Written answers

Tuesday, 24 May 2016

Department of Health

Nursing Homes Support Scheme

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail)
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439. To ask the Minister for Health if he is aware of criticisms levelled at the nursing home support scheme funding model by Nursing Homes Ireland, the representative body for private and voluntary nursing home care, which states the funding model fails to recognise the reality of the costs incurred to provide nursing home care; if the long-awaited review of the fair deal scheme will recommend a further review of the funding model; when the review will be published; and if he will make a statement on the matter. [11378/16]

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail)
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441. To ask the Minister for Health if he is aware of the findings within the recently published DKM Economic Consultants report which was commissioned by his Department, Potential Measures to Encourage the Provision of Nursing Home and Community Nursing Unit Facilities; if he accepts the report is stark in its analysis, stating the funding model to support nursing home care lacks logic and is not fit for purpose; his plans to address the issues highlighted; and if he will make a statement on the matter. [11380/16]

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail)
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503. To ask the Minister for Health why the working group reviewing the pricing system of the nursing home support scheme pricing system, as advanced within his Department’s review of the scheme, has not met with Nursing Homes Ireland, which represents the majority of providers of nursing home care; to request the working group to consult with Nursing Homes Ireland; and if he will make a statement on the matter. [11744/16]

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail)
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504. To ask the Minister for Health to introduce an independent appeals process under the fair deal scheme; to apply the principle of a right of independent appeal; why this does not apply to the National Treatment Purchase Fund; and if he will make a statement on the matter. [11745/16]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 439, 441, 503 and 504 together.

The legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The Department of Health has no role in such individual negotiations. The NTPF may examine 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 negotiating with nursing homes, the NTPF has regard to:

- Costs reasonably and prudently incurred by the nursing home and evidence of value for money;

- Price(s) previously charged;

- Local market price; and

- Budgetary constraints and the obligation on 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.

During 2015 the Department of Health commissioned DKM Economic Consultants to conduct an analysis of potential measures to encourage the provision of nursing home and Community Nursing Unit facilities. This analysis is a useful input to policy in this area, but the DKM Report reflects the views of the consultants rather than those of the Department of Health.

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, submissions were sought from groups or bodies who wished to make a contribution, and Nursing Homes Ireland made a submission in this regard on which they expanded at a subsequent meeting with officials of the Department of Health. The Report of the Review was published in July 2015. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative cost for clients and the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

The Terms of Reference of the NTPF pricing review include consideration being given to the appeals mechanism. However, 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.

A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform and the NTPF, and has commenced its work in this area. The NTPF are in the process of developing an implementation plan that inter alia will include appropriate engagement with stakeholders.

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