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.
The Southern Health 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 can 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. However, 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 individual problems and discussions are continuing in an effort to reach agreement on a more long-term approach to the issue. However, the board has advised that as at 1 November 2001, the number on the waiting list for enhanced nursing home subvention is 251.
As the Deputy is aware, it has been decided that moneys should be paid to those who were adversely affected by the provision in the nursing home subvention regulations which allowed for the assessment of the capacity of the adult sons and/or daughters of older people who applied for nursing home subvention to contribute towards the cost of their parent's nursing home care.
A group representing the Department and the health boards-Eastern Regional Health Authority was established to ensure that this process is carried out on a uniform basis as speedily as possible. Instructions as to how the payments should be made issued recently from my Department and funding has been made available to commence the making of these payments from 1 November 2001. I understand the Southern Health Board is continuing to examine files relating to subvention applications and a final total is not currently available. However, I am advised by the board that so far, 471 cases have been identified where payments may be made.