Dáil Éireann Debate, Tuesday - 27 June 2023
662. Deputy Michael Healy-Rae asked the Minister for Health if his Department will look at reducing the three-year cap to one year in the fair deal scheme; and if he will make a statement on the matter. [30800/23]
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. 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 residential care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. All participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three-year cap, which is intended to protect the value of a principal private residence. The Department of Health has also introduced the Nursing Homes Support Scheme (Amendment) Act 2021, which became operational in October 2021. This introduced a three-year cap on contributions from family farm and business assets, provided that a family successor is appointed to run the asset for at least 6 years. The Act also extended the three-year cap to the proceeds of sale of a principal residence, which means that, from the fourth year in care onwards and provided the house was sold while the person is in care, a nursing home resident may sell their principal private residence without incurring additional costs. Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal and relied on over €360m in client contributions. This will increase to nearly €1.5 billion for 2023. Important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on:
• The nine recommendations that emerged from the Value for Money Review on Nursing Home Costs,
• The 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform,
• The four recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities, and
• The 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will serve to inform future policy. As the NHSS is governed by primary legislation, due consideration must be given to the potential impact and unintended consequences of any changes before they can be introduced.Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
