Michael Moynihan (Cork North West, Fianna Fail)
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Question 25: To ask the Minister for Health if he has begun a full review of the nursing homes support scheme; and if this will be completed before the end of 2011. [17886/11]

Gerry Adams (Louth, Sinn Fein)
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Question 28: To ask the Minister for Health if he will report on his review of the fair deal scheme; and if he will make a statement on the matter. [17895/11]

Barry Cowen (Laois-Offaly, Fianna Fail)
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Question 56: To ask the Minister for Health when he expects that the examination of funding for the nursing homes support scheme to be completed; when he will publish this examination; and when he will commission a full review of the nursing homes support scheme. [17889/11]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 25, 28 and 56 together.

In response, the Minister asked for a full examination of the funding situation, to be conducted jointly by the Department of Health and the HSE.

A report on the examination was submitted to the Minister on the 3rd June. It identified a number of factors that are putting pressure on the overall Fair Deal budget for 2011. These included:

an unexpected and so far unexplained increase in the average length of stay for nursing home patients,

a resultant higher net demand for nursing home places, and

an increase in nursing home costs.

Following this examination, the Minister is considering a range of increased governance and monitoring arrangements and it is hoped to convey these to the HSE within the next few days. These will include issues already signalled by the Minister such as a clinical audit of the Common Summary Assessment Report (CSAR) process to establish the levels of dependency for those accessing care and to attempt to explain the unforeseen increase in average length of stay.

The processing of approvals for financial support under the Nursing Homes Support Scheme re-commenced the week beginning the 13th June. Approvals are being issued to those applicants processed to final stage in the chronological order in which they were received in the Central Office in Tullamore. Approvals are currently being issued to the first 400 of these applicants. Funding is being assigned on a daily basis. There are approximately 700 further applications processed to final stage and now awaiting approval and these will be dealt with as a priority.

The key focus of the Minister for Health is to ensure that those who require nursing home care will be able to access it and, to this end, the Department estimates that almost 24,000 people will be in long-term nursing home care by year end. This would mean a net increase of around 1,700 people between now and the end of the year.

In order to fund this increase, and to offset other pressures on the subhead such as increases in average length of stay, cost increases, etc., the Minister identified a range of savings and income sources, one of which is a potential saving of up to €30 million in non-service related spending. This funding will come primarily from ICT capital spending which is running significantly behind budget so far this year.

The Minister stated in the Dáil that a lack of historical data, combined with a multiplicity of different accounting systems, made it difficult to drill down into the scheme in the way he wanted. As a result, the report's conclusions were not as definitive as he would have wished. The matter, therefore, will continue to be examined until he is satisfied. The main findings and outcomes so far have already been set out by the Minster in the Dáil and by myself in the Seanad. Officials from the Department of Health will monitor developments closely between now and the end of the year.

The Programme for Government commits us to review the system of financing nursing home care with a view to developing a secure and equitable system of financing for community and long term care. This commitment will be carried through.

In addition, the Nursing Homes Support Scheme is due for formal review commencing in 2012. The Scheme will be three years in operation at that stage. The reason for allowing this period to elapse is to ensure that established and validated trends and statistics will be available in order to inform this work. It is still intended to proceed with this review and it will look at the ongoing sustainability of the Scheme, the relative costs of public versus private provision and the balance of funding between residential and community care.