Dáil Éireann Debate, Thursday - 9 July 2015
8. Deputy Thomas P. Broughan asked the Minister for Health the current status of the fair deal scheme; how advanced planning is for dealing with the seasonal upsurge during the winter; and if he will make a statement on the matter. [27370/15]
View answerI am aware that total funding for the fair deal scheme is almost €1 billion and that there was an increase earlier this year. How many of the promised 1,600 places have been delivered? Also, how many of the 300 places promised earlier have been delivered? In general, how prepared are we for the forthcoming winter? Last November, 2,000 people were waiting for a nursing home place. What preparations are being made to avoid that happening this winter?
The nursing homes support scheme, the fair deal scheme, is a system of financial support for those in need of long-term nursing home care. Participants contribute according to their means while the State pays the balance of the cost.
In 2015, the scheme has an allocation of €993 million. In budget 2015, additional funding of €25 million was provided to support services that provide alternatives to, and relieve pressures on, acute hospitals. Of this €25 million, some €10 million was used to provide an additional 300 places under the fair deal scheme. This reduced the waiting time for approved applicants from 17 weeks to four weeks. Some €8 million was used to provide access to an additional 115 short-stay beds across the Dublin area, €5 million was used to provide 400 additional home care packages which will benefit 600 people in the course of the year, and €2 million was used to expand the community intervention team services in primary care across Dublin and the surrounding region.
In April 2015, the Government provided a further €74 million to address issues that impact on delayed discharges. This amount was in addition to €25 million provided earlier and was allocated as follows. Some €44 million was allocated to the nursing homes support scheme to provide an additional 1,600 places and to further reduce waiting times for approved applicants from 11 to four weeks. This funding will allow the HSE to increase the rate of approvals during periods of increased demand, including any surge during the winter months so as to maintain the waiting time for approved applicants at no more than four weeks. In the coming months, the number of people supported under the scheme will increase on an ongoing basis. The scheme will be supporting in excess of 23,900 people by the end of 2015. The remaining €30 million was principally applied to provide additional transitional beds, some of which were on a temporary basis to address the particular pressures then being experienced by acute hospitals.
When the nursing homes support scheme commenced, a commitment was made that it would be reviewed after three years. This review is considering the scheme's long-term viability as well as looking at how well the current model of provision is balancing residential care with care in the community, and whether this needs to be adjusted to better reflect what older people want and need. The review of the scheme is almost completed and is expected to be published shortly.
On the review, is the Minister aware that recommendations have been reported in the media? Are those accurate? When does he expect to be able to publish the recommendations and what might he expect to be in them? There are indications that additional finance will be required from clients of the scheme.
More generally, the Minister spoke a few weeks ago about unmet needs in the health service and indicated that up to €1 billion in additional funding might be required this year. I asked the Taoiseach about this the other day and he seemed to indicate that there might be a supplementary budget before the end of the year for 2015. Will that include the fair deal scheme? The Minister is aware of the work of ALONE and the Home First campaign, which indicates very clearly that many more seniors would do well at home if the Minister were able to put more money into home supports and home care packages. There is a long waiting list for that.
There are a number of questions there. The fair deal review is done and I expect it to be published in the next few weeks. It does not so much make recommendations as suggest different things that could be done to make the scheme more sustainable in the years to come. It then makes recommendations about alternative ways of funding home care in a better way. There are lots of other things like that and it is quite an interesting report. The report also addresses some of the unfairness that may exist, particularly for self-employed people and farmers, in the way people are assessed for the fair deal scheme, and makes recommendations in that regard.
On the ALONE campaign, it is absolutely our preference that people stay at home for as long as possible. By and large, it is also less expensive to provide a home care package than to provide a fair deal place. The proportion of people aged over 65 going in to nursing homes is actually falling, notwithstanding that the raw numbers are increasing. That is illustrative of the fact that better home care is now available.
There is still a significant waiting list for home care packages. The waiting time for the fair deal scheme has decreased significantly, to four or five weeks, but what does the Minister intend to do about the waiting time for home care packages themselves? Does that form part of the amount the Minister was thinking of in terms of unmet needs?
An additional €5 million was provided this year to provide an additional 400 home care packages to the benefit of 600 people. The waiting time for a package varies from region to region quite significantly, which is a real difficulty. The HSE has been given flexibility to spend more on home care packages where it is running into trouble in staffing units. Where the HSE cannot get nursing staff to open a community unit, it can divert funding to additional home care packages. That is actually being done.
