The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
The legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State. In negotiating with nursing homes, the NTPF has regard to:
- Costs reasonably and prudently incurred by the nursing home and evidence of value for money;
- Price(s) previously charged;
- Local market price; and
- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:
- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and work in this area is ongoing and well advanced.
In relation to the Deputy's reference to a national forum for elderly care as requested by the sector, while consultation is, and always will remain, an important part of our approach, it is considered that it would be inappropriate to delegate elements of public policy, possibly including budgetary policy, to any consultative forum, particularly where some of those represented may have a commercial vested interest in the outcome. That said, there are a number of mechanisms through which consultation and ongoing engagement takes place. The Department engages with key stakeholders regularly to discuss concerns and ideas, and hosts an annual stakeholder forum under the umbrella of the National Positive Ageing Strategy.
