Mary Butler (Waterford, Fianna Fail)
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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 Homes Support Scheme (NHSS) for the full calendar year.

The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the National Treatment Purchase Fund (NTPF).

Maximum prices for individual nursing homes are agreed with the NTPF following these negotiations and are 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.

Under the Nursing Homes Support Scheme Act 2009 the NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes. I cannot comment on individual NTPF negotiations and it must be appreciated that this is a matter for each individual nursing home and the NTPF. Nevertheless, it is important that lines of communication are at all times maintained during the negotiation process.

Overall, approximately 425 private nursing homes negotiate with the National Treatment Purchase Fund (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.

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

I am conscious of private and voluntary nursing homes that are not scheduled to renegotiate their Deed of Agreement in 2023 and other options are being considered. One of the options under consideration is for nursing home providers to agree to a shorter contract duration with the NTPF.

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 €150m 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 €77 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. Following a recent review this scheme was extended for a second time to the end of June 2023.

The only mechanism for funding from the public purse for nursing home residents is Fair Deal and it is really important that private and voluntary providers continue to engage in the process as set out in the Nursing Homes Support Scheme Act 2009.

Fergus O'Dowd (Louth, Fine Gael)
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751. To ask the Minister for Health the responses he is planning to make to the report into the death of a person (details supplied) a former resident of a nursing home who died in 2020; if he will ensure the extension of HSE safeguarding and protection teams and clinical governance systems across all private nursing homes; and if he will make a statement on the matter. [33809/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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My officials are engaging with the relevant parties on the progression and implementation of the recommendations contained in the report in question, so that the learning from this tragic death can inform improvement in relation to the quality and safety of service provision.

Significant changes and improvements have been made in recent years arising from learnings during the pandemic. The Nursing Home Expert Panel Report published in August 2020, identified the need for a Clinical Governance Oversight Committee to be established in all nursing homes and the HSE is identified as the lead agency for this recommendation. The HSE established a Clinical Governance Working Group to consider issues relating to clinical governance in nursing homes and to support the development and piloting of a model of clinical governance committees. Funding was provided to the HSE, and work is underway to design a pilot which will be implemented later this year.

The Government has provided a comprehensive suite of measures for nursing homes which is cognisant of the health and well-being requirements of people living in long-term residential care. Such measures include:

• The Patient Advocacy Service was extended to private nursing homes from 1st November 2022.
• Revised Regulations were signed in December 2022 to enhance and streamline complaints processes which came into effect on the 1st of March 2023.
• A new dedicated Infection Prevention and Control resource and Safeguarding Specialist Capacities for nursing homes have been established across the 9 Community Healthcare Organisations.
• Recruitment has also commenced for Community Support Teams with 44% of recruitment completed for phase 1 implementation.
• Training and development opportunities continue for staff working in nursing homes with a new palliative and end-of-life programme for nursing homes launched in 2022 and over 100 places funded on postgraduate gerontological nursing training courses for the academic year 2022/2023.
• More broadly, a General Scheme of a Bill was published in October 2022 to give the regulator (HIQA) further powers, including in relation to enforcement and data collection. Furthermore, the Patient Safety Act has been signed into law in May 2023 providing the Chief Inspector in HIQA with investigation powers for serious incidents in nursing homes.