Billy Kelleher (Cork North Central, Fianna Fail)
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344. To ask the Minister for Health his views on the concerns of the private and voluntary nursing home sector regarding the failings of the fair deal funding model and their push for greater equality in fees payable for the provision of nursing home care; and his further views on whether the fair deal budget and fees payable to nursing homes should be resourced to recognise the escalating cost environment in which nursing homes are operating. [33500/16]

Billy Kelleher (Cork North Central, Fianna Fail)
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345. To ask the Minister for Health if he will justify private and voluntary nursing home operators receiving fees that are up to seven times below those provided to HSE counterparts; and if his attention has been drawn to the fact that the fees payable to HSE nursing homes do not encompass costs such as capital works and commercial rates, whereas private and voluntary nursing homes are expected to absorb such costs within the considerably reduced fees payable to them. [33501/16]

Billy Kelleher (Cork North Central, Fianna Fail)
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346. To ask the Minister for Health his views on fair deal payments being indexed in recognition of the increasing cost environment in which nursing homes are operating. [33502/16]

Billy Kelleher (Cork North Central, Fianna Fail)
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347. To ask the Minister for Health his views on an independent appeals process that would enable nursing homes to have recourse to appeal a fee offered by the NTPF that the provider does not view is fair or sustainable. [33503/16]

Jack Chambers (Dublin West, Fianna Fail)
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355. To ask the Minister for Health if, in view of the huge variances in fees payable between the HSE and private and voluntary nursing homes, he recognises the imperative and urgent requirement for the review of the nursing home support scheme pricing mechanism to support residents requiring nursing home care across all settings, that is, public, private and voluntary; and if he will make a statement on the matter. [33559/16]

Jack Chambers (Dublin West, Fianna Fail)
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356. To ask the Minister for Health if his attention has been drawn to the criticism by a previous Minister of State with responsibility for older persons of the way in which fees for nursing home care are deciphered and the research undertaken by a consultancy firm (details supplied) that highlight considerable failings of the funding model in deciphering and incorporating true costs incurred for provision of nursing home care; and if he will make a statement on the matter. [33560/16]

Helen McEntee (Meath East, Fine Gael)
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I propose to take Questions Nos. 344 to 347, inclusive, 355 and 356 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 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.

The Review of the Nursing Homes Support Scheme, which was published in July 2015, committed to a review of pricing mechanisms 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;

- 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 issue of an appeals process will also be considered in this context.

Work has been underway on this Review for a number of months now and it is expected to be completed in the coming months.

The HSE has recently published the cost of care for all public nursing homes. There are a number of reasons why the costs of public facilities are generally higher than those in the private sector, including a higher nurse staffing ratio and the impact of public service rates of pay and conditions of employment.

The geographical spread of residential placements is also a factor. In some rural areas long stay beds are provided for geographical reasons in smaller centres which would not be profitable for a private provider to supply, e.g. Achill Island; Donegal.

With that said, it is important that public facilities operate as efficiently and economically as possible and deliver the best possible value for money. Towards that end the HSE is already engaged in a comprehensive exercise to review and streamline the operation and cost structures of public facilities. Differences in the comparative cost of public and private long-term residential care will be the subject of a Value for Money and Policy Review to be undertaken by the Department of Health in 2017 to assess reasons for and components of current cost differentials.