Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this important issue. As it transpires, the Minister of State, Deputy Butler, is meeting with the CEO of the National Treatment Purchase Fund, NTPF, Mr. Liam Sloyan, to discuss the issues the Deputy raised and the general issues that face nursing homes and their ongoing relationship with the NTPF. The nursing home representative bodies are also in discussions more generally.

The Nursing Homes Support Scheme Act 2009 is the overall template that governs funding to support people accessing residential care. Prices are negotiated, as the Deputy will know, for delivery by the designated State agency, namely the National Treatment Purchase Fund. Pricing agreements are reached with individual nursing homes by the NTPF, and the rates the fund offers are based on a set of standard criteria that include costs incurred by the nursing home in question. Neither the Minister nor the Department has a role in individual price negotiations. There is a variation between the cost of care in public and private homes. Public nursing homes generally have higher costs and a higher staff-patient ratio. They also deal with far more complex cases, in general. There is about an 80:20 split, that is, 80% of all nursing home care is private and 20% is public, in the form of community nursing units, with a minimum of one in each county. That balance has to be looked at over time but, whether private, voluntary or public care, the resident's financial contribution is the same. The price of care affects only levels of State funding and has no direct impact on the resident.

Last December, the Department published a value-for-money review of nursing home costs. The purpose was to identify and to analyse the reasons for any cost differential between private and public nursing homes. Again, the review found that the cost differential is driven largely by variances in staff-to-resident ratios and the skill mixes in public and private nursing homes. Older infrastructure and the cost of upkeep of older buildings are a contributor in many of our community nursing units. Nine recommendations have come out of that report, and the HSE is, with the Department of Health and the NTPF, working through the recommendations. Delivery of those would lead, I think, to an improvement in the overall value for money delivered by the nursing homes support scheme.

The Department and the Government provided substantial support to the sector over the pandemic, with €134 million to €135 million in additional funding made available to private and voluntary nursing homes. More recently, substantial engagement has taken place on cost increases relating to inflation. The current inflationary cycle is now the subject of discussions between the nursing homes representative bodies and the NTPF.

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