Jackie Healy-Rae
Ceist:262 Mr. Healy-Rae asked the Minister for Health and Children when the Southern Health Board will receive the enhanced subvention payment for nursing home patients; and if he will make a statement on the matter. [19826/01]
Written Answers. - Nursing Home Subventions.
Jan O'Sullivan
Ceist:294 Ms O'Sullivan asked the Minister for Health and Children if he has allocated, or will allocate, extra funding to health boards in order to fund the provision of top-up subventions for elderly citizens who are unable to afford nursing homes; and if he will make a statement on the matter. [20132/01]
I propose to take Questions Nos. 262 and 294 together.
The Health (Nursing Homes) Act, 1990, which came into effect on 1 September 1993, has two principal objectives. The first is to ensure high standards of accommodation and care in all nursing homes registered under the Act. The second is to provide a new system of nursing home subvention so that dependent persons most in need of nursing home care will have access to such care.
Under the Health (Nursing Homes) Act, 1990, health boards provide subventions to assist persons in meeting the costs of nursing home care. 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, and these are in accordance with the three levels of dependency which are eligible for subvention, medium, high and maximum. The new rates represent a 25% increase and were introduced on 1 April.
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. 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.
The position in the Southern Health Board area is that the board has received a significantly increased number of claims from patients for enhanced payments in accordance with Articles 22.3 and 22.4. It is a matter for the board to determine the extent to which it could meet such claims consistent with its requirement to live within its overall revenue allocation and taking account of the fact that such enhanced payments are discretionary. In the interest of avoiding hardship to individual patients, my Department has been in regular contact with the board in an effort to find a solution which would take cognisance of the considerations outlined above. A solution has been found to meet the most immediate problems and discussions are continuing in an effort to reach agreement on a more long-term approach to the issue.
I remind the Deputies that funding for the nursing home subvention scheme has increased significantly in recent years. When this Government came to office in 1997 the funding for the scheme was £27.8 million. By 2000 that figure had risen to £38.479 million. An additional £14 million has been made available for 2001, bringing the total available for the scheme this year to £52 million.
As the Deputies will be aware, in line with a Government decision, an expenditure review of the nursing home subvention scheme has been undertaken by my Department in association with the Department of Finance. It is the intention of my colleague, the Minister for Health and Children, to bring proposals to Government in relation to whatever additional measures may be necessary arising from the expenditure review, the Ombudsman's report, together with experience gained from the operation of the scheme since its inception in 1993.
In the meantime, my Department will continue to liaise with all of the health boards on a regular basis during the course of 2001 in relation to the operation of the scheme.