Holly Cairns (Cork South West, Social Democrats)
Link to this: Individually | In context | Oireachtas source

204. To ask the Minister for Health the steps he is taking in response to a care centre (details supplied) withdrawing from the fair deal scheme at the end of May unless the national treatment purchase fund, NTPF, provides increased funding; and if he will make a statement on the matter. [25122/23]

Holly Cairns (Cork South West, Social Democrats)
Link to this: Individually | In context | Oireachtas source

205. To ask the Minister for Health the steps he is taking with regard to a nursing home (details supplied) that will exit the fair deal scheme at the end of May if the NTPF does not increase payments to it. [25123/23]

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

I propose to take Questions Nos. 204 and 205 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 I am cognisant that the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.

It is important that nursing homes manage potential cost pressures in line with their regulatory and contractual responsibilities, maintaining their quality of care so that residents’ lived experience and comfort is not affected.

The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. 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. This scheme was extended to March 2023 and is now under review for a second extension to end of June 2023.

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.

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.

Overall, 425 private nursing homes negotiate with the NTPF. The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Nursing homes which had a scheduled renegotiation of their Deed of Agreement with the NTPF this year have seen a significant uplift.

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.

The NTPF carry out this role independently under the Nursing Homes Support Scheme Act 2009. It will be appreciated that particulars of all such negotiations and reviews are a matter between the nursing home and the NTPF. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes.

There is no other mechanism for funding from the public purse for nursing home residents outside the NHSS (Fair Deal). I would encourage continued engagement between nursing home providers and the NTPF.

The Department of Health continues to work with the NTPF to take forward the recommended actions that emerged from the review of the NTPF pricing system published in June 2021.

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.

Ensuring that the welfare and safety of residents is secured when nursing homes close is of the utmost importance. It is essential that when nursing homes are intending to close or cease participating in the NHSS, residents and their families must be consulted with and given appropriate notice so that new homes can be found and they can be moved in a safe, planned way.