Thomas Pringle (Donegal, Independent)
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610. To ask the Minister for Health when the review of the fair deal scheme will be complete; if there will be a change to the way in which land value is considered; if other changes are planned; and if he will make a statement on the matter. [4995/21]

Mary Butler (Waterford, Fianna Fail)
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The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The Report of the NHSS Review published in 2015 identified a number of recommendations for immediate implementation and a number of other complex issues that were deemed to require more detailed consideration. One such recommendation was the need to undertake a review of the pricing mechanism used 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 Group was established to oversee and manage the NTPF's pricing review. The Steering Group is chaired by the NTPF and includes representatives from the Department of Health and the Department of Public Expenditure and Reform. There is considerable complexity in both the review and the potential scope of its implementation, which would interact with a broad range of policy initiatives and potential legislative developments that are taking place across the health and social care sectors. These complexities require a considered, integrated approach by the Department and its stakeholders.

The Pricing Review was completed and some preliminary consideration of it was provided by the NTPF to the then Minister in late 2019. Given the complexities involved and the potential far reaching impacts, including in relation to access to care for citizens, it was determined that further briefing and consultation would be required before the Ministers could consider the range of issues and complexities involved.

As the pandemic arose in early 2020, the Department has prioritised focus on supporting nursing homes and nursing home residents, noting the significant impact that COVID-19 has on such services and service users. A number of COVID-19 specific policy responses have been developed and implemented, including a Temporary Financial Support Scheme for private and voluntary nursing homes, which has paid out almost €67m to date in respect of 2020 and made a further €42m available up to the end of June 2021; supply of PPE on a free of charge basis; professional and expert advice, including clinical advice;  a series of serial testing programmes in nursing homes; access to a comprehensive package of training resources; redeployment of HSE staff to private nursing homes; and staff accommodation for nursing home workers. However, the importance of addressing long-term policy consideration with regard to the pricing mechanism is acknowledged. Minister Donnelly and I are currently considering the content of the review and the appropriate next steps.

Separate to the pricing review, the Department of Health has proposed a specific policy change to the Nursing Homes Support Scheme to cap contributions based on family owned and operated farm and business assets at 3 years where a family successor commits to working the productive asset. This change has been approved by Government and undergone pre-legislative scrutiny in the last Dáil. The stated policy objective of the general scheme of the Bill is to introduce further safeguards in the Scheme to further protect the viability and sustainability of family owned and operated farms and businesses that will be passed down to the next generation of the family to continue to work them as productive assets to provide for their livelihood.

Progress on the development of the Bill was negatively impacted by the dissolution of the last Dáil and by the COVID-19 pandemic. However, work on this legislation has continued to progress. I have exchanged letters with the Business Committee requesting a waiver to conduct pre-legislative scrutiny, given this was already undertaken in the previous Dáil. I have met with the Attorney General to discuss this legislation, and there has been an ongoing and active engagement between the Department of Health and the Office of the Attorney General on the development of the legislation, which will be brought to the Houses of Oireachtas at the earliest possible opportunity. It is on the priority list for publication in the Spring legislative session.