Vol. 499 No. 3
231 Mr. Perry asked the Minister for Health and Children the reason the subvention rates for nursing homes have not increased since 1992; the plans, if any, he has in place to increase them; if so, the amount by which they will increase; and if he will make a statement on the matter. [2431/99]
232 Mr. Perry asked the Minister for Health and Children if his attention has been drawn to the fact that level one, two and three subvention rates are mainly used in nursing homes; the reason grade four is not authorised, particularly in the case of long-term patients in private nursing homes; if his attention has further been drawn to the fact that when their own personal finance is depleted they have no option but to seek placement in geriatric units within the health boards which puts additional pressure for beds on the health boards; if his attention has been drawn to the fact that in certain circumstances owners of private nursing homes are subsidising the difference rather than remove the patient from the home as they have built up a relationship with them; the plans, if any, in place to deal with this problem; and if he will make a statement on the matter. [2432/99]
I propose to take Questions Nos. 231 and 232 together.
Under the Health (Nursing Homes) Act, 1990, the health boards provide subventions to assist persons in meeting the costs of nursing home care; however, it was never intended to meet the full costs involved. It had been hoped to increase the rates of subvention this year but it has not been possible to do so as substantial additional funding in excess of £9 million has had to be provided to meet the rising costs of the scheme.
The additional expenditure is due to a number of factors, namely, the increase in the number of people in receipt of subventions, their higher levels of dependency, resulting in more people receiving the higher rates of subventions and the change in the regulations whereby the ability of adult sons and/or daughters over 21 years of age to contribute is no longer taken into account. The amount made available for the scheme this year is £33 million. Any possible increase in the subvention rate next year will depend on budgetary circumstances and competing priorities at the time.
When the Deputy refers to a grade four rate of subvention, it is assumed he is referring to the provision whereby health boards may pay more than the maximum rate of subvention relative to an individual's level of dependency. I am aware that most of the health boards pay enhanced rates of subvention in particular cases. I am satisfied that a sympathetic view is taken of cases where personal funds are exhausted, by increasing the level of subvention where possible. Where this does not solve the problem, a health board will try to provide accommodation in one of their own long stay hospitals or nursing units.
One of the changes made to the subvention scheme operation under the Health (Nursing Homes) Act since its implementation permits health boards to contract beds in private nursing homes above the number contracted on 1 September, 1993, and to pay more than the maximum rates of subvention in such cases. This amendment is to facilitate health boards which do not have sufficient accommodation in their hospitals and homes to meet the needs of those requiring nursing care and which have traditionally relied on the nursing home sector to meet this need. In 1999, the full year costs of contracting an additional 65 nursing home beds is being allocated to the Eastern Health Board, which will help to alleviate the pressure on acute hospital beds in the major general hospitals in Dublin.
