Vol. 437 No. 4
1 Mr. Flanagan asked the Minister for Health if his attention has been drawn to delays in having nursing homes registered in order to qualify for subvention under the recently announced nursing homes regulations; and the action, if any, he will take on the matter.
Under the Health (Nursing Homes) Act, 1990, which was commenced on 1 September last, nursing home proprietors have one year in which to register with a health board. The Act, therefore, provides for the gradual registration of nursing homes with health boards. To date health boards have received 184 applications for registration from nursing homes, of which 60 were received during the month of November. So far 34 homes have been registered by health boards.
My Department was concerned that prior to the month of November, so few homes had applied for registration. It was drawn to my attention that the procedure for confirming that nursing homes had complied with fire safety requirements was causing difficulties and was delaying registration. My Department wrote to the health boards in November clarifying the procedures for registration of nursing homes in relation to confirmation that fire safety requirements were being met. This clarification is a major reason for the increase in applications for registration under the Act and it is expected that significant numbers of homes will be registered before the end of this year.
The Deputy will be pleased to know that my Department has established a group to monitor the implementation of the nursing homes Act comprising representatives of my Department, of health boards, of the principal nursing home associations and of the National Council for the Elderly, which is meeting regularly to monitor progress on implementation including the registration of nursing homes, and to advise on how difficulties encountered in the implementation of the Act can be resolved.
The Deputy will be interested to know that during the year following the commencement of the Act, health boards have discretion to pay nursing home subventions to persons who have qualified for the subventions, to nursing homes which have not yet registered under the Act.
I thank the Minister for his reply. We are pleased that he is taking action by way of establishing a monitoring group. Does the Minister share the view of his ministerial colleague at the Department of the Environment, Deputy Stagg, that nursing homes are a cancer in society?
The Minister is responsible for his own Department only. That would be the responsibility of the Minister of State involved. Let us have questions to the Minister for Health.
If the Minister will not answer we can take it he acquiesces with the comments made.
Corrals of death.
In view of the Minister's silence——
The Minister is always orderly.
——on the comment by his colleague I put it to him that the uptake on the nursing home regulations has been remarkably slow and that action other than that adverted to in his reply is required? Is he aware that approved subventions have been remarkably low? Does he accept that in the Mid-Western Health Board region out of 140 applications only eight have been approved; that of the 70 applications in the Southern Health Board region only eight have been approved; that only 24 have been approved out of more than 170 in the Midland Health Board region and that in the South-Eastern Health Board region very few have been accepted out of 390 applications? Does he accept there is a serious problem in the arrangement for subventions because there appears to be a hold up? What action does he propose to take to minimise the hold up given the welcome by all sides of the House, and the community, for these regulations when they were introduced on 1 September 1993? People are not benefiting.
The Deputy has imparted quite an amount of information rather than seeking it.
The Minister did not respond.
I will be guided by the Chair regarding what is appropriate for me to answer. In relation to the supplementaries, I was most anxious that this legislation be brought into force. I worked with a certain alacrity, since my appointment, to ensure that very complex regulations which were needed to bring the Act into force were worked on. That involved a huge volume of work which was expertly carried out by my departmental staff, to whom I pay tribute. This enabled me to bring the provisions of the Act into force on 1 September. That was welcomed uniformly by all the associations and the proprietors of nursing homes. Everybody will welcome two aspects, the monitoring of the standards of care — which is so important — and the provision of subventions to those in need. I share the Deputy's concern that the volume of take-up has not been as high as I would have wished. That is the reason I outlined a programme of action, including the establishment of a monitoring group. I am confident that significant progress will be made in the coming months.
On the question of subventions, are the appeals officers operating in all the health boards? The Minister can have all the monitoring committees he likes but if the staff is not available there will be a problem. Is the Minister satisfied that sufficient staff is available to implement these very complex regulations?
Part of the allocation of moneys I made to the health boards was to enable specific designated staff to be provided to ensure that all applications were processed expeditiously and responded to. I am content that that is the case. In relation to an appeals mechanism, an appeals officer is in every health board region on the same basis as appeals officers for other benefits provided by my Department. I share the Deputy's view that a health board appeals mechanism alone is not satisfactory. I am giving serious consideration to establishing a better national appeals mechanism, not only under this Act, but in regard to other benefits to which people may be entitled. It is sometimes pointed out to me, and I am sure to Deputies opposite, that there can be disparities and differences in the interpretation of requirements from health board to health board.
