Dáil Éireann Debate, Wednesday - 24 May 2023
194. Deputy Brendan Smith asked the Minister for Health if additional supports will be introduced for the private nursing home sector, particularly for smaller-scale providers; the proposals, if any, to introduce a stabilisation fund; when a review of the fair deal scheme will be undertaken; and if he will make a statement on the matter. [25044/23]
Amharc ar fhreagraFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential.Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €149m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date.
A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. This scheme was extended to March 2023 and is now under review for a second extension to end of June 2023.
In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.Overall, 425 private nursing homes negotiate with the National Treatment Purchase Fund (NTPF). The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Nursing homes which had a scheduled renegotiation of their Deed of Agreement with the NTPF this year have seen a significant uplift.Budget 2023 saw an over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.The NTPF carry out this role independently under the NHSS Act 2009. It will be appreciated that particulars of all such negotiations and reviews are a matter between the nursing home and the NTPF. The NTPF has statutory independence, and neither the Minister for Health nor I have any role in NHSS price negotiations. Nevertheless, it should also be noted that the Department continues to work with the NTPF to take forward the recommended actions that emerged from the review of the NTPF pricing system published in June 2021.It is important to note that the HSE is statutory provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care.It is essential that all future plans for the nursing home sector continue to prioritise the best interests of residents while seeking value for money for the Exchequer. The Government is committed to seeing greater public sector involvement in the residential care of older people in Ireland and to move over time towards a needs-based model of funding and pricing for the nursing home sector. Important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on the 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform, the nine recommendations of the Value for Money Review on Nursing Home Costs, the four recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities and the 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will inform future policy.Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
