Dáil Éireann Debate, Tuesday - 5 July 2016
532. Deputy Jack Chambers asked the Minister for Health if he is satisfied with his Department's implementation of the Nursing Home Support Scheme Act 2009; if he is aware that under the Act private and voluntary nursing homes are being forced to provide care for fees that are on average 58% below those paid to their public counterparts nationally; and if he will make a statement on the matter. [19397/16]
Amharc ar fhreagraThe Nursing Homes Support Scheme (NHSS) is a system of financial support for those assessed as needing long-term nursing home care. Participants contribute according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate setting.
The legislation underpinning the Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The Department of Health has no role in such negotiations. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State.
In negotiating with nursing homes, the NTPF has regard to:
- Costs reasonably and prudently incurred by the nursing home and evidence of value for money,
- Price(s) previously charged,
- Local market price, and
- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:
- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers,
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible, and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and has commenced its work in this area.
There are a number of reasons why the costs of public facilities are generally higher than those in the private sector. More complex and highly dependent residents are more generally catered for by the public system which has obvious cost implications. In addition, conditions of employment and tenure differ between private and public residential care facilities.
However, it is important that public facilities operate as efficiently and economically as possible, and towards that end the HSE is already engaged in a comprehensive exercise to review and streamline the operation and cost structures of public facilities, and the Department of Health will work closely with the HSE in that context to ensure that value for money is delivered.
