Dáil Éireann Debate, Tuesday - 13 June 2023
1328. Deputy Holly Cairns asked the Minister for Health the steps he is taking in relation to a nursing home (details supplied) that will exit the fair deal scheme at the end of May if the National Treatment Purchase Fund does not increase payments to it. [28594/23]
View answerFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential. This is a very difficult decision for people and their families and it often takes place at a time of crisis.
Beaumont Residential Care has decided to withdraw from the Fair Deal scheme and I understand the level of stress and worry this must have caused residents and their families.
This is a commercial decision that has been made by the nursing home provider to withdraw from the Fair Deal scheme. The only mechanism for funding from the public purse for nursing home residents is Fair Deal and it is really important that private and voluntary providers continue to engage in the process as set out in the Nursing Home Support Scheme Act 2009.
I understand that the National Treatment Purchase Fund (NTPF) continues to meet with Beaumont Residential Care. Both parties need to be given space and time to go through the agreed process. Engagement between the nursing home provider and the NTPF is the only way to resolve this issue.
In the interest of the existing Fair Deal residents in the nursing home, the NTPF has offered an extension to the current contract for one month to allow further time for negotiations to continue. This contract extension has been agreed.
The HSE is statutory provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care.
The HSE will support families in a situation where a private nursing home is no longer able or willing to provide care under Fair Deal to a loved one.
Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget must support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.
Budget 2023 saw over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.
It is important that nursing homes manage potential cost pressures in line with their regulatory and contractual responsibilities, maintaining their quality of care so that residents’ lived experience and comfort is not affected.
Should services close, residents must either be catered for within the existing system, with its reduced capacity, or, ultimately, the HSE will step in as the statutory provider of last resort.
The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €149 million of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date. A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. This scheme is now under review for a second extension to end of June 2023.
The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the NTPF.
Maximum prices for individual nursing homes are agreed with the NTPF following these negotiations and are based on the NTPF’s cost criteria, such as costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes.
The Department of Health and I have regular interaction with the National Treatment Purchase Fund (NTPF). I recently met the NTPF to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed.
Anyone who has had a scheduled renegotiation of their Deed of Agreement this year with the NTPF has seen a significant uplift.
In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.
I am conscious of private and voluntary nursing homes that are not scheduled to renegotiate their Deed of Agreement in 2023 and other options are being considered. One of the options under consideration is for nursing home providers to agree to a shorter contract duration with the NTPF.
It is essential that when nursing homes are intending to close or cease participating in the Nursing Home Support Scheme, that residents and their families must be consulted with and given appropriate notice so that new homes can be found and they can be moved in a safe, planned way.
