'Unacceptable' failure to examine value of €1bn Fair Deal scheme
The report describes the Department of Health’s failure to conclude a value-for-money review of the Fair Deal, which was begun in March 2018, as being 'unacceptable', and will call on the department to publish its report 'without delay'.
The HSE has been told it must unite its finances and procurement management under one system as a priority in order to rectify a “serious operational deficiency”.
A report into the administration of the HSE’s nursing home support scheme, the “Fair Deal”, by the Public Accounts Committee, has delivered five recommendations for the improvement of the scheme, which cost the State more than €1bn in 2019.
The as-yet-unpublished report will cite the fact that costs incurred under Fair Deal are currently recorded within nine separate financial systems throughout the HSE, a situation which the executive has claimed previously contributed to so much of its procurement costs being non-compliant with the statutory procedure.
The report will call for the implementation of a united system, which the HSE has previously committed to having online by 2024, to be “prioritised” in order to
ensure “robust financial oversight can be undertaken”.
It will describe the Department of Health’s failure to conclude a value-for-money review of Fair Deal, which was begun in March 2018, as being “unacceptable, and will call on the department to publish its report “without delay”.
The committee described the price-negotiations regarding care provision conducted by the National Treatment Purchase Fund (NTPF), the body which administers the scheme, as having resulted “in the maximum price becoming the standard price”.
It will suggest the Department of Health “provide alternative mechanisms” to “facilitate more effective negotiations”.
An apparent “lack of transparency” in terms of the NTPF’s negotiating procedures is also cited, a fact also cited by the Comptroller and Auditor General in its own review, with its recommendations accepted by the fund.
The committee will call on the NTPF to collate its negotiation documents to provide guidance for future negotiations.
Meanwhile, a shortcoming in the assessment of care for residents has also been highlighted by the committee, with the current system effectively amounting to a standard assessment of need being “carried out once and not reviewed”, meaning residents may get hit by additional costs should their needs change.
The PAC will call for such care to be reviewed “at appropriate intervals” in order to prevent such “additional financial burdens” from falling due.
The investigation by PAC into the 10-year-old scheme came about following a similar audit of its administration by the C&AG, an investigation which led to 12 recommendations, all of which were accepted by the HSE.
That investigation had found that the HSE had spent almost double its budget allocation for public nursing homes in 2018, a figure of €590m.
The average charge rate in 2018 in public nursing homes was €1,564, while the maximum price payable in private institutions averaged just €968.
Meanwhile, Nursing Homes Ireland, the representative body for 390 of Ireland’s 440 private homes, had alleged in a submission to the PAC that Fair Deal in its current form serves to “discriminate against residents in private and voluntary nursing home care”.
