Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this very important issue. He spoke to me about it earlier and when I went back to my office I looked up the facility he mentioned, St. Brendan's in Mulranny. It appears to be a fantastic facility for older people to age in their community.

I am keenly aware of the challenges that have been faced by the nursing home sector over the last three years. These have been exacerbated since last year by inflationary cost increases. I am delighted the Deputy raised the situation relating to voluntary nursing homes. I think he is the first person who has done so. Some 81% of nursing homes in Ireland are privately owned, about 3.5% are voluntary and 16% are in the care of the HSE and the State. The voluntary not-for-profit sector very rarely gets an outing on the floor of the Dáil, so I thank the Deputy for referring to it.

As the Deputy will be aware, budget 2023 saw an additional €180 million of funding for services for older people for winter 2022 and into 2023, building on unprecedented increases in recent years. This includes more than €40 million in additional funding for the nursing homes support scheme, NHSS, that we all know as the fair deal, which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated. The Department of Health has regular interaction with the National Treatment Purchase Fund, NTPF. I met the NTPF again recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed.

Other options to support nursing homes are also being explored. Those who had a scheduled renegotiation of their deed of agreement with the NTPF this year - 60% of nursing homes have renegotiated successfully - have seen a significant uplift of between 6% and 7% on their contracts. That increase will come out of the €40 million provided. In addition, homes that renegotiated their deed this year now have an opportunity to renegotiate every 12 months. Previously, it was every two or three years. We hope this will deal with the inflation issue.

The Deputy will be aware that we are in the budgetary cycle at the moment. I have had several meetings with my team in the Department and with the HSE. I will look positively at securing more funding for the nursing homes sector. I am acutely aware of the challenges small family, community and voluntary nursing homes face. They do not have the same economies of scale as larger nursing homes. We are speaking about 33 community beds in a rural area. While we have lost a lot of nursing homes, we have seen a net increase in beds, although they may not be in the areas where we need them. I take on board all the points the Deputy raised.

I acknowledge that there are variations in the cost of care across public centres and private and not-for-profit nursing homes, with public nursing homes or community nursing units, CNUs, generally having a higher cost of care. The HSE will always step in where a resident's needs are sufficiently complex that he or she cannot be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care. I recognise that private and not-for-profit nursing homes also deliver complex levels of care to residents in many cases.

The cost of care in public nursing homes is calculated annually by the HSE and implemented as part of the funding process for public units under the Nursing Homes Support Scheme Act 2009. A number of factors contribute to these higher costs including the statutory leave entitlements available to staff at public nursing homes, as well as the rate of pay within consolidated pay scales, and reductions in the number of long-stay public beds to comply with health and safety, fire regulations and HIQA compliance. Public nursing homes generally have higher nurse and other staffing ratios in place than private nursing homes.

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