Dáil Éireann debate -
Thursday, 28 Jun 2001

Vol. 539 No. 3

Written Answers. - Nursing Home Subventions.

Seán Ryan

Question:

75 Mr. S. Ryan asked the Minister for Health and Children the steps he is taking to address the concerns of families whose elderly relatives are under the threat of eviction from private nursing homes due to the failure of health boards to pay full financial grants or subventions; and if he will make a statement on the matter. [19224/01]

Minister for Health and Children (Mr. Martin):

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.

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 contracts 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, £150 – in accordance with three levels of dependency – medium, high, 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. As referred to above, 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 would like to remind the Deputy that funding for the nursing home subvention scheme has increased significantly in recent years. When this Government 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 Deputy 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, 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.