Danny Healy-Rae (Kerry, Independent)
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1119. To ask the Minister for Health if he will provide adequate resources for a service (details supplied); and if he will make a statement on the matter. [54956/22]

Mary Butler (Waterford, Fianna Fail)
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Providers of long-term residential care who participate in the Nursing Homes Support Scheme (NHSS) can, from this week, obtain additional funding supports to help meet increased energy costs due to inflation through the Temporary Inflation Payments Scheme (TIPS). Eligible private and voluntary nursing homes can claim 75% of their heating and electricity increases up to a maximum payment of €5,250 per month per nursing home. The aim of the new scheme (TIPS) is to alleviate pressures put on nursing homes by an increase in energy prices and the new scheme will run in parallel with the Temporary Assistance Payment Scheme. The Temporary Inflation Payment Scheme will be kept under review and further funding of these supports will be looked at towards the end of this year.

Prior to Budget Day I stated that my priority was to secure additional funding for Budget 2023 to ensure the continuation of all services to a high standard. Long-term residential care will be supported through additional funding for the NHSS to maintain services and manage inflationary increases. The additional energy supports were announced as part of Budget 2023. A total of €10 million in funding will be made available specifically for nursing homes, drawn from the €100 million once-off fund that has been allocated to support community-based health and social care service providers for 2022 cost increases related to energy inflation.

Budget 2023 also saw an additional €180 million of funding for services for older people for winter 2022 and into 2023, building on unprecedented increases of recent years. This will bring investment in these services to over €2.4 billion in 2023, including nearly €12 million of new developments. 

The Government has provided substantial supports to the nursing home sector over the course of the pandemic. Over €145 million has been claimed by nursing homes under the Temporary Assistance Payment Scheme (TAPS) since its introduction in 2020. The Government has now agreed to extend TAPS to the end of the year by maintaining the availability of Outbreak Assistance support.

Implementation of Policy Reviews

Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity. 

The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021. 

The Review of the Pricing System for Long Term Residential Care Facilities was carried out under the oversight of a steering group with representation from various departments and agencies. The group made four recommendations, which are now being taken forward by the Department of Health and NTPF. 

There are differences in the cost of care between public and private homes, with public, HSE-run nursing homes (Community Nursing Units) generally having a higher cost of care. The main driver of the difference between public and private nursing homes is the resident ratios and a different balance between nursing and other health care staff, with more nursing staff in HSE-run nursing homes. The HSE is staffed to deliver more complex care, typically with a higher nursing ratio per resident and a different skill mix to private nursing homes.

A Value for Money (VFM) Review on Nursing Home Care Costs has also been carried out under the direction of a Steering Committee with an independent chair. The VFM Review sought to identify, quantify and analyse the reasons for any cost differential between private/voluntary and public nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector. The review was published in December 2021 and can be viewed by following this link: www.gov.ie/en/publication/3859f-a-value-for-money-review-of-nursing-home-care-costs/ 

Among the issues raised were the pay costs of staff in nursing homes, the dependency levels of residents, energy costs, and medical supplies charges to the NHSS. The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels.

The VFM Review made nine recommendations which the Department continues to take forward.