Dáil Éireann debate -
Tuesday, 4 Mar 2003

Vol. 562 No. 4

Written Answers - Long Stay Accommodation Charges.

Richard Bruton

Question:

319 Mr. R. Bruton asked the Minister for Health and Children the legal basis on which medical card holders are charged for long stay accommodation in health board long stay homes; his views on the opinion expressed by the Ombudsman in relation to this practice; and the charges which he proposes to apply in 2003 in this regard. [6174/03]

Minister for Health and Children (Mr. Martin)

Charges can be made under two sets of regulations in respect of long-stay care. They can be made under the Health (Charges for In-Patient Services) Regulations 1976 as amended by the Health (Charges for In-Patient Services) (Amendment) Regulations 1987. These regulations enable charges to be made towards the cost of providing hospital in-patient services for persons with income who have been in receipt of such services for more than 30 days or for periods totalling more than 30 days within the previous 12 months. The regulations provide that a charge is made at a rate not exceeding the person's income. Medical card holders and persons with dependants are exempt from these charges. Charges may also be made under the Institutional Assistance Regulations 1965 where the patient receives "shelter and maintenance" rather than treatment. These charges apply from the date of admission and are payable by all patients who are in receipt of incomes, including medical card holders and persons with dependants.

In deciding the amount to be contributed, health boards have regard to the person's individual circumstances. Allowance is made for any financial commitments the person may have and a reasonable amount is left to meet the person's personal needs. Charges may be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship.

As the Deputy is aware, the Ombudsman, in his report on the nursing home subvention scheme, asserted that, under the Health Act 1970 any person in need of nursing home care has a statutory entitlement to the provision of this service by a health board. As my Department advised the Ombudsman in its response to the draft report of the Ombudsman, its view is that the Health Act 1970, as amended, distinguishes between eligibility for a service and entitlement to a service, although the two terms are often used interchangeably. This view is supported by legal advice available to my Department.

The health strategy acknowledges the need to clarify and simplify eligibility arrangements and sets down a commitment to introduce new legislation to provide for clear statutory provisions on entitlement for health and personal social services. As part of the implementation process, a review of all existing legislation is ongoing in my Department. The outcome will inform the approach to the drafting of a new legislative framework on entitlements. I expect that this review will be completed in the current year and that proposals for reform will be submitted to Government.