and community-based care is currently under development based on plans outlined in Sláintecare – an ambitious framework for reforming the Irish health and social care system to ensure that access to services is based on need rather than ability to pay.

Funding for LTC has increased significantly in recent years and in 2023, approximately €2.5 billion was spent by the State on LTC, representing over 10% of the total public health and social care budget. Slow progress on developing unique health identifiers and health information systems, a shortage of  care workers, and the lack of a single assessment tool to assess care needs are key impediments to the development of a LTC system that can meet the varied needs of the population. Demographically, Ireland is also experiencing a period of strong population growth, especially at older ages. Ireland now has among the highest life expectancy in the world. These demographic factors are driving the need for a sustainable LTC system to meet the needs of this growing and ageing population.