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Private care homes want service provider choice retained in reform

Road sign warning of a care home ahead.
Road sign warning of a care home ahead. Source: Olev Kenk/ERR

The state's planned care home reform is a welcome one, but it must preserve the opportunity for the person in need and their loved ones to choose the right service provider for them, said Martin Kukk, chairman of the supervisory board of Südamekodud, Estonia's largest private care home operator.

Kukk noted that according to the current bill, care homes won't be facing any drastic changes, however the bill has yet to pass through the Riigikogu and it's yet uncertain in precisely what form changes will be passed.

"This service must be provided at high quality this upcoming year as well, and the price of the service will be based on market conditions, meaning that as much as a good team of carers, heating, food and everything else costs, that is how much the service will shape up to be," he explained.

The supervisory board chair considers the government's plan a positive one, as it will help reduce the burden of care on those in need as well as their loved ones.

"And hopefully many family caregivers can return to the labor market as a result as well," he added.

"What I consider the biggest risk is that if the state, via local governments, starts to pay part of the price of the service, then the person in need or their loved ones won't be able to choose the service provider and location that are best suited to their needs, but rather this decision will be left up to the authority of local government officials," he said.

The current wording of the bill remains open-ended in this regard, and if local governments' assessments played a more significant role in the decision-making process, Kukk believes this would eliminate competition between service providers, which is a motivating factor in investment into the field.

"In other words, the actual person in need and their loved ones should definitely retain the chance to decide which service they'd like to use and where, especially as the brunt of the price of the service will remain up to the person in need and their loved ones to bear," he stressed.

According to Kukk, there's no reason to fear a significant increase in demand for spots in care homes. "People still tend to opt for nursing homes as a last resort," he explained. "Everyone still prefers to remain in their own home as long and for as long as possible. I don't foresee any major changes occurring in this regard."

Südamekodud is simultaneously preparing to enter the home care field, the improving of access to which is likewise part of the planned reform. According to Minister of Health and Labor Peep Peterson (SDE), it will be possible to direct a total of €12 million in funding into the development of the field.

"There aren't currently any major service providers in this field in Estonia today; this service lacks a real funding model," Kukk said, adding that home care services are currently being provided primarily by local governments as well as a few small service providers.

According to the care home operator supervisory board chairman, the development of a funding model for home care may in fact ease pressure on care homes.

"If you look at the overall nationwide picture, there are almost no free areas in rural areas," he noted. "An actual competitive situation has arisen in Tallinn and the Harju County area in recent years, and everyone is fighting for clients in order to fill their spots."

Once passed into law, the planned general care home reform is slated to enter into effect next July 1.

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Editor: Aili Vahtla

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