Jack Chambers (Dublin West, Fianna Fail)
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167. To ask the Minister for Health if he is aware that the Nursing Homes Support Scheme Act 2009 requires the Health Service Executive (HSE) to place the cost of care in long-term residential care and for the components that make up the cost before the Houses of the Oireachtas; and why this has not happened since March 2011 when the HSE last published the fees payable to its nursing homes for care provision. [18664/16]

Jack Chambers (Dublin West, Fianna Fail)
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168. To ask the Minister for Health if he has concerns regarding breaches of competition law by his Department and the Health Service Executive in relation to the cost of care in State run nursing homes; and if he will make a statement on the matter. [18665/16]

Jack Chambers (Dublin West, Fianna Fail)
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169. To ask the Minister for Health why a report promised in a reply to a Parliamentary Question in February 2015 has not been published; his views on the review of costs undertaken and its conclusions; and if he agrees with the former Minister who stated the review would lead to good practice and value for money actions being embedded within spending for care in Health Service Executive nursing homes. [18666/16]

Helen McEntee (Meath East, Fine Gael)
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I propose to take Questions Nos. 167 to169, inclusive, together.

In relation to the cost of care in public residential facilities, the Nursing Homes Support Scheme Act, 2009 provides that the components that make up the cost of care must be laid before the Houses of the Oireachtas, and the HSE has complied with this requirement. There is no legal obligation under the Act for the HSE to publish the public cost of care.

Over the past number of years the cost of care for public nursing homes under the Scheme as published on the HSE website has not been updated as the HSE was undergoing a process to review all costs associated with both long stay and short stay care services provided in public facilities. This work was acknowledged in the Review of the Nursing Homes Support Scheme, which was published by the Department of Health in July 2015. The HSE will, however, publish the cost of care for public residential care centres in September 2016 as part of a process to provide additional information on its services to the public.

It should be noted that more complex and highly dependent residents are catered for by the public system whereby private nursing homes may not have the available skillset and multidisciplinary personnel to cater for such complex needs. From an acute hospital discharge perspective the challenge to find suitable placements for those with more complex needs is often resolved in public centres where nurse staffing levels in particular can cater for their needs.

In addition, conditions of employment and tenure differ between private and public residential care facilities. Negotiations relating to the review of costs referred to by the Deputy, as mentioned in a reply to a Parliamentary Question in February 2015, have extended longer than anticipated. As part of the process to review and bring consistency to pay costs in public facilities, the HSE has been engaged in extensive negotiations with staff organisations to agree consistent staffing levels and mix in public centres. To date it has not been possible to get agreement despite extensive discussions under the auspices of the Haddington Road Agreement and the Joint Oversight Group. The HSE is now considering its options to focus on those centres with a higher cost of care and will also continue to strive to reach an overall framework agreement with the staff representative organisations.

It is important that public facilities operate as efficiently and economically as possible, and towards that end the Department of Health will conduct a Value for Money Review of public nursing home costs to identify more fully the factors that may be increasing costs and any areas that require correction.

I am not aware of any breaches of competition law arising in this context.