Seán Sherlock (Cork East, Labour)
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432. To ask the Minister for Health his views on the proposed closure of the fair deal scheme at a nursing home in Cork (details supplied). [23686/23]

Seán Sherlock (Cork East, Labour)
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433. To ask the Minister for Health if he will respond to a concern relating to the fair deal scheme (details supplied).; and if he will make a statement on the matter. [23695/23]

Seán Sherlock (Cork East, Labour)
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434. To ask the Minister for Health if he will respond to a concern relating to the fair deal scheme (details supplied). [23696/23]

Seán Sherlock (Cork East, Labour)
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435. To ask the Minister for Health if he will respond to a concern relating to the fair deal scheme (details supplied). [23697/23]

Seán Sherlock (Cork East, Labour)
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436. To ask the Minister for Health if he will respond to a concern relating to the fair deal scheme (details supplied). [23698/23]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 432, 433, 434, 435, 436 and 447 together.

Fair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential.

Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.

The Government is conscious of the financial challenges faced by the nursing home sector, particularly inflationary cost increases. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €149m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date.

A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home, over the period of July-December 2022 (up to a maximum of €31,500 per nursing home). This scheme was extended to March 2023 and is now under review for extension for a second time up until the end of June 2023.

Overall, 425 private nursing homes negotiate with the National Treatment Purchase Fund (NTPF). Minister Butler and the Department of Health has regular interaction with the NTPF and met them last week to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Anyone who has had a scheduled renegotiation of their Deed of Agreement this year with the NTPF has seen a significant uplift.

In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.

The Department of Health acknowledges that there are variations in the cost of care across public centres as well as across private nursing homes, with public Community Nursing Units (or CNUs) generally having a higher cost of care. It is important to note that the HSE is statutory provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care.

Budget 2023 saw an over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.

Private and most voluntary nursing homes agree the price that they can charge for a Fair Deal resident 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 such as costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity. Neither Minister Butler nor Minister Donnelly has any role in this negotiation process.

The NTPF carries out this role independently under the Nursing Home Support Scheme Act 2009 and the Department of Health published a review of the NTPF pricing system in June 2021.

In December 2021, the Department published the independently chaired Value for Money review on nursing home costs. The review 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.

The Value For Money Review made nine recommendations which the Department continues to take forward. It should be noted that many of the recommendations from the report were already in progress and overlap with existing reforms.

Residents in HSE-run Community Nursing Units (CNUs), which are often staffed at a level that allows the delivering of more complex care where required, represent less than 20% of Fair Deal scheme participants. Last year, 4,500 residents were in these public CNUs.

As I understand, engagement continues between the private provider referenced in the details supplied and the NTPF.