Jim Daly (Cork South West, Fine Gael) | Oireachtas source

St. Joseph's in Shankill is part of the St. John of God Hospitaller Services Group. It provides residential care and day care for service users, all of whom have a diagnosis of dementia. Most of the 60 residential places are funded through the nursing homes support scheme. Separately, the HSE contracts for approximately 25 day care places per day at St. Joseph's.

It is most regrettable that residents, their families and the service users of St. Joseph's are in a state of anxiety with regard to the services of which they avail. My overriding message to all parties involved is to use the mechanisms available to engage on the matters of concern.

Recognising the challenges faced by people living with dementia in Ireland and to provide services that will meet growing demand in future years, the Government launched the national dementia strategy in December 2014. The strategy's purpose is to increase awareness of dementia, ensure timely diagnosis and intervention and develop enhanced community-based services, in line with the vision of Sláintecare. The HSE's national dementia office is developing a framework for dementia diagnosis and post-diagnostic supports, the testing and delivery of intensive home support packages and a programme to upskill GPs and primary care teams in diagnosing and managing dementia. The Dementia: Understand Together campaign has also been a major success in making a difference in bringing down the walls surrounding dementia.

In budget 2020, further investment was committed to provide ten additional dementia adviser posts as part of the drive under Sláintecare to reduce our dependence on care in hospitals and support healthcare delivery in the community, along with significant investment in delivering an additional 1 million home support hours in 2020. The Government remains committed to the full implementation of the national dementia strategy and to ensuring that people with dementia can access the services they need to live as well as possible in their own homes and communities for as long as possible.

The nursing homes support scheme, commonly referred to as the fair deal scheme, is a system of financial support for people who require 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. The scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The nursing homes support scheme is expected to support 23,042 people at any one time in 2019. Its budget for 2019 saw an increase of €24.3 million over 2018, making a total budget of €985.8 million for 2019. In 2020, the scheme will see a further investment in its budget of €45 million, bringing its total annual budget to €1.03 billion. This substantial investment will provide ongoing long-term residential care over the course of 2020, ensuring the scheme continues to deliver affordable and accessible nursing home care for our citizens with long-term care needs.

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 non-HSE registered nursing homes to reach agreement on the maximum prices that can be charged for the provision of long-term residential care services to nursing homes support scheme residents. The NTPF has statutory independence in the performance of its function and negotiates with a nursing home on an individual basis. The Minister for Health does not have any role in this regard.

The NTPF has clear established processes for agreeing prices and has successfully negotiated terms with more than 430 private and voluntary nursing homes participating in the scheme. The NTPF's processes are available to all nursing homes, and since the end of 2017 there has been a net increase in the number of nursing homes operating in Ireland, with an increase of almost 1,300 in the number of beds in the nursing homes with which the NTPF has agreed terms.In the context of its statutory role in negotiating maximum prices charged for the provision of long-term residential care services to NHSS residents, the NTPF established processes are the appropriate mechanism for engagement. The established processes include provision for an NTPF review mechanism where agreement is not initially reached on the price. I understand that the initial engagement and negotiation between St. Joseph’s and the NTPF is currently active. Given the NTPF’s statutory independence in the performance of its functions, it would not be appropriate for me to comment any further. As indicated at the outset, engagement through the established mechanisms is the prudent and appropriate course of action.

The HSE has been in extensive engagement with the St. John of God Hospitaller Services Group with regard to the day care service at St. Joseph's and this engagement is ongoing. The HSE has further committed to continued intensive engagement on this matter before the end of 2019. I acknowledge the role of private and voluntary providers in residential care provision. I encourage the St. John of God group to continue its engagement with the HSE with regard to day care services in the context of the HSE's commitment to engagement. I understand that the HSE will endeavour to meet with St. Joseph's in the coming days with a view to continuing the positive dialogue and to try to find a satisfactory resolution to the issue.

Day care centres play an important role in supporting older people to remain in their communities by promoting well-being, preventing or delaying health deterioration, supporting them to remain independent, and supporting the carer. There are in the region of 300 day care centres across the nine community health organisations. They offer services which include nursing and therapy supports, social activities, chiropody and some personal care. The centres play a key role in facilitating early discharge and hospital avoidance.

I recently announced the approval of €1 million in grant funding for community and voluntary groups under the community and voluntary supports grant scheme launched earlier this year. This initiative will provide additional funding to community and voluntary groups to continue to support older people, family carers and significant others to stay well and remain connected with their local community. The funding will support an additional 20,000 meals on wheels per annum, 90 additional day care places per week, 13 new or expanded social centres and 19 befriending projects.