Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

At the outset, I thank Senator Colm Burke for raising this very important matter.

The legislation underpinning the nursing home support scheme requires each private nursing home negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund, NTPF, should it wish to be an approved nursing home for the purposes of this particular scheme. The NTPF has statutory independence in the performance of its functions and negotiates with each nursing home on an individual basis. The Department of Health has no role in such individual negotiations. The NTPF examines the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State. In negotiation with the nursing homes, the NTPF has regard to cost reasonably and prudently incurred by the nursing home and evidence of value for money.The NTPF also has regard to price, prices or prices previously charged, local market price, budgetary constraints and the obligation of the State to use available resources in the most beneficial effective and efficient manner to improve, promote and protect the health and welfare of the public.

When the nursing homes support scheme commenced in 2009, a commitment was made that it would be reviewed after three years. In advance of the review, which was the subject of an extensive and structured public consultation process, submissions were sought from groups or bodies wishing to make a contribution. Nursing Homes Ireland made a submission in this regard and sought an appeals system for nursing home providers.

The report of the review was published in July 2015. A number of issues were identified for more detailed consideration, first, a review of the pricing mechanism of the National Treatment Purchase Fund with a view to ensuring value for money and economy, the lowest possible administrative costs for clients and a minimal administrative burden for providers; second, the need to increase the transparency of the pricing mechanism in order that existing or potential investors can make informed decisions to the greatest extent possible; and, third, to ensure adequate residential capacity for those residents with more complex needs.

Deloitte and Prospectus have been engaged by the National Treatment Purchase Fund to assist in carrying out the review. They have engaged in extensive stakeholder consultation and this includes Nursing Homes Ireland. The pricing review will include consideration of the appeals mechanism. It is not deemed feasible to effectively address this issue in isolation and it must be considered as part of the totality of the pricing system review, which will be completed as soon as possible. In this context, we need to be careful about placing too much reliance on an appeals system. There is little point in establishing an appeals system which quickly becomes the default option for almost all of the operators and, therefore, effectively displaces the main price-setting mechanism. It is more important to develop a robust system that everyone understands and that delivers fair outcomes consistently. If we can achieve this, an appeals system per sewill become far less important.