Dáil Éireann Debate, Thursday - 27 October 2016
145. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 386 of 4 October 2016, his views on the impact on a person's dignity of allocating daily pocket money under the fair deal scheme, where some persons residing in nursing homes are allocated as little as €6.34 per day; and if he will make a statement on the matter. [32502/16]
Amharc ar fhreagraWhile it is the preferred option to support older people in their own homes for as long as possible, there will always be a cohort of people who require quality long term residential care. The aim of the Nursing Homes Support Scheme 'A Fair Deal' is to enure that long term nursing home care is accessible and affordable for everyone assessed as needing it, and that people are cared for in the most appropriate settings. My reply to Parliamentary Question number 386 of 4 October 2016 outlined the financial contribution which participants in the Scheme make towards the cost of their care, regardless of whether they choose a public, private or voluntary care facility. An individual financial assessment is carried out for each applicant to the Scheme.
My reply to Parliamentary Question 386 also described the many safeguards contained in the Scheme, one of which is to ensure that an applicant keeps a personal allowance of 20% of his/her income or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater. This is in recognition of the fact that, although the NHSS covers core living expenses, residents can still incur some costs in a nursing home such as social programmes, newspapers or hairdressing. Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.
Furthermore, registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.
A further safeguard contained in the Scheme relates to certain items of expenditure known as allowable deductions which can be taken into account for the financial assessment, such as health expenses, payments required by law, rent payments and borrowings in respect of a person's principal private residence, maintenance payments, and payments in respect of the maintenance of dependent children.
Importantly, where an applicant's assets include land and property held in the State, the contribution based on such assets may be deferred and collected from their estate. This is to ensure that a person does not have to sell their home during their lifetime to pay for long term nursing home care.
A list of Nursing Home Support Offices are provided on the HSE website. An applicant's local Nursing Home Support Office will be in a position to provide information in relation to having a review of their financial assessment. This can take place if 12 months have passed since the initial financial assessment or the most recent review, or if the HSE is satisfied that there has been a material change to the person's financial circumstances.
