Carol Nolan (Laois-Offaly, Independent)
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204. To ask the Minister for Health the status of his Department’s 2021 output target to establish a nursing home expert panel and report with a view to developing a Bill to enhance the regulation and oversight of nursing homes, including increased enforcement powers and the establishment of a licensing framework for the professional home support providers; and if he will make a statement on the matter. [30664/21]

Mary Butler (Waterford, Fianna Fail)
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In August 2020, the Nursing Home Expert Panel (NHEP) report was published which contained 86 recommendations, across 15 thematic areas, many of which will require legislative measures to implement. HIQA also submitted a paper outlining a number of suggested amendments to the legislation governing the operation of designated centres for older people.

Having regard to the NHEP recommendations, learning from the pandemic and HIQA's suggested regulatory enhancements, the Minister for Health and I approved a two-phased approach to examining the legislation with a view to proposing enhancements to the primary and secondary legislation governing nursing homes.

It is envisaged that phase 1 will bring forward interim enhancements to the primary legislative framework to, amongst other things, enhance the governance and oversight of nursing homes and improve the reporting of key operational data to support national planning in an integrated way and improve the information available. In January 2021 the Government approved the inclusion of a Health (Amendment) Bill 2021 on its legislative agenda. It is expected that, subject to Government approval draft Heads of Bill will be published by the end of the year.

In addition, secondary legislation will be drafted to enhance the current regulations in relation to a number of areas including infection prevention and control, governance and management and staffing.

A bilateral project group, established in October 2020 and comprising representatives from the Department and HIQA, is supporting the legislative process.

A wider review of the regulatory framework, phase 2, will commence in the second half of 2022, taking into account a programme of longer-term strategic reform considerations arising from inter alia pandemic learning with a view to exploring moving towards a service licensing system. HIQA has been requested to undertake an up-to-date international evidence review of nursing home regulatory models to support and inform the wider review. Engagement between the Department and HIQA on the research proposal and methodology is ongoing.

In relation to the home support sector, the Department is currently developing a regulatory framework for home support providers with the aim of ensuring that all service users are provided with a standard, high quality level of care. This framework will comprise (i) primary legislation for the licensing of public and private home support providers; (ii) minimum requirements (regulations); and HIQA National Standards for Home Support Services

On 27 April 2021, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home support providers. This will be progressed as a priority by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity.

It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined.

Carol Nolan (Laois-Offaly, Independent)
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205. To ask the Minister for Health if the recently announced reforms to the nursing home support scheme include a distinction between land which is farmed versus land which is leased; if so, the different treatments that would apply; and if he will make a statement on the matter. [30665/21]

Carol Nolan (Laois-Offaly, Independent)
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206. To ask the Minister for Health if children of farmers who inherit land from a parent who has land and entitlements leased to a non-relative under the tax incentive scheme are to be afforded the same proposed three-year capping at 7.5% as other inheritors whose parents did not lease out land under the recently announced reforms to the nursing home support scheme; and if he will make a statement on the matter. [30666/21]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 205 and 206 together.

The Nursing Homes Support Scheme, commonly referred to as the Fair Deal Scheme, has been in operation for over 10 years and there is broad agreement that the Scheme operates well and continues to provide appropriate financial assistance where it is required.

However, it is recognised that the Act, in its current form, does not place caps on the financial assessment of family owned and operated farms or businesses when calculating the means to pay for nursing home care. This places a potentially onerous burden on family successors and could challenge the future viability of these productive assets.

Therefore, the Department of Health has proposed a policy change to the Scheme, to cap contributions based on farm and business assets at three years where an appointed family successor commits to working the productive asset for a period of 6 years. To be considered for the 3-year cap, the proposed legislation requires that an asset owned by an applicant for the Scheme, or recently transferred to a family member, is a productive family asset that has been actively worked by a family member for a significant period of time in advance of the person entering care.

Where an applicant retired and ceased working the farm or business themselves prior to entering long-term care, it is expected that their partner or a family successor will have taken over from them. In order to acknowledge the fact that many older people will have reduced their engagement in the family farm or business, but that a successor may not have taken over immediately, it is only required that the farm or business was worked by the applicant, their partner, or a family successor, for three of the five years preceding admission to long-term care, and this time need not be continuous.

Although land mobility has been a policy objective of various agricultural reliefs since the 1990s, the policy intent of the Nursing Homes Support Scheme is to protect family farms and businesses that will remain within the family as a source of employment and income into the future, and to ensure the future viability of these productive assets. This policy would not be advanced if income from leasing arrangements was included in the cap.

There is no prohibition of leasing arrangements in the Bill. However, assets that are leased will not be covered by the Bill and both the value of these assets and the income derived from the leasing arrangements will be assessed as part of the financial assessment for the scheme on an ongoing basis.

The Bill passed Committee Stage on 30th June, and is due for Report and Final Stage in the coming weeks. It is expected that the Bill will be enacted prior to the summer recess and will commence shortly thereafter.