The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means 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 Report of the NHSS Review published in 2015 identified a number of issues for more detailed consideration, including a review of pricing mechanism 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 this review which is chaired by the NTPF and includes representatives from my Department and the Department of Public Expenditure and Reform. The NTPF have responsibility for the development of this report, although Department Officials continue to engage with the NTPF regarding the review. The most recent update from the NTPF is that the report will be finalised and ready for review in the first half of 2018.
In relation to variations in the cost of care for public and private nursing homes it is acknowledged that public nursing homes have, in general, a higher cost of care. It is understood that a number of factors contribute to this such as higher dependency levels of clients requiring a higher staff skill mix, environmental implications for staffing levels and the geographical provision of residential placements.
That said, there is a need to undertake a deeper analysis of the factors driving the higher costs of care in public units. This is why the 2015 Review of the Nursing Homes Support Scheme identified the need for a Value for Money and Policy (VFM) review of the cost differentials in public and private/voluntary residential facilities. My Department will be working on this VFM throughout the year.
