I move amendment No. 2:
In page 2, subsection (1), lines 22 to 24, to delete the definition of "licence".
This group of amendments is a response to the wishes of Members as expressed during Second Stage. I wish to set out the composite proposal on the main amendment I am proposing to the Bill which is the registration rather than the licensing of nursing homes. The main changes are to section 4 of the Bill, amendment 26, and there are several consequential changes as a result. In all I will be dealing with 12 amendments together.
The amendment to section 4 replaces the system of licensing nursing homes with a system of registration. Several Deputies indicated during Second Stage that registration would be more appropriate for nursing homes than licensing. This point was also made by the Irish Private Nursing Homes Association.
The procedure for registration will be similar to that for licensing. Each health board will maintain a register of nursing homes. Subsection (1) replaces section 8 in the original Bill which provided for the keeping of a register. A person proposing to carry on a nursing home must apply to the health board to be registered. Registration will be valid for two years. Before granting registration, the health board must satisfy themselves that the registered proprietor and person in charge are fit persons to carry on a nursing home and that the home meets the standards laid down in regulations under this Bill. A health board will be able to revoke the registration or to attach conditions, subsection 8. The board will issue a certificate of registration and any conditions must be stated on the certificate. One addition is subsection (6) (b) (iv) which provides that where a condition of the registration has been contravened in the previous year a health board could cite this as a reason for refusing registration. The purpose of this new subsection is to provide an incentive for nursing home owners to comply with and fulfil conditions of a registration within a reasonable period. Applications for the renewal of registration must be made two months before its expiry and if at the end of that time a board have not notified the person of their refusal to register the home, registration will be granted automatically for a further two years.
An issue raised by a number of Deputies, and a matter which greatly concerned the Irish Private Nursing Homes Association, was the transfer of homes and the problems which could be caused if prospective owners could not be sure before purchase that health boards would accept them as registered proprietors. Section 4 (4) specifically deals with these concerns. This subsection provides for a person who proposes to take over as the registered proprietor of a nursing home which is already registered to apply in advance for a declaration from the health board. The declaration will state that the health board consider that the person is a suitable person to carry on a nursing home.
On the actual transfer the registration will lapse and the new registered proprietor will have to apply for registration but there should be no difficulty with this application as the board will have agreed in advance that they have no objection to that person becoming a registered proprietor. A declaration may only be refused if a person has been convicted of an offence under the Bill, the 1964 Act or any other offence so as to render the person unfit to carry on a nursing home or if the applicant has refused to supply information or supplied misleading information. The grounds for refusal are restrictive. The new person cannot be registered in advance as there can only be one registered proprietor of a nursing home at a time.
A fee will be payable in respect of the declaration. The purpose of the fee is to discourage anyone who is not really intending to become the registered proprietor from applying for advance clearance. The amount of the declaration fee will be prescribed under section 9 and I intend that any subsequent registration fee be reduced by the amount of the declaration fee.
Subsection 14 obliges a health board in notifying a person of a decision not to grant a declaration to inform him or her of the right to make representations to the board within 21 days or to appeal to the District Court within the same period. The same applies to decisions concerning registration.
The Bill also provides that on transfer the registration lapses and the person who proposes to become the registered proprietor must apply for registration within two weeks. These provisions are intended to cover the situation where a registered proprietor dies and someone else assumes responsibility for the home.
An issue which concerned Deputies, and the Irish Private Nursing Homes Association, was the health boards' power to refuse registration on the basis of previous offences committed by the person applying to be the registered proprietor.
In the original Bill, section 4 (3) (a) (ii), allowed a health board to refuse or revoke a licence if the person had committed an offence "under this Act, the 1964 Act or an offence that, in the opinion of the board, would render a person unfit or unsuitable to carry on a nursing home". The section gave a health board a wide discretion in relation to offences. Taking on board the concerns expressed, the section, now subsection 6 (b) (ii), has been redrafted and the words, "in the opinion of the board", and, "unsuitable", deleted to clarify the need for a health board to act on an objective basis in determining whether a person is or is not unfit to run a nursing home.
The consequential changes arising from the system of registration are amendment 2, deleting the definition of a licence and amendment 5, defining what is meant by the register and the registered proprietor. The definition of register states the meaning of this word throughout the Bill and likewise in respect of registered proprietor. A register of all registered nursing homes will be established in each health board area. The name of the registered proprietor will be entered on the register. The registered proprietor would normally be the owner of the nursing home.
Amendment No. 20 revises section 3 of the Bill in line with the proposed system of registration under section 4. The section is not changed materially except to refer to the registered proprietor instead of the licence holder and subsection (3) has been altered. This subsection which prohibits the advertisement of unregistered nursing homes has been simplified to make its meaning and intention clear. This subsection prevents the owner of an unregistered home from trying to advertise it as a "nursing home". The title "nursing home" is reserved for homes registered under the legislation.
Amendment No. 28 to section 5 appeals which replaces the existing subsection (1) provides for appeal to the District Court under the system of registration in the same manner as was provided for with licences. The amendment also provides for appeals in respect of declarations. There is no material change to the purpose of the subsection. The registered proprietor may take an appeal against a decision of the health board to refuse a declaration, to revoke a declaration, to refuse to register the home, to remove the home from the register, to attach a condition to registration, to amend a condition of registration, or to revoke a condition of registration.
Amendment No. 30 is necessary as a consequence of the registration rather than the licensing of nursing homes. It is not materially different from the original draft of the Bill.
Amendment No. 55 provides for the payment of a fee to a health board for registration and for a declaration. Where a declaration fee is paid I intend that this fee will be taken into account in relation to the subsequent registration fee.
Amendments Nos. 59, 60, 61 and 63 provide for a registered proprietor in place of a licence holder.
Amendment 83 amends the Long Title of the Bill to take account of registration.