I propose to take Questions Nos. 278, 279 and 372 together.
Under the Health (Nursing Homes) Act, 1990, health boards provide subventions to assist persons in meeting the costs of nursing home care. However, it was never intended that subventions would meet the full costs involved. Apart from arrangements entered into under Article 22(3) of the Nursing Home (Subvention) Regulations, 1993, which allows a health board enter into an arrangement with a private nursing home, the placement of a person in a private nursing home and the fees charged is a private arrangement between the nursing home and the individual resident.
The Nursing Homes (Subvention) Regulations, 1993, are administered by the health boards and the Eastern Regional Health Authority. There are currently three maximum rates of subvention payable – £90, £120 and £150 – in accordance with three levels of dependency – medium, high and maximum – which are eligible for subvention. The new rates represent a 25% increase and were introduced on 1 April last.
A health board may pay more than the maximum rate of subvention relative to an individual's level of dependency, for example, in cases where personal funds are exhausted. Articles 22(3) and 22(4) of the Nursing Home (Subvention) Regulations, 1993, permit health boards to contract beds in private nursing homes and to pay more than the maximum rates of subvention in such cases. However, the application of these provisions is a matter for the individual health board concerned in the context of meeting increasing demands for subventions within the board's revenue allocation as notified annually in the letters of determination. This is in keeping with the provisions of the Health Amendment (No. 3) Act, 1996. I am aware that the issue of paying enhanced subventions has been raised in the Southern Health Board area and in this regard officials of my Department are in regular contact with the board's officials to monitor the situation.