Colm Burke (Fine Gael) | Oireachtas source

I wish Mr. Horan well in his new role and thank him for his work to date in all of the organisations in which he has been involved. He referred to the nursing homes support scheme. I have the terms of reference for the review of the system for setting nursing homes prices which is due for completion by 1 June. In recent weeks I have received correspondence from a number of nursing homes in which they complain about increased costs. They are being hit on a number of fronts. For example, as a result of the revaluation of commercial rates charged by local authorities, one nursing home has been informed that its rates bill will increase from €18,000 to €54,000 per annum. On average, the rates bills of nursing homes have doubled, which creates a significant drain on their resources.

A second cost for nursing homes arises from regular inspections carried out by the Health Information and Quality Authority, HIQA. While these inspections are appropriate to ensure standards are maintained in nursing homes, they also give rise to costs. Nursing homes must also compete when recruiting staff.

Nursing homes operating under the fair deal scheme face many competing demands. They have also had their payments cut in recent years. When is the review likely to be competed?

There is no appeals process in place when a nursing home is aggrieved about a decision setting the weekly cost of a bed. In some cases, nursing homes operating under the fair deal scheme receive between 30% and 50% less than what is available under the public scheme.

The level of care required by a patient may become more intense after he or she has been admitted to a nursing home facility. People are living longer and the level of care they require increases as they get older, but this is not taken into account when the level of payment is set. What is Mr. Horan's view on this issue?

It is astonishing that a waiting list of more than 4,000 has developed for gynaecological services in Cork. One of the issues that arose was access to theatres. The normal procedure is that the National Treatment Purchase Fund will refer a patient to a private facility, including in Northern Ireland. Gynaecologists and obstetricians in Cork have indicated that they have time on their hands and are prepared to do this work. They have suggested doing it in one of the private hospitals, which would require time to be bought in one of these facilities.

The issue of continuity of care has arisen. Clinicians find that when a patient is referred to another facility, there is a disconnect in providing for continuity of care. Is this issue being examined? If the role of the National Treatment Purchase Fund is to be expanded to deal with people on waiting lists, continuity of care needs to be addressed as it appears to be a problem. It was certainly a problem when people were referred to facilities outside the jurisdiction, for example, in Northern Ireland. When there were complications on their return from such facilities, the issue of who was responsible for their care arose. The issue of continuity of care needs to be examined. What are Mr. Horan's views on the matter? I thank him again and wish him every success in his new role.