Dáil debates
Thursday, 2 May 2024
Ceisteanna Eile - Other Questions
Nursing Homes
9:40 am
Cathal Crowe (Clare, Fianna Fail)
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6. To ask the Minister for Health if a new capital funding stream to support the voluntary nursing home sector in meeting HIQA requirements and upgrading facilities can be considered; and if he will make a statement on the matter. [19781/24]
Cathal Crowe (Clare, Fianna Fail)
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The Minister of State will know about this question because we recently discussed it in a lot of detail. Will she give consideration to a new capital funding stream to support the voluntary nursing home sector in meeting HIQA requirements and providing for all of the upgrades required each year, which are quite costly?
Before I resume my seat, I will congratulate the Minister of State, Deputy Colm Burke, on his elevation. I was sitting right beside him the day before the Minister of State appointments were to be made and his phone buzzed. We all joked that he was getting the call. That was not the call but he did get the call the following day. He deserves his elevation and I congratulate him.
Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question. I also congratulate the Minister of State, Deputy Colm Burke, as I know the Minister, Deputy Donnelly, also does, on sitting here beside us answering questions on public health and drugs.
On the Deputy's question, voluntary organisations form an essential and integral part of the overall health and social care system. Historically, the voluntary sector was the first to provide hospital and social care to the poor and to the most vulnerable in Irish society. Voluntary long-term residential care centres are run by a variety of groups including registered charities, community groups and religious orders. Voluntary nursing homes providers are key players in the Irish long-term residential care sector, operating approximately 10% of centres and delivering approximately 9% of beds. This is a great opportunity to speak about the voluntary sector. We do not often get such an opportunity.
Last week, the Deputy and I had a meeting with two voluntary providers from the Clare area. It was a very positive meeting. There are different ways in which voluntary nursing homes can avail of additional funding. Voluntary and private nursing homes in the mid-west are currently tendering to provide step-down facilities to support the throughput in University Hospital Limerick. That is the first way. The other way is through a scheme I introduced earlier this year, the new capital nursing home resident safety improvement scheme, which has been open for applications since 2 February. The scheme was established to provide funding to eligible private and voluntary nursing homes towards structural works carried out. The closing date for applications to this scheme is 15 November. Importantly, it is backdated to 1 January 2020. I will revert to the Deputy with more information in my next contribution.
Cathal Crowe (Clare, Fianna Fail)
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We had a very positive meeting last week with the Oireachtas Members from Clare. We met Marie O'Malley, representing Carrigoran House, and Michael Harty, formerly of this House, representing the home at Cahercalla. Both of those community hospitals provide fabulous care. These are outstanding facilities in our county providing healthcare to those at an advanced stage of life who have ailing health. It is not just about the beds, but all of the ancillary stuff such as the recreation rooms, gardens and other environments. However, it is very costly to run these facilities. Across the town, in Ennis, there is the fabulous St. Joseph's Hospital, which is also a geriatric hospital but which is funded very differently. It is directly funded by the HSE. These community hospitals would say that the significant costs associated with complying with HIQA requirements and making structural upgrades each year are very difficult for them to meet. Meanwhile, although St. Joseph's does not have a perfect column of funding coming in the whole time, it is ultimately managed by the HSE and can go to the Department if it needs funding. That is not so for the home at Cahercalla or Carrigoran House. Perhaps a new fund or bursary could be devised in the next budget.
Mary Butler (Waterford, Fianna Fail)
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As I have said, the scheme I was speaking about will run through 2024 and allows eligible voluntary and private nursing homes to apply for up to €25,000 from a fund of €10 million to support structural works relating to fire safety and infection prevention. The first payments were made on 28 March, when a total of €1.86 million was paid to 82 nursing homes. That has been very welcome. I take on board the point the Deputy is making. The challenge for me is that the Department of Health is obliged to deliver policies underpinned by the principle of equity of access to related services or supports. We cannot decide to just support the voluntary sector as against the private sector. There is also a large number of small family-run community-based nursing homes.
Further to the Deputy's query, I had a meeting yesterday with officials in the Department and we are looking at ways to further support the voluntary and smaller nursing home sector, maybe in relation to buildings that are built with multiples of years.
9:50 am
Cathal Crowe (Clare, Fianna Fail)
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I thank the Minister of State. That meeting sounds very positive. Long ago I used to believe the budget was set each autumn but I know work on the new budget has already begun. It is positive the Minister of State has had those negotiations and talks.
Even though we are talking about our country's older population, a comparison could be drawn with childcare at the other end of the age spectrum. In childcare, there is the private sector, the public sector and community childcare. There are funding columns, though childcare providers say they are not perfect and there are shortfalls. It is important that the likes of Cahercalla and Carrigoran have something beyond the current fund. The current fund is positive but putting in fire doors is quite expensive. I believe a standard single fire door at the moment costs around €7,000. The capital expansion these hospitals merit needs a better funding column. The Minister of State did it for St. Senan's, Kilrush last year and there was a fabulous outcome but it should be broadened.
I would love to see community hospitals moved from section 39 to section 38 arrangements so they are directly funded, like St. Joseph's, Ennis, by the HSE and there is no annual scratching of heads about how to fund it. They would have certainty that there would be money to properly run these facilities. They are wonderful and deserve as much State backing as we can give them.
Mary Butler (Waterford, Fianna Fail)
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I am conscious of the financial challenges faced by the nursing home sector but this year, the budget will be €1.5 billion to support 22,700 people under the fair deal scheme. There was an additional €45 million provided last year to increase the rates of fair deal. Many of the nursing homes which renegotiated saw an uplift, in rural areas of between 8% and 9% and in urban areas of between 6% and 7%. That increase is continuing this year. Both nursing homes we spoke to last week were tied into a three-year plan but are renegotiating so should see an uplift in what they are getting.
I take on board the question the Deputy raised. I took it seriously and we have already started exploring mechanisms. It is important to say the Department of Health is obliged to deliver policies underpinned by the principles of equity of access to related services or supports. I am bound by that code.
Cathal Crowe (Clare, Fianna Fail)
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Can I correct the record? I said "public childcare" but I meant childcare providers that are engaged with ECCE contracts. There is no public childcare per se.
Catherine Connolly (Galway West, Independent)
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While we are correcting things on equity, I made a mistake. I forgot to let in Deputy Murnane O'Connor. She can come in now but I will not bring in the Minister of State again.
Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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You are very good. Thank you very much.
It was good the Minister of State spoke of voluntary homes and care homes, such as those in Carlow and Kilkenny, and I thank her for the funding. Deputy Crowe spoke of care homes needing funding. We all respect the HIQA reports and whatever but I spoke to the Minister of State recently about looking at local authority grants for when a HIQA inspection came on and they wanted an extra bedroom, bathroom or something like that. Maybe different Departments could help the Minister of State's Department with grants so if one was under pressure we would all work together and try to get that extra funding.
A nursing home was on to me recently where all the residents have medical cards but are all being charged for their blood tests. Is there anything we can do to help these residents? It is important they do not have all these extra fees. I thank the Minister of State for all the work she is doing.