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.

Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers 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. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.

The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021. It recommended several actions to improve the pricing system which are now being taken forward by the Department of Health and the NTPF. One of these actions relates to exploring a new geographical pricing model for the sector.

It should be noted that the amount a nursing home resident pays towards the cost of their nursing home care under the NHSS is calculated based on the value of their assets and income when they apply for nursing home care.

Regardless of whether a person resides in a publicly run Community Nursing Unit or a private/voluntary operated nursing home their contribution to the cost of their own care is calculated under the same criteria, therefore the cost to the resident remains the same.

In 2019, the Nursing Homes Support Scheme funding (NHSS) budget was €985.8m. Year-on-year the budget has increased: in 2023 I secured a funding increase of €40 million for the NHSS. An additional €45.6 million has been allocated to support nursing homes in Budget 2024, including a new €10 million fund to support private and voluntary nursing homes with HIQA compliance.

Overall, €1.5 billion of the total Health Budget was allocated last year to support over 22,800 people under Fair Deal. There was an increase in the budget for 2024 of an additional €45.6 million for 2024, this included €10 million fund to support private and voluntary nursing homes with HIQA compliance. I am cognisant that the budget must support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year. This funding has allowed an increase in rates by the National Treatment Purchase Fund (NTPF) of 5-6% on average per negotiation of Deeds.

It is recognised that the duration of contracts have shortened and that this increase in funding will go toward continuing to help nursing homes with inflationary costs in 2024.

The provision of free PPE and oxygen to private nursing homes continues, as of May 2023 this has cost approximately €77 million.

In the weeks prior to Budget 2024 I held a roundtable discussion with private nursing home provider representative groups where the issue of continued support for the sector was on the agenda and I will continue to engage with them going forward.