Fresh proposals: Plans drawn up by the former minister for health Micheál Martin to develop 850 beds in community nursing units as part of a public private partnership (PPP) arrangement have been shelved on the basis that the move would have breached the Government's employment ceiling.
The Irish Times has learned, however, that in recent weeks the Department of Health has been in talks with the Department of Finance on replacement proposals which would see the private sector provide both the facilities and the clinical care for public patients under a service agreement with the Health Service Executive (HSE).
Internal Department of Health documents reveal that under the new plan, the private sector would qualify for tax breaks on the cost of constructing or refurbishing premises to be used to provide the 850 nursing home beds for public patients.
The proposal to develop community nursing units with 850 beds in the east and the south of the country under a PPP project were announced in 2002 by Mr Martin as part of an initiative to move patients out of acute hospitals.
However, the internal Department of Health documents reveal that "concerns were raised by the Department of Finance about the impact the projects would have on the HSE employment control ceiling and the additional revenue expenditure".
The documents, however, reveal that the provision of the community nursing units was considered as "critical" by health service management and the Tánaiste and Minister for Health Mary Harney who had indicated that other options should be considered.
The Irish Times understands that under the new proposals, currently under consideration, the 850 nursing home beds would be provided under a service agreement with the private sector.
"The private sector would provide all facilities for a range of patients including long-stay, respite, rehabilitation and day care, if necessary," the Department of Health document states.
"At present, most private nursing homes do not cater for the needs of such patients.
"Under this proposal the admission and discharge policy would be the responsibility of the HSE," the document stated.
The private sector would build, finance, operate and maintain the facilities while the specifications of the service to be provided would be agreed with the HSE. The facilities would be for public patients only and and all services - including clinical care and any specialist equipment - would be provided by the private sector.
