Vol. 455 No. 3
9 Mr. Deasy asked the Minister for Health if his attention has been drawn to the fact that the means test for subventions for patients in nursing homes does not allow for mortgage interest relief and medical insurance relief, as is the case of grants in general; and if he will make a statement on the matter. [12054/95]
(Limerick East): The Nursing Homes (Subvention) Regulations, 1993, which accompany the Health (Nursing Homes) Act, 1990, came into effect on 1 September 1993 and ensure that those most in need of nursing home care and without the means to pay for it receive assistance towards the cost.
I wish to draw the Deputy's attention to the Third Schedule of the subvention regulations. The Third Schedule directs the health board to take into account mortgage repayments on a principal residence, payments towards life assurance and payments towards membership of the Voluntary Health Insurance scheme, not already taken into account in income tax exemptions of an applicant's son or daughter, when calculating the assessment of circumstances of a person who has qualified for a nursing home subvention.
Is the Minister saying that these matters are being taken into account?
(Limerick East): They should be.
I have another case with the South Eastern Health Board where these matters are not being taken into account with regard to a nursing home in my constituency. There seems to be a lack of communication or maladministration, I am not sure which. I would appreciate if the Minister advised the health boards of the changes which he has outlined. I have no doubt that he is correct, which means that an injustice is being done in this case.
(Limerick East): There are no changes. The original subvention regulations have a third schedule which states that mortgage interest and life insurance can be taken into account when assessing the means of a son or daughter in respect of a parent applying for this subvention. If the Deputy gives me the details of the case, I will take it up with the South Eastern Health Board. However, if that is the only outstanding issue preventing a person from being awarded a subvention, then the regulations say that can be taken into account.
I will provide the Minister with details of the case because it has been ongoing for some months. Those items have not been taken into account by the health board in assessing the eligibility of the patient for a subvention. There is such a yawning gap between those who are allowed care in the health board's own institutions and those who are allowed a subvention in private nursing homes, that the whole area needs to be re-examined. Some families have to pay enormous sums of money and if their income was a little less they would not have to pay anything. There is a need for a graduated scale rather than a definite cut-off point, besides the issues which I have already raised.
(Limerick East): There is a scale which is graduated in terms of the health needs of the patient with a maximum, medium and minimum level of subvention.
But not the incomes.
(Limerick East): There is very wide discretion in the application of the scheme. I have seen health boards allocating all levels of subvention, from £20 to £120, depending on their own assessment of need. It is graduated.
Will the Minister look at particular cases and health boards because in my area there seems to be quite a different interpretation from what he has outlined?
(Limerick East): The scheme has not been in place for very long and there are regional disparities, both in how the regulations are being applied and the level of subvention being awarded. We will have a look at the situation. It is also true that the scheme is well beyond budget, so whatever restrictions are there, it is still well ahead of what was estimated when it was introduced.
Will the Minister appoint a senior official in his Department to adjudicate in an official capacity as ombudsman on cases where there is a problem?
(Limerick East): I would not give a commitment on that because as soon as there is a right of appeal to the Department of Health, everything will end up there. The health services will have to be delivered by the health boards. They have very large staffs and are well funded. It is up to them to make the decisions on these matters.
Will the Minister look at the specific case?
(Limerick East): I will; the Secretary of the Department of Health has regular meetings, at least on a monthly basis, with the chief executive officers of the health boards and I will ask him to bring it up in that context.
