Chapter 3 - The Circumstances of this Case

Whether or not Mrs. Coffey was a public patient is the key issue in this case. She was resident in a private nursing home from March 2003 to her death in February 2011. If she was placed in a “contract bed” in the nursing home by the NAHB, and charged in-patient charges by the health board, then a refund is due to her under the Health Repayment Scheme. If, on the other hand, she was there under a purely private contract between herself and the private nursing home, albeit in receipt of a health board subvention towards the cost of her care, no refund is due. There was a dispute between the family and the HSE as to which was the case.

The position of the HSE was that Mrs. Coffey was a private and not a public patient. The HSE said that Mrs. Coffey’s placement in the private nursing home was a private arrangement and not one for which it was responsible. It said that, like other private patients, Mrs. Coffey was entitled to, and was paid, a nursing home subvention. It said she did not pay charges to the health board and that, accordingly, she fell outside the scope of the Health Repayment Scheme. Both the Scheme Administrator and the Appeals Officer accepted the HSE position and decided that recoverable health charges had not been paid and that, accordingly, no repayment of charges was due under the Health Repayment Scheme.

The position of Mrs. Coffey’s family was that their mother was a public patient, that they had no contract with the nursing home regarding fees, that their mother was placed in the nursing home by the health board which had contracted beds in it, and that they were invoiced for hospital in-patient charges by the health board which they paid to the health board. The family said that at no stage did it ever pay nursing home fees to the private nursing home, that the only fees or charges paid were those paid to the health board.