Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this matter. I note his interest in the private nursing home sector. The fair deal scheme was designed to protect and support vulnerable older people and to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. To be very clear, Government funding for the fair deal scheme aims to support vulnerable older people at a time in their lives when full-time care is essential. This is a very difficult decision for families and their loved ones that often takes place at a time of crisis. That is why I, as Minister of State with responsibility for older people, find it essential to ensure that the budget for the scheme, to which a massive almost €1.5 billion has been allocated this year, will last from 1 January to 31 December for the 22,700 people who may need nursing home care.

It is imperative that nursing homes manage potential cost pressures in line with their regulatory and contractual responsibilities, maintaining quality care so that residents’ lived experience and comfort is not affected. However, the Government and I are 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. I note that 15 companies control 10,700 beds in Ireland. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. More than €149 million in financial support has been provided to private and voluntary nursing homes through the Covid-19 temporary assistance payment scheme. The provision of free personal protective equipment and oxygen to private nursing homes continues - not that I hear that very often - and has cost approximately €75 million to date. In light of inflationary cost pressures, a new €10 million scheme 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 over the period from July to December 2022. At that stage, a nursing home could claim up to €31,500. I extended that scheme up to the end of March. It is now under review for extension for a second time up until the end of June 2023.

Both the Department of Health and I have regular interaction with the National Treatment Purchase Fund, NTPF. I met its representatives last week to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Some 425 private nursing homes negotiate with the NTPF. Anyone who has a scheduled renegotiation of their deed of agreement with the NTPF this year has seen a significant uplift. I have met many of these nursing home operators. Neither I, nor the Minister, Deputy Stephen Donnelly, have any role in this negotiation process. Other options to support nursing homes are being explored, particularly in respect of the often costly nature of compliance for nursing homes under necessary HIQA regulations. Budget 2023 saw more than €40 million in additional funding for the scheme, which will provide an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.

When the Deputy spoke about cost differential, he did not mention that the HSE is the statutory provider of last resort and will always step in when a resident’s needs are sufficiently complex that he or she cannot be cared for anywhere else in the community. The HSE needs to be equipped to deliver that kind of complex care. As the Deputy is aware, Nursing Homes Ireland has lodged a state-aid complaint against the Government with the European Commission regarding the State's subvention scheme for nursing home care. That is as much as I am prepared to say at present.

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