Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I appreciate the opportunity to speak on the important issue raised by Deputy Butler, which has been reported in the media and is a source of considerable concern for the individuals affected and their families.

The nursing homes support scheme, otherwise known as the fair deal scheme, provides financial support towards the cost of long-term residential care services in nursing homes and ensures that long-term nursing home care is accessible to everyone assessed as needing it. Participants contribute to the cost of their care according to their means, while the State pays the balance of the cost. The scheme covers the cost of the standard components of long-term residential care, namely, nursing and personal care, bed and board, basic aids and appliances and laundry service. A person's eligibility for other schemes, such as the medical card scheme or drugs payment scheme, is unaffected by participation in the nursing homes support scheme or residence in a nursing home.

In determining the services covered by the nursing homes support scheme, it was considered very important that the care recipient and taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the nursing homes support scheme as this would involve effectively paying twice for the same service.

Although the nursing homes support scheme covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the nursing homes support scheme retains at least 20% of his or her income. The minimum amount that is retained is the equivalent of 20% of the non-contributory State pension. An operator should not seek payment from residents for items which are covered by the nursing homes support scheme, the medical card or any other existing scheme.

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 his or her admission to the nursing home. This contract must include details of the services to be provided to the 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 Health Service Executive are not parties to such contracts, which are concluded between each resident and the private or voluntary nursing home.

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. I would encourage anyone with concerns to raise them with the nursing home through this complaints procedure. 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 gone through the complaints procedure of the private nursing home concerned.

Age Action's paper, which highlights this issue, is welcome and I assure the Deputy that we are committed to ensuring members of the older population are protected and get the care they need and deserve, particularly at this vulnerable stage in their lives. An interdepartmental agency working group has been established to progress some of the recommendations contained in the review of the nursing homes support scheme, which was published in 2015. I have requested that the working group further examine the matter the Deputy has raised, namely, additional charges, and report to me on same. I have also met Age Action and Nursing Homes Ireland in the past week to discuss the issue of additional charges. It was a productive meeting.

To improve the transparency of these additional charges, I have outlined that a schedule of charges should be provided to potential residents on inquiry as opposed to at the point of admission to a nursing home. Nursing Homes Ireland undertook to advise its members to do so and has reissued its template contract for care to all members. Furthermore, next week I will meet the National Treatment Purchase Fund, NTPF, and HIQA to discuss this issue further and determine their positions on it. The Department of Health will continue to engage with relevant bodies and monitor the issue.

It is important that older people are protected and have all the information they need to make an informed decision, especially as many older people who are entering long-term residential care are at a vulnerable stage in the lives.

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