Jim O'Keeffe
Question:139 Mr. J. O'Keeffe asked the Minister for Health and Children his views on whether the payments under the nursing home subvention scheme are now adequate; and if the payments will be substantially increased. [24562/01]
Written Answers. - Nursing Home Subventions.
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 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 or 114.28, £120 or 152.37 and £150 or 190.41 – in accordance with three levels of dependency – medium, high and maximum – which are eligible for subvention.
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.
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 and the Ombudsman's report, together with experience gained from the operation of the scheme since its inception in 1993.