Written answers

Tuesday, 5 December 2017

Department of Health

Nursing Homes Support Scheme Expenditure

Photo of John McGuinnessJohn McGuinness (Carlow-Kilkenny, Fianna Fail)
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325. To ask the Minister for Health the reason an organisation (details supplied) that represents 80% of service providers is not represented on the steering committee to oversee pricing in the sector; the reason no such steering committee was set up to review the cost of elderly care in the public sector; if a review of the capital costs in the public and private sector has been examined; if not, his plans for same; and his views on whether the private operators in seeking the appointment of a national forum for the sector asked for or expected a role in the public sector budgets or policy. [51539/17]

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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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.

When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. 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 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.

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, work in this area is ongoing and well advanced. There are no service providers included on the steering group from either the public or private nursing home sectors.

During the review of the pricing mechanism, key stakeholders were given the opportunity to contribute to the examination. Nursing Homes Ireland were one of these stakeholders and my understanding is that they availed of this opportunity to contribute.

The 2015 NHSS Review also identified the need for a Value for Money (VFM) review of the cost differentials in public and private/ voluntary residential facilities. This VFM review has recently commenced and is being lead by my Department.

While consultation is, and always will remain, an important part of the approach my Department takes, it would be inappropriate to delegate elements of public policy, to any consultative forum. Were such a forum to be established it would create a situation where some of those represented and giving direction will inevitably have a commercially vested interest in the outcome. Furthermore, organisations including HIQA and the NTPF operate independently and provide a clear and essential service to the sector, this independence could be eroded were they seen to be engaging in collective decision making with representative groups. Decision making in areas of budgetary concern, as you are aware, is a matter for the Government.


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