Dáil Éireann debate -
Wednesday, 28 Feb 2001

Vol. 531 No. 4

Written Answers. - Care of the Elderly.

Rory O'Hanlon

Question:

177 Dr. O'Hanlon asked the Minister for Health and Children the plans there are to ensure elderly people who so wish can gain access to the health boards residential units on the same terms as would apply to them entering private nursing homes; if he intends to introduce legislation in this regard; and if he will make a statement on the matter. [6259/01]

Minister for Health and Children (Mr. Martin)

Under the Health Act 1970, entitlement to health services is primarily based on residence and means. Any person, regardless of nationality, who is accepted by the health boards as being ordinarily resident in Ireland is entitled to either full eligibility, category 1, i.e. medical card holders, or limited eligibility, category 2, for health services. Health boards normally regard a person as "ordinarily resident" in Ireland if he or she satisfies the health board that it is his or her intention to remain in Ireland for a minimum period of one year.

Persons in category 1 are medical card holders and they are entitled to a full range of services including general practitioner services, prescribed drugs and medicines, all in-patient public hospital services in public wards including consultants services, all out-patient public hospital services including consultants services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.

Persons in category 2, non-medical card holders, are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultants services and out-patient public hospital services including consultants services. The current public hospital statutory in-patient charge is £26 in respect of each day a person is maintained, subject to a maximum payment in any twelve consecutive months of £260. Dental and routine ophthalmic and aural services are excluded from out-patient services available. However, such treatment is provided to children who have been referred from a child health clinic or a school health examination. Attendance at accident and emergency departments is subject to a charge of £25 where the patient does not have a referral note from his or her doctor. This charge applies only to the first visit in any episode of care.

The role of the health boards in relation to private nursing homes as provided for in the Health (Nursing Homes) Act, 1990, is twofold – firstly, to ensure high standards of accommodation in the homes, and secondly, to operate a subvention scheme towards the cost of nursing home care. Under the Nursing Homes Act, health boards are empowered to pay a subvention where a person has been assessed on the grounds of means and dependency, as provided for in the Nursing Homes (Subvention) Regulations 1993 to 1998, which set down the requirements for this assessment. It is important to point out that, subject to a means test, a person will only be entitled to a subvention if they fulfil the dependency criteria laid down in the Subvention Regulations, 1993.

An expenditure review of the nursing home scheme is currently being undertaken by my Department in association with the Department of Finance and is expected to be completed shortly. It is my intention to bring proposals to Government in relation to whatever further measures may be necessary arising from the findings of this review and the Report of the Ombudsman and experience gained from the operation of the scheme since its inception in 1993.