Bríd Smith (Dublin South Central, People Before Profit Alliance)
Link to this: Individually | In context | Oireachtas source

482. To ask the Minister for Health if his attention has been drawn to the ever-rising costs of nursing home care, with relatives reporting significant extra costs in addition to the basic contribution they make in addition to the fair deal scheme contribution; the Government’s plans to reduce this burden on relatives of nursing home patients; if the Government plans to increase support to relatives and nursing homes; if there are plans to increase the level of State provision of nursing home beds for those who cannot afford these significant costs; if he will acknowledge that there are people who require nursing homecare but who cannot avail of it due to the prohibitive costs; and if he will make a statement on the matter. [2704/23]

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

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.

Data from HSE indicates that, on average, NHSS residents cover around 30% of their cost of care, with the state covering the remaining 70%. This proportion is based on the assessment of residents' assets and income, rather than on the cost of providing their care, and has remained stable over recent years.

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.

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).

The Department of Health is currently reviewing the available evidence and considering various policy options with relation to additional nursing home charges.

The Government is conscious of the financial challenges faced by the Nursing Home sector, particularly in terms of inflationary cost increases. A €10m scheme (the Temporary Inflation Payment Scheme or TIPS) has been established that will cover 75% of energy cost increases in private and voluntary nursing homes between July - December 2022 and is currently under review.

The Government has also provided substantial support to the private and voluntary nursing home sector over the course of the pandemic, with over €146 million in funding delivered through the Temporary Assistance Payment Scheme (TAPS). This Payment was most recently extended to end December 2022, and the Department is currently considering the future of the scheme.Other supports are directly delivered through the HSE, including serial testing, the provision of PPE and deployment of expert response teams. This includes provision of free PPE and oxygen to private nursing homes with an estimated value of €72 million from 1 April 2020 to 31 October 2022.

Budget 2023 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. Long-term residential care will be supported through additional funding for the Nursing Homes Support Scheme (NHSS) to maintain services and manage inflationary increases. Just over €40m has been secured for NHSS, including pressures for 2023.

It is important to note also that the nursing home sector has changed in recent years from a predominantly State led service to a situation today where approximately 80% of nursing home services are provided by the private sector. The Government is committed to greater public sector involvement in the residential care of older people in Ireland.