Re­view into fund’s nurs­ing home price mech­a­nism

Irish Examiner - - News - Eve­lyn Ring

A re­view of how the Na­tional Treat­ment Pur­chase Fund ne­go­ti­ates prices with pri­vate and vol­un­tary nurs­ing homes un­der the Fair Deal scheme is al­most com­plete.

NTPF chair­man John Ho­ran told the Oireach­tas Pub­lic Ac­counts Com­mit­tee, that pro­pos­als on the “pric­ing mech­a­nism” would be pre­sented to the De­part­ments of Health and Pub­lic Expenditure and Re­form in a “mat­ter of weeks”.

Mr Ho­ran said a de­ci­sion would be made to ei­ther move to a new pric­ing sys­tem, stay with the ex­ist­ing one, or just “tweak” it.

He said the NTPF was man­dated by statute to ne­go­ti­ate with nurs­ing home pro­pri­etors for the pur­pose of reach­ing an agree­ment as to the max­i­mum cost for spec­i­fied long-term res­i­den­tial care ser­vices.

“By the end of April 2018, more than 430 nurs­ing homes had pric­ing con­tracts with the NT PF and the average price of long-term res­i­den­tial care paid to these nurs­ing homes amounted to €957 per res­i­dent per week,” said Mr Ho­ran.

“Any pro­pos­als to amend a suc­cess­ful sys­tem ben­e­fit­ting 17,500 res­i­dents and in­volv­ing State expenditure of c lose to €900 m should be very care­fully scru­ti­nised and con­sid­ered.”

Ear­lier, the chief ex­ec­u­tive of Nurs­ing Homes Ire­land, Tadhg Daly, told the com­mit­tee the NTPF was “abus­ing” its dom­i­nance as a mo­nop­oly pur­chaser and threat­en­ing the vi­a­bil­ity of pri­vate and vol­un­tary nurs­ing homes.

Mr Daly said that five pri­vate nurs­ing homes closed last year due to fi­nan­cial con­cerns.

Mr Ho ran said its in­for­ma­tion was that four nurs­ing homes had closed last year but that a more im­por­tant is­sue was the num­ber of beds — point­ing out that dur­ing the same year, the num­ber of beds in­creased by 313.

“The bed num­bers are grow­ing; the num­ber of nurs­ing homes is fairly static over the last three to four years. It has hardly changed,” he said.

The average con­tract term had also in­creased from 19 months to 30 months over the last three years, he said.

“Pri­vate nurs­ing homes are vol­un­tar­ily sit­ting down and in­di­vid­u­ally ne­go­ti­at­ing deals with the NTPF for the prices that will be paid un­der the Fair Deal scheme — tax­pay­ers’ money,” said Mr Ho­ran.

“So I would be very re­luc­tant to say, ‘Let’s have a new sys­tem’. I like the sys­tem the way it is be­cause I be­lieve it is work­ing. That is not to say that what is work­ing could not be im­proved.

“That is why we are do­ing this ma­jor re­view and do­ing it very care­fully.”

Mr Daly said the NTPF, as a mo­nop­oly pur­chaser, had adopted a ‘take it or leave it’ ap­proach within its ne­go­ti­a­tions of fees with pri­vate and vol­un­tary providers. There was no in­de­pen­dent ap­peals mech­a­nism for a provider who failed to agree on a fee with the NTPF.

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