Dáil Éireann debate -
Tuesday, 12 Jun 2001

Vol. 537 No. 5

Written Answers. - Nursing Home Subventions.

Bernard Allen

Question:

278 Mr. Allen asked the Minister for Health and Children when he will make sufficient funding available to the Southern Health Board in order that the board can pay an enhanced nursing home subvention to those who qualify therefor; and the reason he has not responded to requests from the Southern Health Board to allow them to treat the nursing home enhanced subvention scheme as a demand-led scheme. [17418/01]

Bernard Allen

Question:

279 Mr. Allen asked the Minister for Health and Children if his attention has been drawn to the fact that elderly residents of nursing homes are being threatened with eviction due to the failure of his Department to make sufficient funding available to allow health boards pay enhanced nursing home subventions. [17489/01]

Noel O'Flynn

Question:

372 Mr. O'Flynn asked the Minister for Health and Children the action he intends taking in providing the shortfall of funding for nursing home care in the Southern Health Board area; if his attention has been drawn to the fact that £12 million is required in 2001 for fully enhanced subventions and that £6.6 million has been made available by his Department to the Southern Health Board in 2001; if his attention has further been drawn to the fact that a significant number of applications for enhanced subventions are on hold due to the lack of funding and that patients in nursing home care are concerned that they may be evicted due to their inability to pay; and if he will make a statement on the matter. [17203/01]

Minister of State at the Department of Health and Children (Dr. Moffatt)

I propose to take Questions Nos. 278, 279 and 372 together.

Under the Health (Nursing Homes) Act, 1990, health boards provide subventions to assist persons in meeting the costs of nursing home care. However, it was never intended that subventions would meet the full costs involved. Apart from arrangements entered into under Article 22(3) of the Nursing Home (Subvention) Regulations, 1993, which allows a health board enter into an arrangement with a private nursing home, the placement of a person in a private nursing home and the fees charged is a private arrangement between the nursing home and the individual resident.

The Nursing Homes (Subvention) Regulations, 1993, are administered by the health boards and the Eastern Regional Health Authority. There are currently three maximum rates of subvention payable – £90, £120 and £150 – in accordance with three levels of dependency – medium, high and maximum – which are eligible for subvention. The new rates represent a 25% increase and were introduced on 1 April last.

A health board may pay more than the maximum rate of subvention relative to an individual's level of dependency, for example, in cases where personal funds are exhausted. Articles 22(3) and 22(4) of the Nursing Home (Subvention) Regulations, 1993, permit health boards to contract beds in private nursing homes and to pay more than the maximum rates of subvention in such cases. However, the application of these provisions is a matter for the individual health board concerned in the context of meeting increasing demands for subventions within the board's revenue allocation as notified annually in the letters of determination. This is in keeping with the provisions of the Health Amendment (No. 3) Act, 1996. I am aware that the issue of paying enhanced subventions has been raised in the Southern Health Board area and in this regard officials of my Department are in regular contact with the board's officials to monitor the situation.

I remind the Deputies that funding for the nursing home subvention scheme has increased significantly in recent years. When this Govern ment came to office in 1997, the funding for the scheme was £27.8 million. By 2000 that figure had risen to £38.479 million. An additional £14 million has been made available for 2001, bringing the total available for the scheme this year to £52 million.

As the Deputies will be aware, in line with a Government decision, an expenditure review of the nursing home subvention scheme has been undertaken by my Department in association with the Department of Finance. It is the intention of my colleague, the Minister for Health and Children, Deputy Martin, to bring proposals to Government in relation to whatever additional measures may be necessary arising from the expenditure review, the Ombudsman's report, together with experience gained from the operation of the scheme since its inception in 1993.

In the meantime, my Department will continue to liaise with all the health boards on a regular basis during the course of 2001 in relation to the operation of the scheme. The assessment of entitlement to and payment of the mobility allowance in any individual case is a matter for the relevant health board. Accordingly, the Deputy's question has been referred to the chief executive officer of the Western Health Board with a request that she examine the query and reply directly to the Deputy as a matter of urgency.