Thank you for allowing me to raise this very important issue this evening. However, I regret that the Minister for Health or his Minister of State is not here to respond.
Adjournment Debate. - Private Nursing Home Care.
I am the Minister of State at the Department of Health.
I would prefer to see the Minister here as this matter is appropriate to him.
He cannot be here as he is in the Seanad.
The Minister ought to be here as this is a very serious problem relating to the impending collapse of the operations of the Health (Nursing Homes) Act, 1990, which was brought into effect by order of the Minister less than ten months ago. The Act was a response to the growing problem of looking after our elderly population by easing the burden on relatives, hospitals for the aged and other institutions. Raising standards made the stay of elderly people cared for in private nursing homes more acceptable.
The Minister and his formidable battery of spin doctors milked the introduction of the Act last September for all it was worth. It was another episode in the image building of that Minister as the world's greatest carer and healer. Behind the hype characterised by the Minister, kissing old ladies on one occasion in a nursing home, serving or sipping tea with a couple in another establishment which apparently was brought about by his caring, there was a different reality.
Funding for the Health (Nursing Homes) Act was never realistic and the approach to funding was downright dishonest. For the four months of its operation in 1993 the Minister provided only £4 million, £500,000 of which was used to relieve acute bed pressure in Dublin and £600,000 spent on administration. The remaining £2.9 million was disbursed among the eight health boards. The Western Health Board, to which I shall confine the rest of my remarks, received a contribution of 5 per cent of that allocation although it has 12.5 per cent of the total elderly population in the State.
Taking account of the four months in 1993 and the 12 months of 1994 up to 31 December, the total allocation from the Department of Health to the Western Health Board was £550,000. This figure is ridiculously short of what is needed to fund the scheme in counties Galway, Mayo and Roscommon. To illustrate how wrong the Minister and the Department were in estimating the take-up of the scheme, they announced in May 1993 that there would be 1,200 new subventions, in addition to section 51 subventions, over a four year period from 1993 to 1997. By the end of April 1994, eight months after the legislation was implemented, 2,132 subventions had been approved in all the health boards. In this period the Western Health Board approved 302 new subventions costing £1,526,604 but the Minister allocated just one-third of that amount. Up to this week the Western Health Board has approved 400 new subventions. At the rate in which applications are coming in it is realistic to assume that the number of applicants sanctioned for subvention by the end of this year will be in excess of 500. There is a statutory obligation on each health board, under the Act, to deal with each application and inform the applicant, as speedily as possible, of the outcome. There is also a statutory obligation on the Minister to ensure the subvention is paid to each person who has undergone a humiliating means test.
The Minister cannot play a waiting game with this problem as it needs immediate attention. Asking health boards for reports on various silly details to try to bide time is not acceptable. In the Western Health Board no subvention has been paid to any patient or private nursing home in County Roscommon since last March and a subvention has not been paid to any patient or private nursing home in counties Galway or Mayo since last April. In other words, there is no more money in the Western Health Board to continue this scheme and the patients in private nursing homes are being told to pay their full maintenance or go home.
The time has come to call the Minister of State.
No other spin can be put on this story. The money must be provided.
I have given the Deputy some latitude.
The Minister for Health is conducting business on the floor of the Seanad. While he has many talents, bilocation is not one of them. The Deputy made a personal attack on the Minister but he is around long enough to know that jealousy will get him nowhere.
The legislation to which he referred, the Health (Nursing Homes) Act, 1990 which was brought into effect on 1 September 1993, has two principal objectives. The first is to ensure high standards of accommodation and care in all nursing homes registered by health boards under the Act and the second is to provide a new system of nursing home subvention so that dependent persons most in need of nursing home care would have access to such care. The new Act is a major step forward in ensuring that dependent elderly persons will be well cared for.
A total of £9 million has so far been made available for the implementation of the Health (Nursing Homes) Act. Of funding distributed to date to the health boards, the Western Health Board received £390,900. Funding was allocated to health boards on the basis of the size of the nursing home sector and expected demand under the new subvention scheme. It would appear that demand in the Western Health Board for nursing home subventions has been higher than expected. Discussions are taking place between officials of my Department and the Western Health Board to establish the extent of the problems facing the board. My Department is monitoring the situation closely and will work with the board to resolve difficulties which have arisen.
I realise that the implementation of the new legislation has not been plain sailing for either the health boards or the nursing home sector. To deal with issues arising from commencement of the Act, my Department set up an implementation group which includes representatives of the Irish Private Nursing Homes Association, as well as members of the Federation of Catholic Voluntary Nursing Homes, the National Council for the Elderly, the health boards and officials of my Department. The purpose of the group is to highlight problems at an early stage and to resolve them in a way which meets the concerns of all parties. The group has met on over eight occasions and has reported good progress in all areas of the implementation.
Private and voluntary nursing homes fulfil an important role in providing high quality care for our dependent elderly population. The nursing homes Act is strengthening the bonds of partnership between public health services and private nursing homes so that they can provide the best care and facilities for the elderly who need residential care.