Dáil Éireann Debate, Wednesday - 5 July 2023
188. Deputy Seán Haughey asked the Minister for Health if he will provide further assistance to the private and voluntary nursing home sector to help these providers deal with the difficulties they are experiencing as regards increased costs and recruitment; and if he will make a statement on the matter. [32901/23]
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.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 has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.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 National Treatment Purchase Fund (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. Under the NHSS Act 2009 the NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes. I cannot comment on individual NTPF negotiations and it must be appreciated that this is a matter for each individual nursing home and the NTPF. Nevertheless, it is important that lines of communication are at all times maintained during the negotiation process.Overall, approximately 425 private nursing homes negotiate with the National Treatment Purchase Fund (NTPF). The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Budget 2023 saw an 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. 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.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 €150m 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. Following a recent review this scheme has been extended for a second time to the end of June 2023.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.
