Vol. 539 No. 3
22 Mr. McGinley asked the Minister for Health and Children if his attention has been drawn to the concerns of those operating nursing homes regarding the variety of funding arrangements across the country, including for example, different arrangements for the provision of incontinence wear and the variety of inspection procedures for nursing homes; and if he will make a statement on the matter. [19341/01]
The Health (Nursing Homes) Act, 1990 which came into effect on 1 September 1993 has two principal objectives. The first is to ensure high standards of accommodation and care in all nursing homes registered under the Act and the second is to provide a new system of nursing home subvention so that dependent persons most in need of nursing home care will have access to such care. The Nursing Home (Subvention) Regulations, 1993 allow health boards to exercise their discretion in a number of areas, including, for example, articles 22.3 and 22.4 allows the payment of an amount in excess of the current rate of subvention in some cases. This element of discretion allows health boards to consider each application on its own merits and offers the flexibility necessary to best meet the interests of the applicant.
In relation to the two specific issues raised by the Deputy, the Health (Nursing Homes) Act, 1990 requires nursing homes to be registered with their local health board. Regulations made under the Act require that there must be proper standards in nursing homes, including adequate and suitable accommodation, staffing, kitchen and sanitary facilities, access to medical care, facilities for recreation and other arrangements to ensure the health and well-being of residents. Nursing homes are required to renew their registration every three years and a health board may at the time of registration, or subsequently, impose conditions in relation to registration. The regulations provide for periodic inspections at least once every six months by the health boards, which are empowered to prosecute registered proprietors and persons in charge in the event of breaches of the regulations.
To obtain a rounded and comprehensive view of a nursing home and the standard of care, the home will have to be inspected by professionals of various disciplines such as a public health nurse, medical officer and an environmental health officer. Nonetheless, the exact formation of the inspection teams will be a matter for determination by the chief executive officer or deputy chief executive officer of a health board.
Article 16.1 of the Nursing Homes (Subvention) Regulations 1993 provides that individuals resident in private nursing homes who are in receipt of a subvention from the health board may not be charged extra for any service which is considered to be essential to their maintenance in the home and common practice in most nursing homes. Such services include bed and board, nursing care appropriate to the level of dependency of the person and incontinence wear.
Arrangements are currently in place for the supply of incontinence wear by health boards to medical card holders living in the community. On 26 February, on the instructions of my colleague, the Minister for Health and Children, a letter was issued to the health boards-Eastern Regional Health Authority requesting that the boards ensure that medical card holders who have entered, or will enter, private nursing homes, retain their eligibility for incontinence wear under the GMS scheme and that all medical card holders in receipt of a subvention be supplied with incontinence wear on the same basis as if they were residing in the community.
