Mary Butler (Waterford, Fianna Fail)
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The Nursing Home Support Scheme (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.

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. 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.

It is important to state that residents of nursing homes should enjoy the same levels of support and access to services for which they are eligible 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.

Private nursing homes hold responsibility for delivering care to their residents in line with their terms of registration and the relevant regulations under the Health Act 2007. It is clear that under the terms of the NHSS Act 2009, private nursing homes should not levy additional charges on NHSS residents for services coming within scope of the Nursing Home Support Scheme.

In acknowledgement of the concerns that have been raised in relation to additional charges, the Department of Health is currently reviewing the available evidence and a focused piece of work to examine the issues in relation to additional charges is underway. There are a number of separate factors driving this issue and potential actions to address each of these are being considered.

More generally, important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on:

• The nine recommendations that emerged from the Value for Money Review on Nursing Home Costs,
• The 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform,
• The four recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities, and
• The 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants.

Work continues within the Department of Health to deliver on all of these recommendations.

Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.