Dáil Éireann Debate, Thursday - 6 July 2023
348. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that no nursing homes support scheme resident is charged for services they do not use, since the establishment of the current Government; and if he will make a statement on the matter. [33324/23]
View answerThe 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 NHSS covers the cost of the standard components of long-term residential care which are:
• Nursing and personal care appropriate to the level of care needs of the person;
• Bed and board;
• Basic aids and appliances necessary to assist a person with the activities of daily living; and
• Laundry service.
Costs not covered by the NHSS include those individually incurred for items like social activities, newspapers and hairdressing. This may also include medical services such as therapies and some medical equipment. A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
It is important to state that residents of nursing homes should enjoy the same levels of support and access to services for which they are eligible as when they lived in their own homes. It is acknowledged that the reason they require 24-hour levels of support is due to their level of dependency, which in turn may require access to clinical services including hospital and other outpatient appointments in the community.
The Department of Health does not currently hold data relating to additional charges in private nursing homes; these vary according to each individual nursing home depending on the services offered. It is important to note that it is private nursing homes who hold responsibility for delivering care to their residents in line with their terms of registration and the relevant regulations under the Health Act 2007. It is clear that under the terms of the NHSS Act 2009, private nursing homes should not levy additional charges on NHSS residents for services coming within scope of the Nursing Home Support Scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.
The Competition and Consumer Protection Commission (CCPC) has published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers.
Concerns about additional charges should in the first instance be taken up with the nursing home provider. Where an individual is not satisfied with the response they receive, they may wish to take their complaint further by seeking a review from the Office of the Ombudsman.
The Department of Health is currently reviewing the available evidence and a focused piece of work to examine the issue in relation to additional charges is underway.
There are a number of separate factors driving this issue and potential actions to address each of these are being considered.
