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

I thank Senator Colm Burke for raising and highlighting this very important issue.

The nursing homes support scheme, commonly known as the fair deal scheme, is a system of financial support for those in need of long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. Approximately 23,000 people are availing of long-term residential care through the scheme at any given time. The National Treatment Purchase Fund, NTPF, has been designated by the Minister for Health, pursuant to section 40 of the Nursing Homes Support Scheme Act 2009, as a body authorised to negotiate with proprietors of registered nursing homes to reach agreement on the maximum price that will be charged for the provision of long-term residential services to nursing home support scheme residents.As part of this function, the NTPF enters into approved nursing home agreements with registered private and voluntary nursing homes to record the maximum prices that have been negotiated. The NTPF takes the following guidelines into account in negotiating the prices: whether costs are reasonably and prudently incurred by the nursing home and evidence of value for money; 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 all of the public. The NTPF is independent in its functions in reaching maximum pricing agreements with proprietors of registered nursing homes.

The report of the nursing homes support scheme review, published in 2015, identified a number of issues for more detailed consideration, including a review of the pricing mechanism used by the NTPF with a view to ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers. A second issue identified by the report was increasing the transparency of the pricing mechanism so that existing and potential investors could make as informed decisions as possible and a third was ensuring adequate residential capacity for those residents with more complex needs.

As the Senator himself has said, a steering group was established in 2016 to oversee and manage the pricing review. The steering group was chaired by the NTPF and included representatives of the Departments of Health and Public Expenditure and Reform. As part of its work on the review, the NTPF sought various inputs, including external expertise and stakeholder engagement, to inform the review. These inputs have been considered in great detail. It is recognised that any change to any part of the scheme must be considered in terms of short-term and long-term impact on the viability of the scheme and accessibility of long-term residential care in general. I am please to advise Senator Colm Burke that the review is expected to be completed very shortly.