Jack Wall (Kildare South, Labour)
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Question 85: To ask the Minister for Health and Children if she will intervene to ensure that charges in regard to the implementation of regulations in respect of the monitoring of nursing homes imposed by the Health Information and Quality Authority on nursing homes are not passed on to residents; and if she will make a statement on the matter. [39308/09]

Seán Barrett (Dún Laoghaire, Fine Gael)
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Question 112: To ask the Minister for Health and Children the action, legislative or other, she will take to prevent the €190 per bed annual Health Information and Quality Authority licensing and registration fee from being passed on to nursing home residents; and if she will make a statement on the matter. [39319/09]

Áine Brady (Kildare North, Fianna Fail)
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I propose to take Questions Nos. 85 and 112 together.

I understand the Deputies' questions relate to the fees associated with the system of registering and inspecting nursing homes which commenced on 1 July 2009. Under the Health Act 2007, statutory responsibility is given to the chief inspector of social services, part of the Health Information and Quality Authority, for inspecting and registering categories of designated centres, including nursing homes for older people. The authority's inspection process comprises three parts: pre-assessment, the inspection visit and report completion, including a process of fact-checking and verification. Since July 1, the authority has begun 106 inspections. Of these, 59 were announced and 47 were unannounced visits. The average duration of inspection visits to date has been two days. Of the inspection processes begun, nine have reached conclusion with the publication of reports, along with the publication of one additional inspection report. The remaining reports will be published shortly.

It is important that this new inspection regime is effective, robust, independent and properly resourced. It was decided that the new registration and inspection regime would mainly be self-financing. The 2007 Act provides for the following fees: applications for registration or renewal of registration under section 48, where this section states that the applicant shall include with the application the prescribed application fee; an annual fee payable by the registered provider under section 99; and a fee for variation or removal of any conditions of the registration under section 52. A registered provider making an application under this section must include the fee with his or her application.

Following analysis of the types of centres, numbers of places and so on, it was decided to set a registration fee of €500, payable every three years by each nursing home together with an annual fee of €190 per place in each registered centre. It is estimated that the fee represents an average weekly cost of €3.73 per registered place. The fees are payable by the registered provider, or in the case of applications for registration, by the applicant who for existing designated centres would normally be the registered provider. These fees are not due or payable by the resident or their family.

It is a matter for each individual nursing home to determine the price charged for services. However, article 28 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 states that:

(1) The registered provider shall agree a contract with the resident within one month of the admission of that resident to the designated centre.

(2) Such contract shall deal with the care and welfare of the resident in the designated centre and shall include details of the services to be provided for that resident and the fees to be charged.

Therefore, only those fees set out in the contract, including any agreed increases, should be charged by the registered provider to the resident.

Jan O'Sullivan (Limerick East, Labour)
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While the Minister of State may say that it is the nursing homes that must pay the fees, the fact is that many nursing homes are passing on that fee to the residents. One hundred and ninety euro per place is quite a lot of money to an elderly person who has very little left in his or her pension to pay for other extras like chiropody, physiotherapy and other things that may not be covered under the fair deal. What will the Government do to make those nursing homes not charge that money to their patients? The Minister of State has just said that under the 2007 Act, only what is contracted for is meant to be charged. I presume this would not have been in the contract when the nursing home residents came in. Can the Minister of State clarify that she will tell the nursing home owners not to charge the residents?

Áine Brady (Kildare North, Fianna Fail)
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We have already done that. It is understood that Nursing Home Ireland advised their members that the fee should be passed on to residents. This disregarded the obvious intention that the fees should be considered in the context of the National Treatment Purchase Fund negotiations. The Department wrote to Nursing Homes Ireland in August and October 2009 to advise that as private enterprises, it is a matter for each individual private nursing home to determine the rate charged for services, and that the price set by each nursing home is not determined by the Minister, the Department or by HIQA.

When these new fees were introduced, the Minister anticipated that they would naturally be subject to periodic renegotiations to take account of inflation, deflation and other developments. The Department stressed that this should in no way be taken as an imprimatur for individual nursing homes to invoice their residents with an additional charge on the introduction of the new fees.

Jan O'Sullivan (Limerick East, Labour)
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How is the Minister of State going to protect old people from this?

James Reilly (Dublin North, Fine Gael)
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I would like to raise a point of order before I comment on the Minister of State's response. A few moments ago, the Minister corrected me when I said that 21,000 people had given up their health insurance, by stating that the figure was 12,000. I would like her to correct the record. I have in front of me Question No. 248 on 20 October 2009, which was addressed to the Minister for Health and Children by Deputy Richard Bruton, and the response given by the Minister. The figure for those on health insurance for December 2008 is 2,299,000, while the figure for June 2009 is 2,278,000. The difference is 21,000 people and I found it in an answer from the Minister's Department.

Brendan Howlin (Wexford, Labour)
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That is not a point of order.

James Reilly (Dublin North, Fine Gael)
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I apologise. Whatever technicality it should come under, the Minister should correct the record and I presume she will do that.

Mary Harney (Dublin Mid West, Independent)
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My brief contains the HIA statistics. If there is any need to correct the record, I will certainly do that.

Brendan Howlin (Wexford, Labour)
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Very good. I will allow Deputy Reilly a brief supplementary on the question.

James Reilly (Dublin North, Fine Gael)
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The Minister of State has raised a very interesting point. It is incumbent on any business to make sure that it can meet its costs. This is an additional cost to business. I do not think it will surprise anybody in the Chamber that this will have to be factored into what is charged for the service. When the NTPF was negotiating its fees with nursing homes, was this fee factored in by both sides?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It is very difficult to accept what the Minister of State is saying about the Department's attitude to the passing on of this nursing home inspection fee of €190 when the Minister for Health and Children stated last March at a press conference that "€3.73 per week, it is an appropriate fee that is necessary to ensure that standards are enforced... clearly it will be passed on, I accept that". Those were the Minister's own words only six months ago at a press conference here. How does that sit with HIQA's statement that the practice contravenes official regulations? Where is the truth in all of this?

Áine Brady (Kildare North, Fianna Fail)
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The misinterpretation of what the Minister said was taken out of context by the private sector. Nursing Home Ireland was advised that these fees could not be passed onto the residents, and that they were to be taken into consideration by the NTPF when negotiating their fees.

Jan O'Sullivan (Limerick East, Labour)
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If the Minister was misinterpreted, will she-----

Brendan Howlin (Wexford, Labour)
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I call the House to order.