Dáil Éireann Debate, Tuesday - 8 July 2025
835. Deputy Robert O'Donoghue asked the Minister for Health if there are any plans to expand funding streams for activities for adults in nursing homes; and if she will make a statement on the matter. [37502/25]
Amharc ar fhreagraThe 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 the person with the activities of daily living
• Laundry service.
It excludes other costs such as therapies, more specialised aids and appliances, social activities, transport and individual items and services such as specialised laundry, newspapers and hairdressing. Many of these items were excluded from the definition of long-term residential care because they relate to services covered under the medical card or other eligibility schemes. Other services such as specialised laundry, newspapers and hairdressing were excluded as these are discretionary charges that should only be applied when the resident chooses to avail of the service. Typically, social charges are levied on all residents to cover the cost of activities.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 (as amended) stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged and is inclusive of all additional charges. Residents should never be charged fees which are not set out in the contract.
The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home. 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.
Concerns about additional charges should in the first instance be taken up with the nursing home provider. Registered providers are obliged to provide an accessible and effective complaints procedure. Where an individual is not satisfied with the response they receive, they may wish to take their complaint further by seeking a review from the Office of the Ombudsman. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaint’s procedure of the private nursing home concerned.
The Patient Advocacy Service provides a free, independent and confidential advocacy service to assist people to make a complaint about the care they or a family member has experienced in a nursing home and can be contacted by telephone at 0818 293 003 between Monday to Friday from 10am – 4pm.
The Competition and Consumer Protection Commission (CCPC) is an independent statutory body with a dual mandate to enforce competition and consumer protection law in Ireland. CCPC’s mission is to promote competition and enhance consumer welfare. The CCPC has published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers. The guidelines can be found on the website https://www.ccpc.ie/business/help-for-business/guidelines-for-business/nursing-home-guidelines/.
The issue of additional charges is multifaceted; there are a number of separate factors driving this issue. The Department of Health is currently reviewing the available evidence and potential actions to address the different factors are being considered.
