Written Answers. - Nursing Home Subventions.
John McGuinness
Question:
91
Mr. McGuinness
asked the
Minister for Health and Children
if his Department will review the private nursing home subvention system operated by the health boards with a view to making it more possible in relation to the means of the applicant and encourage its use during times when the elderly are prone to illness; his views on whether this subvention system could be used to take elderly patients off the corridors of public hospitals and into private care thus relieving the pressure being experienced in most public hospitals; and if his Department are considering any scheme which could bring about a greater use of private nursing homes.
[3141/99]
Since coming into office, this Government has provided significant additional resources for the nursing home subventions scheme. Over £17 million was provided for the scheme in the Estimates for 1998. Additional funding of £6.9 million was provided in the Supplementary Estimate for 1998.
A further £9 million was allocated to health boards this year to meet, inter alia, increased demand for nursing home subventions, the additional costs arising from increased dependency levels and the change in the regulations which applies from 1 January 1999. This regulation removes the provision which allowed health boards to assess the capacity of adult sons and/or daughters over 21 years of age to contribute towards the cost of nursing home care of their parent. The cost of this change alone is estimated at about £2 million per annum. The additional funding provided this year brings the total amount of funding available for the scheme to £33 million.
The budget allocation for older people includes a sum of £1.45 million which will enable a new 50-bed community nursing unit at St. Clare's, Ballymun to be opened this year, together with a new 27-bed unit in Clonmel. In addition, the full year costs of contracting an additional 65 nursing home beds is being allocated to the Eastern Health Board, which will help to alleviate the pressure on acute hospital beds in the major general hospitals in Dublin.
The need to develop better health and other support services for older people is regarded as a priority by this Government. An indication of our commitment to improving services for older people during our term of office can be seen in the fact that we have doubled the capital allocation to services for older people, from £7 million in 1997 to £14 million in 1998. New community nursing units are under construction at Achill and Killybegs. Another important aspect of the capital programme is to replace old, unsatisfactory accommodation with new, modern facilities and such work has started, or is being planned, at locations such as Birr, Cavan and Enniscorthy.
The report of the Review Group on the Waiting List Initiative identified the long-term inappropriate occupancy of approximately 3.3 per cent of the total number of acute hospital beds available as a factor in compromising the efficient throughput of elective surgical patients and, as a result, increasing waiting lists and waiting times for individual specialities.
Pending the implementation of more comprehensive services for older people and for persons who receive rehabilitation and long-term care in the acute hospital setting, health boards and voluntary hospitals have been requested to make arrangements for the appropriate post-hospital care of such persons.
The Minister has asked health boards and the voluntary hospitals to consider the following measures: the development of a network of private nursing home places, as satellite step-down facilities, around each acute hospital. It is envisaged that acute hospitals would, under the waiting list initiative, make arrangements with such nursing homes, by way of service agreements, to provide appropriate convalescent care to persons discharged from the hospitals. Hospitals would have access to an agreed number of places in the nursing homes and would have control over the persons admitted to these places; acute hospitals to be supported by district care teams, which would provide out-reach support services to persons discharged, either in step-down facilities or in their own homes. The teams would be comprised of relevant healthcare professionals, such as physiotherapists; occupational therapists, home helps and general practitioners and would be co-ordinated through the health board community care arrangements and the role of district hospitals in the catchment area of the acute hospital should be maximised. I am confident that these measures will help to alleviate the pressure on acute hospital beds.
