Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I am acting in that capacity at the moment. I thank Deputy Maureen O’Sullivan for raising this issue. The Minister of State, Deputy Jim Daly, apologises for not being here.

The Government’s core stated objective is to promote care in the community so that people can continue to live with confidence, security and dignity in their own homes and communities for as long as possible. There will, however, always be a cohort of older people who require a quality long-term residential care option. The nursing homes support scheme provides financial support for those in need of long-term nursing home care. Participants in the scheme contribute to the cost of their care according to their means while the State pays the balance of the cost. The aim of the scheme is to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The review of the nursing homes support scheme, NHSS, published in 2015, identified a number of issues for more detailed consideration, including a review of the pricing mechanism used by the National Treatment Purchase Fund, 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 us possible; and ensuring that there is adequate residential capacity for those residents with more complex needs. A steering group was established to oversee and manage the pricing review. The steering group is chaired by the NTPF and includes representatives from the Departments of Health and Public Expenditure and Reform. As part of its work on the review, the NTPF sought various inputs including external expertise and stakeholder engagement to inform the review. These inputs are being considered in detail.

This report is significantly overdue, however. I understand that the NTPF is close to completing the report and it is expected that the steering group will be provided with a final draft very shortly. Once complete, the report of the review will then be submitted to the Department of Health. It is recognised that any change to any part of the scheme must be considered in terms of the short and long-term impact on the viability of the scheme and accessibility of long-term residential care in general. It is important, therefore, that the relevant issues are considered thoroughly through this review process and that we ensure that support for people who require it remains on a sustainable footing.

The nursing home sector has also raised concerns in relation to staffing, particularly in terms of securing access to appropriately qualified staff. On foot of these concerns, nursing home providers have requested the removal of healthcare assistants from the ineligible list for permits issued by the Department of Business, Enterprise and Innovation to bring in workers from outside of the European Economic Area, EEA. These permits may be issued for occupations in respect of which there are labour or skills shortages. The results of the most recent review of the employment permits critical skills list and ineligible lists of occupations that come into effect on 22 April 2019, as set out on the website of the Department of Business, Enterprise and Innovation, contain no changes to the grades of care worker arid healthcare assistants.

There needs to be a clear demonstration that recruitment difficulties are solely due to shortages and not to other factors, such as salary or working conditions.

Both Departments met sectoral representatives and considered their business case. The sector has been advised that more evidence is required of the labour shortage and that they must demonstrate full engagement with the Department of Employment Affairs and Social Protection. On provision of this evidence, the matter will then be reconsidered. The Minister of State, Deputy Jim Daly, acknowledges the significant role of private and voluntary providers in residential care provision. I assure the House that he and the Department will continue to engage with the nursing home sector.

See this speech in context