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Written Answers - Nursing Home Services

Tuesday, 27 March 2012

Dáil Éireann Debate
Vol. 760 No. 3

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 652.  Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the basis on which the cost of beds in public nursing homes are calculated; if he will indicate in tabular form the total all in cost of a place; the basis on which this is made up; the scale and quality of the service provided; if all in costs are calculated on the basis only of cost in the particular home or whether a cost in respect of higher levels Health Service Executive management is included; and if he will make a statement on the matter. [16975/12]

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 653.  Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the basis on which the cost of beds in private nursing homes is calculated; if a figure is included to cater for profit or higher level administrative cost is included; if any such nursing homes are subject to upward only rent reviews; and if he will make a statement on the matter. [16976/12]

 654.  Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the extent to which he has compared the standard, quality and scale of service in private and public nursing homes and the dependability of the patients in each in the determination of a comparison on the cost of a bed in both sectors; and if he will make a statement on the matter. [16977/12]

 661.  Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the extent to which the psychological or medical assessment services are updated in line with demographic change in respect of the needs of older persons; and if he will make a statement on the matter. [16984/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch I propose to take Questions Nos. 652 to 654, inclusive, and 661 together.

The legislation underpinning the Nursing Homes Support Scheme (NHSS) requires all private nursing homes and voluntary nursing homes to negotiate and agree a price for the cost of care with the National Treatment Purchase Fund (NTPF) should they wish to participate in the scheme. This is a necessary feature of the scheme due to the commitment by the State to meet the full balance of the cost of care over and above a person’s contribution.

The NTPF is independent in the performance of this function and, in carrying it out, it must ensure value for money for both the individual and the State. It negotiates with each nursing home individually and may examine the records and accounts of nursing homes as part of the process. This method of negotiation is necessary in order to ensure that the State obtains the best value for each individual in a nursing home and to comply with competition law.

The services which fall within the scope of long-term residential care and which are covered by the cost of care are:

nursing and personal care appropriate to the level of care needs of the person,

basic aids and appliances necessary to assist a person with the activities of daily living,

bed and board, and

laundry service.

The NHSS Act 2009 requires the Minister to lay details of the goods and services which constitute long-term residential care services in public nursing homes before the Houses of the Oireachtas. The full list of goods and services which was laid before the Houses is available on the Department’s website at: http://www.dohc.ie/issues/fair_deal/cost_components.pdf.

The list of goods and services set out in the Deed of Agreement between the NTPF and each private nursing home that is approved for the purposes of the Nursing Homes Support Scheme is consistent with the list of goods and services which was laid before the Houses. The cost of care in both public and private nursing homes is published on the HSE’s website at: http://www.hse.ie/eng/services/Find_a_Service/Older_People_Services/nhss/costs.html.

I would like to advise the Deputy that the cost of care in public nursing homes is currently being reviewed. in order to establish their need for long term residential care services — as outlined in Section 7 of the NHSS Act, 2009. This assessment is carried out by health care [970]professionals and considers whether a person can be supported to continue to live at home or whether long-term nursing home care is more appropriate.

The HSE is currently piloting a Single Assessment Tool. The introduction of a single assessment tool will assist the HSE to further key strategic objectives i.e. meet needs in the most appropriate setting; enhance quality and efficiency; promote value for money; facilitate access to long-term residential care or a home care package; and enable older people to remain at home for as long as possible.

The NHSS will be three years in operation in October 2012 and will be reviewed at that time. The reason for allowing this period to elapse is to ensure that trends and statistics will be available in order to inform the work. The review will look at, amongst other issues:

the ongoing sustainability of the scheme,

the relative cost of public versus private provision,

the effectiveness of current methods of negotiating price in private and setting price in public nursing homes, and

the balance of funding between residential and community care.

The views of relevant stake-holders will be considered as part of the review.

The Government is improving the planning, policy, and service delivery for older people. In particular, we will ensure that the Department of Health, the Health Service Executive, and all other relevant agencies, whether in the statutory or non-statutory sectors, implement the policies and services set out in the current Programme for Government, Government for National Recovery, 2011-2016.

The various initiatives planned or underway will also have to take account of reform of our health and personal social services overall, including addressing the challenges and opportunities presented by changing demographics and care needs of older people in future years. This includes, for example, a projected significant increase in the population, in the coming decades, of those aged 65 and over.

The Health Information and Quality Authority (HIQA) is the statutory body responsible for the registration and inspection of all designated centres for older people, including public, voluntary and private nursing homes. HIQA has been given until 30 June 2012 to fully register all existing nursing homes. Details of all currently registered nursing homes, including the maximum number of residents who can be accommodated and their levels of dependency; as well as inspection reports can be found on the HIQA website, www.hiqa.ie.

Since 1 July 2009 all nursing homes, public and private, must comply with Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, as amended, and must meet the National Quality Standards for Residential Care Settings for Older People in Ireland.

 655.  Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the total number of patients in both private and public nursing homes on average over the past five years; the degree to which such numbers have fluctuated in the period in question; and if he will make a statement on the matter. [16978/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter it has been referred to the Health Service Executive for direct reply.

Question No. 656 answered with Question No. 602.


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