Jim O'Keeffe
Question:102 Mr. J. O'Keeffe asked the Minister for Health and Children the present scale of nursing home subvention; his views on the fact that they are entirely inadequate; and his proposals in this regard. [17618/03]
Written Answers. - Nursing Home Subventions.
Under the Health (Nursing Homes) Act 1990, a health board may pay a subvention to assist a person in meeting the costs of their long stay care in a private nursing home. However, it was never intended that a subvention payment 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 to 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 individual and the nursing home proprietor.
The Nursing Home (Subvention) Regulations 1993 are administered by the health boards and the Eastern Regional Health Authority. There are currently three rates of subvention payable –€114.30, €152.40 and €190.50 – for the three levels of dependency which are medium, high and maximum. Included in these payments is an increase of 25% which came into effect in April 2001.
A health board may pay more than the maximum rate of subvention relative to an individual's level of dependency in a case for example 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 subvention 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 since its inception. In 1994, the first full year of the scheme, €5 million was allocated for its operation. The Deputy may be interested to note that funding of €110 million is being allocated in 2003 for the operation of the scheme.
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. The objectives of the review of the subvention scheme were,inter alia, to examine the objectives of the nursing home subvention scheme and the extent to which they remain valid, to assess the service delivered and to establish what scope, if any, exists for achieving the programme objectives by other more efficient and effective means. I will be launching the review later in the week in association with my colleague, the Minister for Social and Family Affairs, who will be also launching a report on the future financing of long-term care in Ireland.
A review of the nursing home regulations is also being undertaken within my Department. The objective of the review is to develop a scheme which will be transparent; offer a high standard of care for clients; provide equity within the system to include standardised dependency and means testing; be less discretionary; provide both a home and nursing home subvention depending on need; be consistent in implementation throughout the country and draw on experience of the operation of the old scheme. My Department will also be consulting with all stakeholders as part of the review process.
Question No. 103 answered with Question No. 87.