Thursday, 12 May 2022
Department of Health
344. To ask the Minister for Health the reason that medical card holders who are resident in nursing homes are being denied their right to a public ambulance to transport them to either outpatient or inpatient hospital appointments and that families are being presented with accumulating bills from private ambulance providers. [24034/22]
345. To ask the Minister for Health the reason that private ambulances are being utilised by nursing homes for the transport of medical card holders who cannot be transferred by wheelchair taxi to hospital in cases in which the national ambulance service or another ambulance service (details supplied) could provide this service either freely or for a nominal fee. [24035/22]
I propose to take Questions Nos. 344 and 345 together.
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 NHSS covers the cost of the standard components of long-term residential care which are:
- Nursing and personal care appropriate to the level of care needs of the person;
- Bed and board;
- Basic aids and appliances necessary to assist a person with the activities of daily living; and
- Laundry service.
Costs not covered by the NHSS include those individually incurred for items like social activities, newspapers and hairdressing. This may also include medical services such as therapies and some medical equipment. A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
It is important to state that residents of nursing homes should enjoy the same levels of support and access to services as when they lived in their own homes. It is acknowledged that the reason they require 24 hour levels of support is due to their level of dependency, which in turn may require access to clinical services including hospital and other outpatient appointments in the community. The HSE provides for a level of Intermediate Care Vehicles, which are used predominantly for non-emergency transport between acute hospitals for admission and discharge purposes. They would be reserved for those who would need specific support in transport. In other cases, normal transport arrangements apply. These arrangements (e.g. wheelchair taxi) are normally funded by the individual.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, as set out above. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory).