Health (Nursing Homes) (Amendment) Bill 2006: Report Stage (Resumed)

Wednesday, 1 November 2006

Dáil Eireann Debate
Vol. 626 No. 4

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Debate resumed on amendment No. 8:

Mr. S. Ryan: Information on Seán Ryan  Zoom on Seán Ryan  In supporting these amendments, I believe the long-term care arrangements for older people are unplanned, inadequate, inequitable and underfunded. All older people wish to continue to live in their own homes and, fortunately, the vast majority succeed in doing so. They mainly live healthy and active lives, with some support from general practitioners, community care services, their families and communities. They are able to make and implement decisions about their lives and do not need constant or sustained care.

We are speaking about people who require long-term care. Those who must leave their homes and enter long-stay institutional care are among the most vulnerable members of our society. Our society is civilised, respects human rights and promotes human dignity. It should be judged on the way the care is provided and the quality of life facilitated within the care system.

There are major shortcomings in this regard. Any objective judgment on our care system would be harsh. We have a stated policy in the context of this section of the Bill. It demonstrates that we have a stated policy which favours community or home care. The practice makes such care extraordinarily difficult and effectively supports institutional care more than it supports home care.

We do not have a fair and equitable system for financing care, and we do not have a fair and transparent set of rights and entitlements. In the context of the Bill, the Minister has stated he is just regularising the situation. He has also indicated that fundamental changes are proposed in legislation, which would reflect on many of the concerns and points expressed by other Deputies during the course of the Bill. If we are to believe what the Minister has stated and accept that the primary piece of legislation will be in place before the next general election, why are we proceeding down this road and not putting all the resources of the Department into finalising the primary legislation?

The explanatory memorandum to the Bill states the purpose of the subvention scheme is “to provide financial assistance to persons towards the cost of maintenance in a private nursing home”. The Bill defines subvention as a payment towards the cost of care and maintenance [1089]of a dependent person in a nursing home. The 1993 regulations simply state that the payment of subventions was towards the cost of nursing home care. There is a fundamental difference between this Bill and previous regulations.

The financial assessment of an applicant’s means is to include all income and investments, including life policies and any assets transferred within the previous five years, for nominal considerations. It will also include up to 5% of the market value of one’s house. Some 80% of the income from the State non-contributory pension is also included in the means test. In the previous regulations, assets may have been taken into consideration when taking means. They do not state assets shall be taken into account. In the Bill “the first €11,000, or the prescribed amount, whichever is the greater, of the applicant’s assets” is also excluded from the financial assessment of means. However, for the social welfare means test, the exclusion amount is €20,000. The social welfare means test allows for earnings up to €100 per week to be disregarded. There are further exclusions under social welfare, including income from renting a room where a person would otherwise live alone. None of these exclusions is included in the Bill. Furthermore, for the social welfare means test the principal residence is not considered in the financial assessment of means. If one sells a house to buy or rent more suitable accommodation or enters the care of a nursing home, the first €190,460.71 of the sale proceeds are disregarded. The Bill makes no reference as to whether such income will be considered for the nursing home subvention means test. Let us be clear in the comparison between the Bill and other legislation. The exclusion of the home where a relative is residing makes no provision for cohabiting couples in the same section. This should be included in another section and an amendment is required.

The difficulty of setting upper limits for the income level and the valuation of houses in primary legislation poses major difficulties. Given the spiralling cost of houses, should amounts be reviewed annually? Reviews of eligibility can be made at any time and 60 days' notice can be given of withdrawal or reduction of subvention. That is an inconsistency.

The limit of €9,000 on income before housing assets are considered for means testing is already exceeded by the State non-contributory pension. Is this equitable and fair for elderly people? What does €9,000 represent? Should we believe the Minister of State’s statement of 12 October 2006 when that “the HSE will not implement existing rules in such a way that people would lose their houses”? Where is this reflected in the Bill? It is not the Minister of State’s commitments, nor those of his successor, that are relevant but the Bill. If such discretion is given by the HSE, what is the use in setting up percentages in the first place?

[1090]An appeal against the decision of the HSE will be heard by someone who may be an employee of the executive and who must comply with guidelines set out by the executive. There is no independent appeals system or advocacy service for an appellant. Both services are proposed in the case of other Bills. They should be set up before the Bill is enacted. The Bill should clearly state the decisions of an appeals officer should be reviewed by the Ombudsman.

There is no reference to those in nursing homes with low dependency. Reference is only made to those with maximum, high and medium dependency levels. No further clarity is given regarding enhanced subventions or fully contracted beds. It is easy for the Minister of State to give the impression he is doing something by referring to enhanced subvention and contract beds. We all know that availability of enhanced subvention is minimal and fully contracted beds are no longer in existence in some areas.

Older people who raised their children, allowing them to be part of the Celtic tiger, cannot be cared for at home. They cannot be given a commitment because of the waiting list. I have attended the funerals of many constituents who were told they could be on a waiting list for nine years before a public sector bed became available. They died at home rather than receiving care to which they were entitled under legislation as citizens of the State. The Minister of State refers to implementing policy. The Government made a commitment to providing 2,000 extra long-term public beds. The health strategy referred to a lower figure of 800 but none has been delivered.

This section of the Bill allows a high degree of discretion to the executive. The intention of a standardised system of assessment will not be achieved. On the basis of comparisons with the means testing of the Department of Social and Family Affairs, efforts to introduce standardised eligibility criteria will be further frustrated by the lack of consistency in means testing across Departments. This will result in allegations of unfairness and inequality. This is the last thing we want for people concerned about their final years in the world. The necessity of staying at a long-term, private facility means they have used up the nest egg and are faced with the threat — implicit in the Bill — of their house being sold over their heads.

Older people are not treated in the same way as everyone else. A young child coming into the world is entitled to care and attention in a public hospital. The care to which someone aged 65 years or over is entitled under the Constitution is not available. If one has the money, one can go into a private nursing home. There are three degrees of subvention for others but if one earns over €11,000 per annum, one has a problem. If one’s house is worth more than the valuation stipulated in the Bill, one is not entitled to a sub[1091]vention. House values in rural areas and Dublin are inconsistent.

The Minister of State and his officials are well aware of the problems encountered. Court cases are pending on the issue of elderly people’s constitutional entitlement to care. Many reports outlining the need for action have been placed before the Minister of State or someone else in his Department. The result is a commitment from the Government and the Minister to regularise the existing arrangement rather than deal with the problem. This at a time when we are told the resources of the State are not always available, or there is a staff shortage. The Minister of State should be ashamed.

While the Bill is an attempt to incorporate a 1993 regulation in primary legislation, other legislation and regulations have superseded many aspects of the 1993 regulations. For example, the assessment of a child’s income was provided for in the 1993 regulations but ended in 1999. It makes no sense to include old regulations in new laws, notwithstanding that the old regulations were bad law in the first instance. New legislation requires new regulations. The elderly are entitled to legislation that will protect them and provide the care and attention they deserve. The Bill does not meet that need. I fully support the amendment.

Mr. Wall: Information on Jack Wall  Zoom on Jack Wall  I support the amendment in respect of the definition of the Dublin area. The Bill sets a ceiling of €300,000 and above on the value of a principal residence outside the Dublin area. An article in the Irish Examiner on 26 October stated the cost of housing in the greater Dublin area, including counties Kildare, home to the Minister of State and me, Louth, Meath and Wicklow, bucked the trend for house prices to ease off. Instead they had increased by 14%. If the average cost of a house in Dublin is €419,000 and the greater Dublin area extends to the counties I have named, will the Minister of State accept that it is necessary to reconsider that section of the Bill and agree to the amendment? These counties form a commuter belt for people working in Dublin because of their proximity to the city. There is no obvious reason not to accept that they form part of the greater Dublin area in the context of house prices.

The Minister of State has said the Bill is intended to provide in legislation for the decision made in 1993. There will be no further legislation on this matter for some time and many families will suffer as a result. If the newspapers report a percentage rise in house prices in clearly defined areas, it is difficult to understand why we cannot agree that the definition of the Dublin area should be extended to include the greater Dublin area. One could then reflect on including the four local authorities in the four named counties. I have heard no one say the prices mentioned in the report are out of line with reality. The Bill [1092]will affect a senior citizen who owns such a house. If, under the legislation, the Department does not recognise a senior citizen who owns a house in this area, that person’s home will be sold over his or her head. There should be no problem in accepting the amendment because there is a definite line around the counties to which I refer. The figures are available at the press of a button to show how the commuter belt affects them.

I do not see how the Minister of State can refuse to accept the amendment. He was under pressure on Committee Stage to resolve this matter but refused to accept the amendment. On occasions when I have discussed the Bill with him he has told me it is not the “be all and end all” of a Bill but that some changes have been made. This is one change he must accept. He should agree to consider this aspect of the Bill and recognise that it threatens family homes. No member of the Government has said there is a mechanism available to protect the family home if the value of the home must be taken into account. The cost of nursing home care in the areas mentioned is such that one can see how it would affect local families. A person in receipt of an old age pension in any part of the country will receive €800 a month. The cost of a nursing home place in County Kildare is €2,800 per month. It will, therefore, cost over €100,000 a year to sustain a person in a nursing home. If a person cannot receive a subvention and must sell his or her home, the price will only give them three years in a nursing home. Allowing that a place in a nursing home will cost €2,000 per month, the yearly cost will be €104,000.

Minister of State at the Department of Health and Children (Mr. S. Power): Information on Seán Power  Zoom on Seán Power  No, it will not; the Deputy has multiplied the figure by 52 weeks rather than 12 months.

Mr. Wall: Information on Jack Wall  Zoom on Jack Wall  Regardless, it will eat into the value the person received for his or her home. I do not understand why the Minister of State cannot accept that the greater Dublin area comprises four other counties. If this amendment is accepted, it will put some substance into the value of the Bill for families from those counties that are affected.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  I question these amendments’ sufficiency. On the final Stages it is worth questioning the Bill’s essential constitutionality. It is legally fragile in so far as it sets out to treat citizens in a different fashion, in a manner which could be construed as arbitrary. Separate from the issue of strict constitutionality, other questions arise. There is a real problem as there is such a significant departure from any rights-based approach in the legislation. In identifying forms of physical dependency, the legislation purports to deal with the needs of a citizen. On the other hand, it proposes to meet the needs of the citizen [1093]through a set of mechanisms. This will create problems.

When compared internationally the Bill is not consistent with several European conventions. It will not stand up to a court challenge if a case is brought. It is my expectation and hope that such a case will be brought. The fundamental principle is that citizens are entitled, even in the scarcest of times, to be treated equally. The 1966 International Covenant on Economic, Social and Cultural Rights contains several crucial words, “the progressive realisation of one’s rights”. One cannot structure an inequity of treatment.

The Minister of State will be advised that he is legally entitled to establish some form of a means test. That will not rescue him from the fact that people are being treated unequally. These are fundamental points. The only way of delivering a system, even if one did not have the surplus we have now in the State’s revenues, is by treating people equally. The legislation does not treat citizens equally. That is its fundamental flaw and it will fall, rightly, on it.

The Bill eschews the principle of universality. I accept that is an ideological position. The Government, particularly its junior partners, rejects a robust citizenship founded on the principle of universality. In ordinary language, this means each child is entitled to a decent education. People must be treated equally in housing legislation, which has already been tested in the courts. These principles have been established in different aspects of health care. The system proposed in the Bill rejects universality and establishes a set of tiered qualifications based on the most dubious principles. If one followed it from a rights perspective, one would expect to be moving towards the progressive realisation of care for an older person. Accountability is not being offered. One is burying different forms of discretion but the citizen does not receive a guarantee. The system is not based on a principle of guarantee. It is, therefore, moving out of the framework of any constitutional certainty. It is simply bad legislation.

Having been a sociologist for 20 years, I have spoken on occasion about the various academic work on longevity. There is that great curve of life where one has no roles when one is born or dead and the great parabola when one is most active. The longer one stays active in different interests, the longer one lives. Few Members are willing to speak about the short period people actually live after they enter a nursing home. It raises questions as to the degree of activity available to residents. It raises questions as to the urgency of a nursing home inspectorate which is not yet in place.

A most important aspect is when one moves from one’s home to an institutional setting. The Bill assumes that one can put a market value on a person’s home. It is assumed that it is available as an asset, free to go on the market and based on the market value in one region or another. [1094] This principle would not last a day in court because of its highly arbitrary structure. Older people moving to an institutional setting must make a choice as to what they must leave behind. They are limited in what objects that have connotations of intimacy or are family-related they can bring with them. One goes as a single person rather than as a unit. It is a traumatic transition. Most people visiting relatives in nursing homes will often tell them how well they are being looked after. They are likely to get a withering look because the relatives in the nursing home know the difference between their current situation and that which they enjoyed in their own home. Anybody who says to such persons that they must put a value on their house, that it is simply an asset, knows nothing about social gerontology and the aging process. It is rubbish.

In regard to the family home, there are several ways the obligations of the beneficiaries of estates and so on can be structured through the taxation system. However, this is not the direction being taken. Instead, nursing home residents must concern themselves, as my colleague, Deputy Wall, pointed out, with the price they got for their home, the difference between it and the current rate and the division of the sum they secured by the monthly charge. They must ask themselves how long will it last and what is to happen when it is used up.

There is a waiting list of five years at the St. Francis nursing home in Galway and some one third of those on the waiting list are more than 80 years old. Some 15 public nursing home beds were made available in County Galway in the past ten years. There are no step-down facilities in the county and the spare capacity in hospitals is being given over to private medicine, for private rackets in the sickness industry.

All Deputies are aware of the situation. We should agree in a cross-party way on the urgent need for an inspectorate and an enhancement of the level of nursing home care. We all agree there are circumstances in which people need care. However, I do not agree with the substitution proposed in section 3 in regard to the definition of need. The problem is that if we are to meet the definition of need on a rights basis, there must be something that is coterminous between the assessed need of a person and the provision he or she receives. For instance, three levels of dependency are defined. If these are assessed externally, what will happen in the context of the institutional setting of the nursing home? Who is to decide whether it is maximum, high or medium? Will this be assessed by the inspectorate or otherwise?

Even before Committee Stage, I noted a serious flaw in the Bill in the provision relating to those who will make an assessment of impairment, whether physical, psychological or social. There are major deficiencies in regard to the social and psychological aspects. Might there be a suggestion that environmental inspections could [1095]be followed up by other inspections and that this would be adequate? It is an absurd prospect. In the transition from a home setting to a nursing home assessments must take account of the whole person. The definitions in the explanatory memorandum do not address this issue which was not dealt with on Committee Stage.

My attitude to this issue is straightforward and republican. In a republic what should count is citizenship. From that citizenship certain rights should be derived. Nobody is saying everything one demands should be provided today or tomorrow. However, the rights perspective, traced through economic conditions, should be based on vulnerability. The State can be reasonably required to move towards the progressive realisation of these basic needs, whether in regard to children, the elderly, disabled people or other vulnerable categories.

It is disgraceful in such conditions of surplus that this legislation should demand that the homes of elderly people must have a market value and that estate agents will decide their entitlement to nursing home subvention. The estate agents who publish the average price of a house, whether in Dublin, the greater Dublin area, Leinster, Munster, Galway or elsewhere, are the ones who report victory every other week when a particular house breaks the magic figure of €1 million. They are parasites who are simply massaging speculators, completely oblivious to any decent consideration of rights, needs or necessities in regard to young people, the elderly or other vulnerable groups.

I do not give a damn whether the value of a person’s home exceeds some specified threshold. It is an obscenity that the House should discuss the needs of older people in such terms. The citizens of a republic are entitled to be treated according to a progressive realisation of their needs. That is the basis of a rights perspective. Consequently, they are entitled to be treated equally and to a service that is accountable. Beyond this, they are entitled to an inspectorate and the dignity of assessment as a whole person. They must not be sent to places where they will spend the remainder of their lives — less than three years on average — wondering whether the yield from their home, the asset value, will suffice and whether there will be anything left for their children.

If the Government has concerns about the beneficiaries of estates, it should have the courage to deal with that issue through the taxation system. Will it be the case that the HSE in the different regions will approach the local auctioneer to discover the average price of a house in that location? Will there be people wondering whether they should put half their house over the border into the greater Dublin area and the kitchen in Leinster? All of this is an insult in regard to the care of the aged.

[1096]Mr. S. Power: Information on Seán Power  Zoom on Seán Power  Two particular issues have been raised by Members and we must not confuse them, although they are related. One relates to the nursing home subvention scheme, the subject of this legislation, while the other is the funding of long-term care. Members have pointed out the faults and failings attached to the subvention scheme and the changes they would like to see introduced. I repeat, however, that it is on the advice of the Attorney General that we are placing the subvention scheme on a primary legislative basis.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  He will find himself at the European Court of Justice and I hope it is soon.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  Deputy Higgins made a wonderful contribution to this debate in explaining how he is highly insulted by the scheme as it operates. I remind him that the regulations were introduced by his colleague, Deputy Howlin, when he was Minister for Health and Children. Clearly, he was not insulted at their introduction in 1993 and they have been used by successive Governments since. Unfortunately, there is no bottomless pit of funding for schemes such as this. There is a limit to the amount we can spend on the scheme.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  That is not the issue.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  We must attach a means test to it. While some €5 million was provided for it 1993, the corresponding figure for this year is €160 million. More than 8,000 people are in receipt of subvention.

The amendments tabled by Deputies McManus and Twomey attempt to change the term “Dublin area” used in the Bill to “Greater Dublin area” and to include several local authority areas in the definition of “Greater Dublin area”. Deputy Twomey’s amendments were not accepted on Committee Stage because we have used the same definition of the Dublin area as is used by the Department of the Environment, Heritage and Local Government when compiling data on house prices. It is logical to do so. It is not feasible to begin including other areas in the definition because some geographical boundary must be drawn. If we were to include the counties immediately surrounding Dublin, we would have to include the counties adjacent to them.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  The Minister of State could have asked the GAA about this.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  Deputy Twomey’s amendment includes County Westmeath, for example, which is not even adjacent to Dublin. If that county was to be included, so also would counties Longford and Offaly. We would end up including the entire country.

Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin  Zoom on Caoimhghín Ó Caoláin  That is exactly what should be done; there should be no differentiation.

[1097]Mr. S. Power: Information on Seán Power  Zoom on Seán Power  Deputy McManus’s amendment proposes doing just that by increasing the principal private residence threshold to €500,000 for the entire country.

  6 o’clock

In responding to the Deputies’ proposals it is crucial that I clarify a certain point in taking into account a property for the purposes of considering subvention applications. When carrying out financial assessment for the purpose of subvention, the applicant’s home is not taken into account in certain circumstances. Examples of this include where it is occupied by a spouse, a child under 21 years of age, a child in full-time education or a relative in receipt of certain social welfare payments or where taking 5% of the value of the residence into account could give rise to destitution or homelessness of a person closely connected to the applicant. The last provision is a new one which was not contained in the regulations and allows the HSE discretion to take into account exceptional circumstances if and when they arise. If none of these situations applies, 5% of the imputed value of the person’s principal private residence is taken into account as part of the financial assessment. This 5% is imputed in all such cases regardless of the value of the property and the thresholds on property were updated in the Nursing Homes (Subvention) (Amendment) Regulations 2005 from €95,000 for the whole country to €500,000 and €300,000 for the Dublin area and the rest of the country, respectively. It is, therefore, not proposed to accept these amendments as we used the Department of the Environment, Heritage and Local Government house price data to reach the figures of €300,000 and €500,000 and also used its definition of the Dublin area, so we intend to keep both of these for the purpose of consistency.

The funding of long-term care was mentioned on the different Stages of the Bill. We have given the matter serious consideration and it has been examined inside out. I realise there is an issue to be tackled, and we will do so. There are proposals before Cabinet and it will make decisions on them in the near future.

Dr. Twomey: Information on Liam Twomey  Zoom on Liam Twomey  I have no difficulty giving way to my colleagues in the Labour Party and will withdraw most of my amendments if we can take the family home issue out of this. During Leaders’ Questions the Taoiseach acknowledged that elderly patients will have to sell their homes because the HSE may refuse the subvention. He agreed with what we have said all along that elderly patients may have to sell their homes. This is basically a property grab by Fianna Fáil which the Minister of State fully acknowledged this evening after five months of trying to get it out of him.

In a press release issued in October, the Minister of State said the income threshold above which subvention may be refused was €36,000 and the principal residence value above which subvention may be refused was €500,000 in the [1098]Dublin area and €300,000 outside the Dublin area. The press release and this legislation state “may be refused”. Every Deputy will have come across at least one case in the past ten months where people have been refused subvention on the grounds of this provision even though it is quite clear it states “may be refused”. When the Taoiseach said during Leaders’ Questions today that a person “may be refused” subvention, he was basically saying that one could read it as “will be refused” subvention.

What is coming out on the final Stages of the Bill is that Fianna Fáil will take houses from elderly people. There are no two ways about it; it is now official Government policy. That is the only clarity we have received in respect of this legislation in the past five months. As has been pointed out, patients have already had to sell their homes to pay for nursing home care. It has happened at least three times not to constituents of mine but to patients of mine in the past two to three years. The most despicable aspect of this is that when they have exhausted their assets, they have received no assistance from the HSE. In fact, we have had to go begging and scraping for them to get a contract bed when their funds were exhausted.

This legislation and the way the Government is behaving is a race to the bottom in terms of looking after elderly people into the future. The Minister of State will not apply consistent standards across the country on the back of this legislation, rather it will apply consistently low standards. He said the amount people receive in subvention is unequal throughout the country and that some HSE areas give more. It looks as if the only thing he wishes to give is less subvention to every elderly person in the country.

Deputy Higgins raised constitutional issues in this regard. We saw what happened with the former health boards when the issue of illegal nursing home charges cropped up. When people said they would challenge the charges in the courts, their fees were paid and they were told they would not be charged. This is exactly how the Government will respond when court cases are brought in this instance. It will suddenly drop the notion of expecting patients to pay. It will buy off those it believes might cause it a problem but will attempt to screw every other elderly person from whom it believes it can get property. That is what the Government is doing and it is shameful. What is even more shameful is that Fianna Fáil does not have the guts to admit it is taking people’s houses from them through the back door.

If the Government had the courage of its convictions, which I doubt it has, it would have first brought forward its policy on funding care of the elderly into the future and would have told us what was to happen. We have waited long enough for its policy. I have press statements from the former Minister, Deputy Martin, dating back as far as 2003 stating that a Government decision on [1099]the O’Shea report, the Mercer report and funding care of the elderly into the future was imminent. In 2003 it told us it would be fair but by 2006, the Government has obviously made up its mind exactly how it will fund care of the elderly into the future; it will take their houses from them. The Minister of State more or less said that when he said the only aspect which worried him was how much it will cost. He made direct comparisons between how much it cost in 1993 with how much it costs now. He does not give a hoot about equality, rights and how elderly patients will be treated in the future. The only aspect which bothers the Government is the bottom line.

The Tánaiste and Minister for Justice, Equality and Law Reform said there were so many billions of euro sloshing about in the Department of Finance that the Government did not know what to do with them. Obviously, it has changed its mind and has decided that the only way to keep the coffers full is to penalise elderly people and take their homes from them. I will withdraw amendments Nos. 8 and 12.

Mr. S. Ryan: Information on Seán Ryan  Zoom on Seán Ryan  The Minister of State probably did not have sufficient time to take on board some of my contribution on my assessment of the Bill but I thought he would have referred to some of the relevant points I made. I referred, in particular, to the provision for cohabiting couples which should be included. I made some other realistic proposals. The Minister of State said he wished to be consistent. However, he is being anything but consistent. I referred to the social welfare means test. If he wishes to be consistent, why does he not take that on board rather than have different standards in the Department of Health and Children and the Department of Social and Family Affairs?

I have listened to the representatives of older people, including Age Action Ireland, the Irish Senior Citizens Parliament and other organisations. Time and again, they have expressed grave concern in regard to the assessment of the principal residence of the applicant. The assessment of the degree of dependency and means of the applicant brings us to the core of the issue. Our amendment No. 6 reads “In page 7, to delete lines 20 to 48 and substitute the following: “(i) the principal residence of the applicant,“. The Minister of State can refer to 1993 but the situation has changed. We have learned that more older people are seeking care and attention. By accepting our amendment, the Minister of State would be taking on board the views of older people living at home and those in long-stay institutions. Amendment No. 6, reads,

I do not accept the argument that there may be people who will benefit from the sale of a house when loved ones have died. That is not the principle at stake. The principle is one of universality with regard to services and as Deputy Higgins clearly outlined, there are other means of dealing with income deriving from the sale of a family home subsequent to the death of the main resident. That issue can be addressed and the Labour Party will draw up proposals to do so. I urge the Minister of State to accept our amendment but on the basis of what he has said so far, I doubt he will do so.

Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin  Zoom on Caoimhghín Ó Caoláin  With regard to this group of amendments, I welcome Deputy Twomey’s decision regarding amendment Nos. 8 and 11. As I have indicated previously, I find greater favour with the amendments proposed by Deputy McManus, namely Nos. 9 and 10, but only in the context of our not being able to establish with the Minister of State and his colleagues in Government the absolute requirement of the exception of the family home.

It is absurd to even suggest this is not a consequence that will be faced by many people. As Deputy Twomey said, it is already a reality. I have previously put on record in the House the situation of a family in my own home town. There are many cases but one in particular drove the issue home to me very clearly. An elderly lady had to go into nursing home care. She had very little by way of savings but the family home, the simple, council-built home that had appreciated in value over time, was factored into her means assessment because none of her offspring was living there. They were living elsewhere in the country and overseas. The HSE’s drive to force that lady to dispose of her home forced her adult children to face all of the effects of the loss of a parent, even though their mother was in a nursing home facility. The disposal of the home and of all their mother’s personal effects had to be endured. The memories of their childhood growing up there had to be dispersed, displaced and disposed of. I personally witnessed the pain of all of that and it was absolutely harrowing. These were young adults who would come home to visit their mother and stay in the home where they grew up. Now, because that home is no longer in the family’s possession, they are faced with the added burden of the cost of accommodation when they come home to visit their mother in the nursing home. This is already an expensive trip, as three of them have to make their way back to Ireland to do so. They now have to come to their home town and find there is no longer a home for them to visit. They are forced into hotel or bed and breakfast accommodation. It is an absolutely dreadful scenario and that is what the Govern[1101]ment is compounding. That is what the Government will force more and more families to face.

If one thinks ahead, the scenario is equally dreadful. Thankfully, the lady is still alive but when she dies, where will her family gather to grieve? Where will they gather to think back on the years of their childhood, the years they shared with their parent in the nursing home? Where will the lady be waked? There will be no home open to her neighbours, friends and community to come to sympathise. What is the Government doing? Does the Minister of State have any idea of the consequences of what is being proposed for the reality of life for families throughout the country? This is the most poorly thought-out legislation put before us for some time. I know it is not all the fault of the Minister of State. He has been entrusted with the role and responsibility of having to defend the Bill but where are the drafters coming from, the people to whom the Taoiseach referred? Where are they living? How distant have they and those in the Department who advise on the preparation of such legislation become from the reality of life for ordinary people in our communities? It is shameful and a disgrace. The Bill is compounding a pain that is already in evidence and making the situation even worse.

I indicated during my contribution to the Second Stage debate that I welcomed the presentation of a Bill that would place the subvention scheme on the basis of primary legislation but what is it that we have before us? If the Minister of State holds his current line, particularly in this area — although that is not to say there are not other areas of the Bill which are seriously flawed — other Deputies and I will have no choice but to oppose the Bill outright. People throughout the State, when they become aware of the reality and see the pain the outworking of this legislation will cause, as I have described, will also oppose it and the Government will deservedly face a very irate public.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  I must make the point that what we are doing here is converting regulations into primary legislation. With regard to the financial assessment, we are not proposing any change here. We are not proposing any great change in the way the scheme will operate.

[1102]From the point of view of looking after older people, the Government has treated them very much as a priority. We have seen that in successive budgets, with the old age pension increasing. We increased the number of home care packages. Last year we had 1,100 and have increased that this year by an extra 2,000 throughout the country. These are things that have made a real difference and have improved the quality of life of so many.

We are introducing the measures proposed today on the advice of the Attorney General. We are criticised when we do not take advice. Now that we are taking advice and acting upon it, we are being criticised for that as well. With regard to Deputy Twomey’s comments on funding, that is fine when one is in Opposition because one can be as carefree as one likes. However, any reasonable person will accept that in proposing any scheme, one must be very conscious of how much it will cost. I suggest that if he happens to be in the Cabinet after the next election, he make the same proposals. He will see what short shrift he gets from the Department of Finance if he does not cost a scheme he proposes to introduce. We are living in the real world here.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  They were against electricity in their day. They said it would not catch on.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  I hope they never oppose power in Kildare.

Mr. Wall: Information on Jack Wall  Zoom on Jack Wall  Perhaps one or two might.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  As with all constituencies, old people live in Kildare and I am familiar with the difficulties and pressures exerted on those families that find themselves in the unfortunate position where they are obliged to provide for long-term care for a family member. The Deputy is asking me to exclude the principal residence from the Bill. While that proposal might be desirable, it is not possible to agree to it.

Amendment, by leave, withdrawn.

Mr. S. Ryan: Information on Seán Ryan  Zoom on Seán Ryan  I move amendment No. 9:

Amendment put.

[1101]The Dáil divided: Tá, 57; Níl, 64.

Information on Dan Boyle  Zoom on Dan Boyle  Boyle, Dan. Information on James Breen  Zoom on James Breen  Breen, James.
Information on Thomas P. Broughan  Zoom on Thomas P. Broughan  Broughan, Thomas P. Information on Richard Bruton  Zoom on Richard Bruton  Bruton, Richard.
Information on Joan Burton  Zoom on Joan Burton  Burton, Joan. Information on Paul Connaughton  Zoom on Paul Connaughton  Connaughton, Paul.
Information on Paudge Connolly  Zoom on Paudge Connolly  Connolly, Paudge. Information on Joe Costello  Zoom on Joe Costello  Costello, Joe.
Information on Jerry Cowley  Zoom on Jerry Cowley  Cowley, Jerry. Information on Seymour Crawford  Zoom on Seymour Crawford  Crawford, Seymour.
Information on Sean Crowe  Zoom on Sean Crowe  Crowe, Seán. Information on Ciaran Cuffe  Zoom on Ciaran Cuffe  Cuffe, Ciarán.
Information on John Deasy  Zoom on John Deasy  Deasy, John. Information on Jimmy Deenihan  Zoom on Jimmy Deenihan  Deenihan, Jimmy.
Information on Bernard Durkan  Zoom on Bernard Durkan  Durkan, Bernard J. Information on Damien English  Zoom on Damien English  English, Damien.
Information on Olwyn Enright  Zoom on Olwyn Enright  Enright, Olwyn. Information on Martin Ferris  Zoom on Martin Ferris  Ferris, Martin.
Information on Eamon Gilmore  Zoom on Eamon Gilmore  Gilmore, Eamon. Information on John Gormley  Zoom on John Gormley  Gormley, John.
Information on Marian Harkin  Zoom on Marian Harkin  Harkin, Marian. Information on Tom Hayes  Zoom on Tom Hayes  Hayes, Tom.
Information on Seamus Healy  Zoom on Seamus Healy  Healy, Seamus. Information on Joe Higgins  Zoom on Joe Higgins  Higgins, Joe.
Information on Michael D. Higgins  Zoom on Michael D. Higgins  [1103]Higgins, Michael D. Information on Philip Hogan  Zoom on Philip Hogan  Hogan, Phil.
Information on Paul Kehoe  Zoom on Paul Kehoe  Kehoe, Paul. Information on Kathleen Lynch  Zoom on Kathleen Lynch  Lynch, Kathleen.
Information on Pádraic McCormack  Zoom on Pádraic McCormack  McCormack, Padraic. Information on Shane McEntee  Zoom on Shane McEntee  McEntee, Shane.
Information on Finian McGrath  Zoom on Finian McGrath  McGrath, Finian. Information on Paul McGrath  Zoom on Paul McGrath  McGrath, Paul.
Information on Paddy McHugh  Zoom on Paddy McHugh  McHugh, Paddy. Information on Arthur Morgan  Zoom on Arthur Morgan  Morgan, Arthur.
Information on Breeda Moynihan-Cronin  Zoom on Breeda Moynihan-Cronin  Moynihan-Cronin, Breeda. Information on Catherine Murphy  Zoom on Catherine Murphy  Murphy, Catherine.
Information on Gerard Murphy  Zoom on Gerard Murphy  Murphy, Gerard. Information on Denis Naughten  Zoom on Denis Naughten  Naughten, Denis.
Information on Dan Neville  Zoom on Dan Neville  Neville, Dan. Information on Caoimhghín Ó Caoláin  Zoom on Caoimhghín Ó Caoláin  Ó Caoláin, Caoimhghín.
Information on Fergus O'Dowd  Zoom on Fergus O'Dowd  O’Dowd, Fergus. Information on Jim O'Keeffe  Zoom on Jim O'Keeffe  O’Keeffe, Jim.
Information on Brian O'Shea  Zoom on Brian O'Shea  O’Shea, Brian. Information on Jan O'Sullivan  Zoom on Jan O'Sullivan  O’Sullivan, Jan.
Information on Séamus Pattison  Zoom on Séamus Pattison  Pattison, Seamus. Information on Willie Penrose  Zoom on Willie Penrose  Penrose, Willie.
Information on Ruairí Quinn  Zoom on Ruairí Quinn  Quinn, Ruairi. Information on Pat Rabbitte  Zoom on Pat Rabbitte  Rabbitte, Pat.
Information on Eamon Ryan  Zoom on Eamon Ryan  Ryan, Eamon. Information on Seán Ryan  Zoom on Seán Ryan  Ryan, Seán.
Information on Trevor Sargent  Zoom on Trevor Sargent  Sargent, Trevor. Information on Joe Sherlock  Zoom on Joe Sherlock  Sherlock, Joe.
Information on Róisín Shortall  Zoom on Róisín Shortall  Shortall, Róisín. Information on Billy Timmins  Zoom on Billy Timmins  Timmins, Billy.
Information on Liam Twomey  Zoom on Liam Twomey  Twomey, Liam. Information on Mary Upton  Zoom on Mary Upton  Upton, Mary.
Information on Jack Wall  Zoom on Jack Wall  Wall, Jack.  


[1103]Níl
Information on Dermot Ahern  Zoom on Dermot Ahern  Ahern, Dermot. Information on Michael Ahern  Zoom on Michael Ahern  Ahern, Michael.
Information on Noel Ahern  Zoom on Noel Ahern  Ahern, Noel. Information on Johnny Brady  Zoom on Johnny Brady  Brady, Johnny.
Information on Martin Brady  Zoom on Martin Brady  Brady, Martin. Information on Seamus Brennan  Zoom on Seamus Brennan  Brennan, Seamus.
Information on Joe Callanan  Zoom on Joe Callanan  Callanan, Joe. Information on Pat Carey  Zoom on Pat Carey  Carey, Pat.
Information on John Carty  Zoom on John Carty  Carty, John. Information on Donie Cassidy  Zoom on Donie Cassidy  Cassidy, Donie.
Information on Michael Collins  Zoom on Michael Collins  Collins, Michael. Information on Mary Coughlan  Zoom on Mary Coughlan  Coughlan, Mary.
Information on Brian Cowen  Zoom on Brian Cowen  Cowen, Brian. Information on John Cregan  Zoom on John Cregan  Cregan, John.
Information on Noel Davern  Zoom on Noel Davern  Davern, Noel. Information on Tony Dempsey  Zoom on Tony Dempsey  Dempsey, Tony.
Information on John Dennehy  Zoom on John Dennehy  Dennehy, John. Information on Jimmy Devins  Zoom on Jimmy Devins  Devins, Jimmy.
Information on John Ellis  Zoom on John Ellis  Ellis, John. Information on Frank Fahey  Zoom on Frank Fahey  Fahey, Frank.
Information on Michael Finneran  Zoom on Michael Finneran  Finneran, Michael. Information on Dermot Fitzpatrick  Zoom on Dermot Fitzpatrick  Fitzpatrick, Dermot.
Information on Pat the Cope Gallagher  Zoom on Pat the Cope Gallagher  Gallagher, Pat The Cope. Information on Jim Glennon  Zoom on Jim Glennon  Glennon, Jim.
Information on Noel Grealish  Zoom on Noel Grealish  Grealish, Noel. Information on Mary Hanafin  Zoom on Mary Hanafin  Hanafin, Mary.
Information on Seán Haughey  Zoom on Seán Haughey  Haughey, Seán. Information on Máire Hoctor  Zoom on Máire Hoctor  Hoctor, Máire.
Information on Joe Jacob  Zoom on Joe Jacob  Jacob, Joe. Information on Cecilia Keaveney  Zoom on Cecilia Keaveney  Keaveney, Cecilia.
Information on Billy Kelleher  Zoom on Billy Kelleher  Kelleher, Billy. Information on Peter Kelly  Zoom on Peter Kelly  Kelly, Peter.
Information on Tony Killeen  Zoom on Tony Killeen  Killeen, Tony. Information on Seamus Kirk  Zoom on Seamus Kirk  Kirk, Seamus.
Information on Tom Kitt  Zoom on Tom Kitt  Kitt, Tom. Information on Conor Lenihan  Zoom on Conor Lenihan  Lenihan, Conor.
Information on Michael McDowell  Zoom on Michael McDowell  McDowell, Michael. Information on Tom McEllistrim  Zoom on Tom McEllistrim  McEllistrim, Thomas.
Information on John McGuinness  Zoom on John McGuinness  McGuinness, John. Information on John Moloney  Zoom on John Moloney  Moloney, John.
Information on Donal Moynihan  Zoom on Donal Moynihan  Moynihan, Donal. Information on Michael Moynihan  Zoom on Michael Moynihan  Moynihan, Michael.
Information on Michael Mulcahy  Zoom on Michael Mulcahy  Mulcahy, Michael. Information on Éamon Ó Cuív  Zoom on Éamon Ó Cuív  Ó Cuív, Éamon.
Information on Seán Ó Fearghaíl  Zoom on Seán Ó Fearghaíl  Ó Fearghaíl, Seán. Information on Charlie O'Connor  Zoom on Charlie O'Connor  O’Connor, Charlie.
Information on Liz O'Donnell  Zoom on Liz O'Donnell  O’Donnell, Liz. Information on John O'Donoghue  Zoom on John O'Donoghue  O’Donoghue, John.
Information on Dennis O'Donovan  Zoom on Dennis O'Donovan  O’Donovan, Denis. Information on Batt O'Keeffe  Zoom on Batt O'Keeffe  O’Keeffe, Batt.
Information on Ned O'Keeffe  Zoom on Ned O'Keeffe  O’Keeffe, Ned. Information on Fiona O'Malley  Zoom on Fiona O'Malley  O’Malley, Fiona.
Information on Tim O'Malley  Zoom on Tim O'Malley  O’Malley, Tim. Information on Tom Parlon  Zoom on Tom Parlon  Parlon, Tom.
Information on Peter Power  Zoom on Peter Power  Power, Peter. Information on Seán Power  Zoom on Seán Power  Power, Seán.
Information on Dick Roche  Zoom on Dick Roche  Roche, Dick. Information on Mae Sexton  Zoom on Mae Sexton  Sexton, Mae.
Information on Brendan Smith  Zoom on Brendan Smith  Smith, Brendan. Information on Michael Smith  Zoom on Michael Smith  Smith, Michael.
Information on Noel Treacy  Zoom on Noel Treacy  Treacy, Noel. Information on Mary Wallace  Zoom on Mary Wallace  Wallace, Mary.
Information on Ollie Wilkinson  Zoom on Ollie Wilkinson  Wilkinson, Ollie. Information on G. V. Wright  Zoom on G. V. Wright  Wright, G.V.

[1103]Tellers: Tá, Deputies Broughan and Kehoe; Níl, Deputies Kitt and Kelleher.

[1103]Amendment declared lost.

Mr. S. Ryan: Information on Seán Ryan  Zoom on Seán Ryan  I move amendment No. 10:

[1104]

Question put: “That the words and figures proposed to be deleted stand.”

[1103]The Dáil divided: Tá, 62; Níl, 55.

Information on Dermot Ahern  Zoom on Dermot Ahern  Ahern, Dermot. Information on Michael Ahern  Zoom on Michael Ahern  Ahern, Michael.
Information on Noel Ahern  Zoom on Noel Ahern  Ahern, Noel. Information on Johnny Brady  Zoom on Johnny Brady  Brady, Johnny.
Information on Martin Brady  Zoom on Martin Brady  Brady, Martin. Information on Seamus Brennan  Zoom on Seamus Brennan  Brennan, Seamus.
Information on Joe Callanan  Zoom on Joe Callanan  Callanan, Joe. Information on Pat Carey  Zoom on Pat Carey  Carey, Pat.
Information on John Carty  Zoom on John Carty  Carty, John. Information on Donie Cassidy  Zoom on Donie Cassidy  Cassidy, Donie.
Information on Mary Coughlan  Zoom on Mary Coughlan  Coughlan, Mary. Information on Brian Cowen  Zoom on Brian Cowen  Cowen, Brian.
Information on John Cregan  Zoom on John Cregan  Cregan, John. Information on Noel Davern  Zoom on Noel Davern  Davern, Noel.
Information on Tony Dempsey  Zoom on Tony Dempsey  Dempsey, Tony. Information on John Dennehy  Zoom on John Dennehy  Dennehy, John.
Information on Jimmy Devins  Zoom on Jimmy Devins  Devins, Jimmy. Information on John Ellis  Zoom on John Ellis  Ellis, John.
Information on Frank Fahey  Zoom on Frank Fahey  [1105]Fahey, Frank. Information on Michael Finneran  Zoom on Michael Finneran  Finneran, Michael.
Information on Dermot Fitzpatrick  Zoom on Dermot Fitzpatrick  Fitzpatrick, Dermot. Information on Pat the Cope Gallagher  Zoom on Pat the Cope Gallagher  Gallagher, Pat The Cope.
Information on Jim Glennon  Zoom on Jim Glennon  Glennon, Jim. Information on Noel Grealish  Zoom on Noel Grealish  Grealish, Noel.
Information on Mary Hanafin  Zoom on Mary Hanafin  Hanafin, Mary. Information on Seán Haughey  Zoom on Seán Haughey  Haughey, Seán.
Information on Máire Hoctor  Zoom on Máire Hoctor  Hoctor, Máire. Information on Joe Jacob  Zoom on Joe Jacob  Jacob, Joe.
Information on Cecilia Keaveney  Zoom on Cecilia Keaveney  Keaveney, Cecilia. Information on Billy Kelleher  Zoom on Billy Kelleher  Kelleher, Billy.
Information on Peter Kelly  Zoom on Peter Kelly  Kelly, Peter. Information on Tony Killeen  Zoom on Tony Killeen  Killeen, Tony.
Information on Seamus Kirk  Zoom on Seamus Kirk  Kirk, Seamus. Information on Tom Kitt  Zoom on Tom Kitt  Kitt, Tom.
Information on Conor Lenihan  Zoom on Conor Lenihan  Lenihan, Conor. Information on Michael McDowell  Zoom on Michael McDowell  McDowell, Michael.
Information on Tom McEllistrim  Zoom on Tom McEllistrim  McEllistrim, Thomas. Information on John McGuinness  Zoom on John McGuinness  McGuinness, John.
Information on John Moloney  Zoom on John Moloney  Moloney, John. Information on Donal Moynihan  Zoom on Donal Moynihan  Moynihan, Donal.
Information on Michael Moynihan  Zoom on Michael Moynihan  Moynihan, Michael. Information on Michael Mulcahy  Zoom on Michael Mulcahy  Mulcahy, Michael.
Information on Éamon Ó Cuív  Zoom on Éamon Ó Cuív  Ó Cuív, Éamon. Information on Seán Ó Fearghaíl  Zoom on Seán Ó Fearghaíl  Ó Fearghaíl, Seán.
Information on Charlie O'Connor  Zoom on Charlie O'Connor  O’Connor, Charlie. Information on Liz O'Donnell  Zoom on Liz O'Donnell  O’Donnell, Liz.
Information on John O'Donoghue  Zoom on John O'Donoghue  O’Donoghue, John. Information on Batt O'Keeffe  Zoom on Batt O'Keeffe  O’Keeffe, Batt.
Information on Ned O'Keeffe  Zoom on Ned O'Keeffe  O’Keeffe, Ned. Information on Fiona O'Malley  Zoom on Fiona O'Malley  O’Malley, Fiona.
Information on Tim O'Malley  Zoom on Tim O'Malley  O’Malley, Tim. Information on Tom Parlon  Zoom on Tom Parlon  Parlon, Tom.
Information on Peter Power  Zoom on Peter Power  Power, Peter. Information on Seán Power  Zoom on Seán Power  Power, Seán.
Information on Dick Roche  Zoom on Dick Roche  Roche, Dick. Information on Mae Sexton  Zoom on Mae Sexton  Sexton, Mae.
Information on Brendan Smith  Zoom on Brendan Smith  Smith, Brendan. Information on Michael Smith  Zoom on Michael Smith  Smith, Michael.
Information on Noel Treacy  Zoom on Noel Treacy  Treacy, Noel. Information on Mary Wallace  Zoom on Mary Wallace  Wallace, Mary.
Information on Ollie Wilkinson  Zoom on Ollie Wilkinson  Wilkinson, Ollie. Information on G. V. Wright  Zoom on G. V. Wright  Wright, G.V.



[1105]Níl
Information on Dan Boyle  Zoom on Dan Boyle  Boyle, Dan. Information on James Breen  Zoom on James Breen  Breen, James.
Information on Thomas P. Broughan  Zoom on Thomas P. Broughan  Broughan, Thomas P. Information on Richard Bruton  Zoom on Richard Bruton  Bruton, Richard.
Information on Joan Burton  Zoom on Joan Burton  Burton, Joan. Information on Paul Connaughton  Zoom on Paul Connaughton  Connaughton, Paul.
Information on Paudge Connolly  Zoom on Paudge Connolly  Connolly, Paudge. Information on Joe Costello  Zoom on Joe Costello  Costello, Joe.
Information on Jerry Cowley  Zoom on Jerry Cowley  Cowley, Jerry. Information on Seymour Crawford  Zoom on Seymour Crawford  Crawford, Seymour.
Information on Sean Crowe  Zoom on Sean Crowe  Crowe, Seán. Information on Ciaran Cuffe  Zoom on Ciaran Cuffe  Cuffe, Ciarán.
Information on John Deasy  Zoom on John Deasy  Deasy, John. Information on Jimmy Deenihan  Zoom on Jimmy Deenihan  Deenihan, Jimmy.
Information on Bernard Durkan  Zoom on Bernard Durkan  Durkan, Bernard J. Information on Damien English  Zoom on Damien English  English, Damien.
Information on Olwyn Enright  Zoom on Olwyn Enright  Enright, Olwyn. Information on Martin Ferris  Zoom on Martin Ferris  Ferris, Martin.
Information on Eamon Gilmore  Zoom on Eamon Gilmore  Gilmore, Eamon. Information on John Gormley  Zoom on John Gormley  Gormley, John.
Information on Marian Harkin  Zoom on Marian Harkin  Harkin, Marian. Information on Tom Hayes  Zoom on Tom Hayes  Hayes, Tom.
Information on Seamus Healy  Zoom on Seamus Healy  Healy, Seamus. Information on Joe Higgins  Zoom on Joe Higgins  Higgins, Joe.
Information on Michael D. Higgins  Zoom on Michael D. Higgins  Higgins, Michael D. Information on Philip Hogan  Zoom on Philip Hogan  Hogan, Phil.
Information on Paul Kehoe  Zoom on Paul Kehoe  Kehoe, Paul. Information on Kathleen Lynch  Zoom on Kathleen Lynch  Lynch, Kathleen.
Information on Pádraic McCormack  Zoom on Pádraic McCormack  McCormack, Padraic. Information on Shane McEntee  Zoom on Shane McEntee  McEntee, Shane.
Information on Finian McGrath  Zoom on Finian McGrath  McGrath, Finian. Information on Paul McGrath  Zoom on Paul McGrath  McGrath, Paul.
Information on Paddy McHugh  Zoom on Paddy McHugh  McHugh, Paddy. Information on Arthur Morgan  Zoom on Arthur Morgan  Morgan, Arthur.
Information on Breeda Moynihan-Cronin  Zoom on Breeda Moynihan-Cronin  Moynihan-Cronin, Breeda. Information on Catherine Murphy  Zoom on Catherine Murphy  Murphy, Catherine.
Information on Gerard Murphy  Zoom on Gerard Murphy  Murphy, Gerard. Information on Denis Naughten  Zoom on Denis Naughten  Naughten, Denis.
Information on Dan Neville  Zoom on Dan Neville  Neville, Dan. Information on Caoimhghín Ó Caoláin  Zoom on Caoimhghín Ó Caoláin  Ó Caoláin, Caoimhghín.
Information on Fergus O'Dowd  Zoom on Fergus O'Dowd  O’Dowd, Fergus. Information on Brian O'Shea  Zoom on Brian O'Shea  O’Shea, Brian.
Information on Jan O'Sullivan  Zoom on Jan O'Sullivan  O’Sullivan, Jan. Information on Séamus Pattison  Zoom on Séamus Pattison  Pattison, Seamus.
Information on Willie Penrose  Zoom on Willie Penrose  Penrose, Willie. Information on Ruairí Quinn  Zoom on Ruairí Quinn  Quinn, Ruairi.
Information on Pat Rabbitte  Zoom on Pat Rabbitte  Rabbitte, Pat. Information on Seán Ryan  Zoom on Seán Ryan  Ryan, Seán.
Information on Trevor Sargent  Zoom on Trevor Sargent  Sargent, Trevor. Information on Joe Sherlock  Zoom on Joe Sherlock  Sherlock, Joe.
Information on Róisín Shortall  Zoom on Róisín Shortall  Shortall, Róisín. Information on Billy Timmins  Zoom on Billy Timmins  Timmins, Billy.
Information on Liam Twomey  Zoom on Liam Twomey  Twomey, Liam. Information on Mary Upton  Zoom on Mary Upton  Upton, Mary.
Information on Jack Wall  Zoom on Jack Wall  Wall, Jack.  

[1105]Tellers: Tá, Deputies Kitt and Kelleher; Níl, Deputies Costello and Kehoe.

[1105]Question declared carried.

Amendment declared lost.

Amendments Nos. 11 to 14, inclusive, not moved.

Dr. Twomey: Information on Liam Twomey  Zoom on Liam Twomey  I move amendment No. 15:

Every opportunity should be taken to discuss the Bill in as much detail as possible. The aim of the amendment is to enable the HSE to allow patients to receive a subvention for a specific period. The difficulty is that the payment of a subvention can be queried almost within months of a patient receiving it. Subventions should not be reviewed for a certain period of time. They should be treated like medical cards which can be issued for three to six months. If a subvention is reviewed soon after it is given because information has been provided for the HSE which [1107]might not be true, it makes matters difficult for the patient involved.

Many of the amendments are based on the one issue. I am disappointed the Minister of State is not reciprocating in any way with this side of the House. The Minister, Deputy Harney, stated that under the new policy no one would be forced to sell his or her house and that the HSE would not implement existing rules in such a way that people would lose their homes. This appeared on the website of Age Action Ireland.

The Taoiseach implied that funding for the care of the elderly in the future had already been decided and that discussions had taken place with mythical stakeholders. I previously asked the Minister of State to identify these mythical stakeholders who had already decided it was perfectly valid to take the homes of elderly people in order to pay for their private nursing home care. He did not answer the question. It is clear that the words of the Minister to the effect that houses will not be taken from elderly people will have no value in years to come because they do not have any value today. We have already pointed out that patients are being forced to sell their homes to pay for their nursing home care. Therefore, her words have zero value.

What will matter is legislation; that is what we are discussing. The measly words of the Minister, the Minister of State and the Taoiseach will mean nothing when it is passed. Will the Minister of State indicate who are the stakeholders with whom he had discussions and who agreed that homes should be taken from elderly people? As he did not discuss the issue with anybody on this side of the House, it is clear that the stakeholders are not on this side. Who are they? Age Action Ireland stated its group was not involved and that it was against the legislation. With whom has the Minister of State had discussions? Who decided that homes would be taken from elderly people to fund their care? We now know this is Fianna Fáil and Progressive Democrats policy but we do not know with whom it was agreed. Fianna Fáil brings in everybody to discuss matters. It brings in IBEC and the trade unions. The elderly people who are engaged in this discussion would like to know who is representing them who allowed this proposal to go forward. It is most important that the Minister of State answers this question.

We are aware the Government parties have no respect for the Dáil. They will be backtracking when this measure is reflected in the opinion polls. It will be suggested not much will be taken from elderly people but there will be a difference between what the parties will state in their general election manifestoes and what is contained in the legislation. The Minister can write on any website she wishes, including that of Fianna Fáil, that she will not take anybody’s home, but it is already happening. Her words and those of the Minister of State have no value. What matters is the legislation. This is different [1108]from regulations which can be and were interpreted differently by the CEO. Believe it or not, in the past ten months, when we knew the legislation would be brought forward, the HSE has been more inclined to stop elderly patients receiving subventions.

The subvention rates have been the same since 2001 and there have been no discussions to increase them. An attempt to increase them might be made once the Government copperfastens the arrangements to deprive a large percentage of elderly people of the right to receive a subvention.

The Minister of State must answer the questions asked. I asked about the figure of 5% as far back as 11 May in my Second Stage speech. The Minister of State avoided that question completely until he attempted to explain the situation in a press release issued before he was due to speak on “The Last Word” with Matt Cooper on 12 October. No attempt was made to explain it clearly in the House. While he is here, will he indicate who are the stakeholders with whom he discussed the issue and who agreed to allow legislation under which the homes of elderly people would be taken from them to pass through the House? He should do so without further prevarication.

Families will have some job in obtaining a subvention under this legislation as the Government will take everything into account and ensure families will have to go to a solicitor to sign off or risk being locked up in jail for a couple of months. If a family does succeed in obtaining a subvention, the elderly person concerned will deserve to receive it and hold on to it for a few months.

Mr. S. Power: Information on Seán Power  Zoom on Seán Power  More constructive debate.

Dr. Twomey: Information on Liam Twomey  Zoom on Liam Twomey  That is the purpose of the amendment which I will press because the Minister of State must explain himself to the House.

Mr. M. Higgins: Information on Michael D. Higgins  Zoom on Michael D. Higgins  I certainly support the amendment. One must ask whether there is a balance of fairness between the executive and the citizen in a nursing home. On the one hand, an elaborate set of procedures is laid down in the Bill for a person who wants to appeal against a refusal. The grounds must be within a framework acceptable to the executive and a particular set of requirements must be followed. On the other hand, section 7D states that at any time the executive may arrange for a review to be carried out.

The formulation regarding the executive is loose. Almost immediately after granting a subvention, should it wish to do so, it may change either the degree of dependency or the level of means. However, the procedures laid down in the section governing a dependant or a person acting on his or her behalf are more cumbersome. This raises a further question about the human being involved in the assessment.

[1109]The reason I support the amendment is the decision should apply for at least 12 months. Otherwise, there could be an absurd situation whereby a person will be subject to this strange method of decision making on degree of dependency and then be vulnerable in having it redefined almost arbitrarily within an extremely short period of time. As I understand it, all the amendment seeks to ensure is that a decision arrived at would apply for 12 months.

I am regularly invited to be practical. I would like to be practical about this issue also. Let us suppose a hypothetical case concludes with a person being moved from one category of dependency to another. Can I assume the contribution of the HSE will automatically change? I cannot find any such guarantee in the legislation. While one could find one’s category has changed, one’s liability has remained stable. That is not in the interests of anybody. The case can be made that it could work the other way but that is a separate issue. This involves a person being assessed using multiple criteria. In many cases there is considerable merit in leaving a decision stand for a period of time. The rights of the person concerned included in a later section can be invoked better in such circumstances.

Mr. Naughten: Information on Denis Naughten  Zoom on Denis Naughten  I support the amendment. It is critically important that when a decision is made it should apply for 12 months. In many cases the battle in going back and forth to appeals officers to get the right decision for an elderly person can take almost 12 months. The Bill gives the executive the right to automatically review a decision.

The topical issue is taking 5% of the value of a property or house. In reality, this will force many elderly people to sell their homes. That is morally wrong and the Minister of State should review the matter. The average price of a house price is approximately €300,000. The Minister of State has stated, as the Taoiseach did earlier today, that if a house outside Dublin is worth €300,000, the owner will not be entitled to receive a nursing home subvention.

Let me give as an example a semi-detached house valued by an auctioneer at €200,000, 5% of which is used, even though the elderly person concerned cannot liquidate or sell that asset. If the house next door is sold at auction for €300,000 the week after a subvention is granted, under the legislation the HSE will be able to review its decision it made, even though the valuation will have been made by a certified valuer. All of a sudden, the elderly person concerned will have his or/her nursing home subvention withdrawn.

The rates of subvention mentioned by Deputy Twomey are appalling. The maximum rate in County Roscommon is €308. Last month the HSE decided it would not provide an enhanced subvention for anyone. This will result in people living in poverty. I know of one instance where a man lived in his home with his elderly mother [1110]who had to go into a nursing home. The 5% valuation came into play. He did not have any assets, other than the roof over his head. Because he did not meet any of the criteria laid down, he had to try to find the money somewhere. He committed suicide.

The executive should not have such flexibility. I came across a policy within the HSE on medical cards under which people were not told that they had the right of appeal. A person may be granted a subvention and believe it will be be payable for at least 12 months. However, the HSE will be able to review it immediately. In many cases, people are not informed that they have the right of appeal under certain schemes. It is important to have such a right.

Debate adjourned.


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