Dáil Éireann debate -
Thursday, 18 May 2006

Vol. 619 No. 6

Adjournment Debate.

Nursing Home Subventions.

Mr. P. Breen

Nursing home subvention levels are payable by the HSE. The subvention is means-tested and there are considerable problems associated with the means by which applicants are measured. The most substantive issue, however, is the subvention amount. Prevailing market conditions among private nursing homes makes the means-testing and the subvention amounts meaningless.

I have received many complaints about this. In Ennis, I have one instance where an individual is paying €1,500 a month to a nursing home. Despite the resident being on the top level of subvention — €400 of this is for a special bed — he must pay an enormous sum to make up the deficit. For a person on a modest salary, paying €1,100 a month for a relative in a nursing home is the equivalent to paying a sizeable mortgage.

I have examined nursing home charges in County Clare. With the exception of public nursing homes, the amounts charged bear no relation to the subvention amounts paid. Six private nursing homes in County Clare charge between €560 and €657 a week for a private room. The cheapest rate I could find in the private sector was €540 a week for a twin room. In contrast the amounts payable by the HSE for subvention are €114, €152.40 and €190.50 a week, according to the level of dependency of the patient. Nursing home charges, therefore, amount to between three and four and a half times the subvention rate, without the luxury of a private room. If the modest old age pension of less than €200 a week is applied, there is still a considerable shortfall which very often has to be met by hard-pressed relatives struggling with their own financial problems. If one is paying the more expensive nursing home charges being levied in the cities, such as in the Minister of State's area of Dublin, the gap widens even more.

The Government's continuing failure to tackle the accident and emergency crisis has led to some people opting to stay at home to die rather than face the drudgery of the health service, as highlighted in last week's "Prime Time Investigates" programme. Furthermore, due to the costs of private nursing home care and the State's failure to provide more realistic subvention levels, people are being forced to stay at home in more problematic conditions. Hardship cases cannot be taken on directly by the State because of the lack of sufficient numbers of public nursing home beds. Only applicants with nursing home needs can make it through the assessment criteria even though they must often wait a year or more before a place comes up. Those who are particularly vulnerable are bachelors and spinsters with no near relatives. Even if they have assets such as land or a home, for one reason or another they often cannot realise them. These people end their days in poverty. They may not be in ill health but cannot cook for themselves or carry out some basic tasks and they fall through the State safety net. This year is the 90th anniversary of the 1916 Rising and it is astonishing that elderly people are still treated in such a shabby manner. It is appalling that those who built the State should have to end their days in such conditions.

I was amazed to learn that despite the huge rises in nursing home care costs, the Minister has not deemed it necessary to increase the subvention levels or to relax the means testing criteria in recent years. The Minister should also look at the discretionary hardship payments from the HSE. In County Clare, it is €65 per week. This is not just discretionary it is subject to budgetary constraint and varies from region to region. Why is it not standardised and separate from budgetary conditions?

I implore the Minister to look at this area, which is of great concern to the people of County Clare and other areas, and to increase subvention levels or authorise the HSE to provide finance to allow for the relaxation of the means test and standardisation of the discretionary hardship payment. The money should be spent where it is needed, not on wasteful projects such as electronic voting.

Minister of State at the Department of Health and Children (Mr. B. Lenihan)

I will take the Adjournment on behalf of my colleague, the Tánaiste and Minister for Health and Children. I thank the Deputy for raising the question as it provides me with an opportunity to outline to this House the current situation with regard to the nursing home subvention scheme.

A nursing home subvention may be paid towards the cost of private nursing home care where a person is unable to meet the cost and where he or she has been assessed as needing nursing home care by the Health Service Executive and where the person has satisfied a means test. The amount of subvention granted will depend on the degree of nursing home care required, medium, high or maximum, and the amount of the person's assets, including property, stocks and shares, savings, etc. The rates of subvention payable are: medium dependency €114.30 per week, high dependency €152.40 per week and maximum dependency €190.50 per week. The nursing home subvention scheme was introduced to assist with the cost of private nursing home charges and was not intended to cover the entire cost of nursing home care.

Under Article 22.3 of the Nursing Homes (Subvention) Regulations 1993, the HSE may enter into an arrangement with a registered private nursing home to provide inpatient services under section 52 of the Health Act 1970. In making an arrangement with a private nursing home under Article 22.3, the HSE may pay more than the maximum rate of subvention, as mentioned already, relative to an individual's level of dependency, for example in cases where personal funds are exhausted, in accordance with Article 22.4 of the Nursing Home (Subvention) (Amendment) Regulations 1996. The application of these provisions, however is a matter for the HSE in the context of meeting increasing demands for subventions. The average rate of subvention paid by the HSE generally exceeds the current approved basic rates.

Spending on the nursing home subvention scheme has increased from €5 million in 1993, when it was introduced, to €140 million in 2005. Additional funding for services for older people and palliative care amounting to €150 million was allocated in the 2006 budget. This is the largest ever increase in funding for services for older people and palliative care services and demonstrates the Government's continued commitment to older people and putting them at the centre of health policy now and in the future.

The investment package is primarily focused on caring for people at home, in accordance with their expressed wishes. This is in line with international trends and reflects the growing independence of older people who want to stay living in their communities. However, for those requiring residential care, the Government has allocated an additional €20 million towards the nursing home subvention scheme for 2006 to provide for extra subvention payments. The Department of Health and Children is also currently working on primary legislation to expand the policies and principles of the subvention scheme to facilitate implementation of the scheme by the HSE throughout the country and this legislation is currently proceeding through the Oireachtas.

The thresholds contained in the Nursing Homes (Subvention) Regulations 1993 for an applicant's assets and the value of an applicant's primary residence, were increased by regulation on 14 December 2005 to bring them into line with today's values.

A working group chaired by the Department of the Taoiseach and comprising senior officials from the Departments of Finance, Health and Children and Social and Family Affairs was established following on from the publication of the Mercer report entitled, Study to Examine the Future Financing of Long-Term Care in Ireland. The objective of this group was to identify the policy options for a financially sustainable system of long-term care, taking account of the Mercer report, the views of the consultation that was undertaken on that report and the review of the nursing home subvention scheme by Professor Eamon O'Shea. The report of the group has been submitted to Government, where it is being considered.

Social Welfare Code.

Mr. Gilmore

This issue concerns a couple who do not wish to be publicly identified so I will refer to them as Mary and Tom. Mary was a lone parent with three children, who are now aged seven, two and nine months. She had been renting a home privately in my constituency for €1,200, for which she was in receipt of a rent allowance of €999 per month. On 7 April, she married Tom. Because Tom is in full-time employment, the couple immediately lost their rent allowance. Tom's income, however, is quite low, €505 per week, which is clearly not sufficient to pay €300 rent a week while maintaining a family of five on the balance.

The couple notified the community welfare officer of their new circumstances after their wedding and were informed that they no longer qualify for rent allowance because one of them was in full-time employment. They subsequently notified their landlord that the rent allowance would be discontinued and the landlord has issued them with notice to quit, effective from next Thursday.

They are on the local authority housing list and inquired as to their prospects of a local authority house. They are placed 199 on a list which has some 4,000 applicants on it. The council stated that it could not offer them housing at this stage and that they would be waiting for some time. It advised them to make contact with the homeless persons unit. The homeless persons unit informed them that it could possibly provide them with emergency accommodation from Thursday but the family would have to be separated as it could not access accommodation to house them as a family.

Recently, on behalf of the Labour Party, I proposed a motion calling for the replacement of the rent allowance system with a new form of housing support which would be related to income and would not discriminate between those in work and those in receipt of social welfare. I pointed out during the debate that the existing rent allowance system creates a massive poverty trap, acts as a disincentive to work and discriminates against working families. The Government voted down that motion. Now I have this case in my constituency and I would like the Minister to address a number of questions.

How is this family to be housed from next Thursday? They will lose their private rented accommodation, will not have housing from the local authority, will not have rent allowance to pay rent and the best the homeless persons unit can do is to send the husband and son in one direction and the wife and daughters in the another direction — back to the workhouse. Will the family get some form of assistance towards paying their rent to resolve this problem? The community welfare officer cannot do anything about it. I have spoken to the superintendent community welfare officer and his hands are tied. The regulations explicitly state that if someone is in full-time employment, he cannot get the rent allowance.

There is a question mark over the constitutionality of the situation. The Constitution protects marriage but here a person marries and loses an entitlement she previously had and will now lose her home. This case highlights the need to reform the rent allowance scheme and provide for the housing needs of low-income working families. This case requires urgent action to deal with the housing needs of this family which will become critical next Thursday.

Mr. B. Lenihan

The supplementary welfare allowance scheme, which is administered by the community welfare division of the Health Service Executive on behalf of the Minister for Social and Family Affairs, provides for the payment of rent supplement to eligible people whose means are insufficient to meet their accommodation costs.

Under standard assessment rules, rent supplements are calculated to ensure that an eligible person, after the payment of rent, has an income equal to the rate of basic supplementary welfare allowance appropriate to his or her family circumstances, less a minimum contribution, currently €13, which each recipient is required to pay from his or her resources. Where a person has an additional income as a result of participation on a training course or in part-time employment, the standard means test now provides for a weekly disregard of up to €60 per week of additional income, with half of any additional income between €60 and €90 also disregarded for means assessment purposes. For those participating in approved training courses, any lunch or travel allowances paid may also be disregarded. In addition, certain training courses now provide a child care allowance to participants on certain courses. The 2006 budget provided that these child care allowances are to be treated in the same manner as a lunch or travel allowance and disregarded.

With the exception of those participating in approved employment schemes, people engaged in full-time remunerative employment are excluded from receiving assistance under the supplementary welfare allowance scheme. This requirement is set out in the Social Welfare Act and has been a feature of the scheme since it was established in 1977. In recent years, this provision had been bypassed by the practice of applications being made by the spouse or partner of a person in full-time employment.

In the 2004 budget, measures were introduced to give effect to the original intention that the supplementary welfare allowance should not be paid in households with full-time open market employment. Paying a rent supplement to working households clearly goes beyond the income support objective of the rent supplement scheme and into the areas of housing provision and wage subsidisation.

The Health Service Executive has been contacted concerning this case and has advised that the person concerned had been in receipt of rent supplement of €999.90 per month. As part of a routine review, the executive requested details of income and tenancy from the person concerned. The executive suspended payment of rent supplement when the details were not forthcoming from the person concerned.

The community welfare officer subsequently discovered that the person concerned had been married in April 2006. Following further investigation, it came to light that the husband of the person concerned is in full-time remunerative employment. The executive has further advised that the person concerned would not have an entitlement to rent supplement from the date of her marriage as, under social welfare legislation, a person may not receive rent supplement if that person or his or her spouse or partner is engaged in full-time employment.

The executive has further advised that any arrears due to the person concerned for the period prior to her marriage would be payable upon receipt of the outstanding documentation. It is open to the person concerned to appeal the decision to the designated appeals officer within the Health Service Executive.

Air Services.

Ms C. Murphy

I wish to discuss an airspace change proposal currently before the Irish Aviation Authority. The proposal was prepared by consultants for Weston Limited in conjunction with the Irish Aviation Authority, the Irish Air Corps and Dublin Air Traffic Control. The Irish Aviation Authority, which was party to the drawing up of the proposal, will decide whether to approve the proposal so it is valid to ask whether it will be impartial in its judgement.

The proposal seeks to add instrument control to Weston Aerodrome in conjunction with visual control for take-off and landings. It proposes that, for the first time, night flying be allowed and it will permit Air Corps airspace, or part of it, to be used when it is not active by Weston. The proposal states that stakeholders have been consulted but I suggest that it is vested interests which have been consulted rather than stakeholders. The local authorities and the surrounding communities were not consulted and found out about the proposal by accident.

The only conclusion that can be drawn from reading the proposal is that the intention is to intensify use at the aerodrome. The local view is that a commercial airport is being introduced by stealth. Many people in the surrounding towns of Lucan, Leixlip, Celbridge and Maynooth do not trust Weston Limited because of a litany of unauthorised developments and uses, some of which were the subject of enforcement notices and one of which resulted in the owner of the company facing proceedings in the High Court last summer. Weston Limited has not complied with the order made against it. People wonder why a company which has not complied with a High Court order is being entertained by State authorities.

When Kildare County Council was in the process of producing its development plan last year, it consulted different parties because the aerodrome straddles two local authority areas. According to a letter sent by the Department of Defence to Kildare County Council:

As the Department understands it, the proposal to make use of, inter alia, the paved stopway/clearway would in fact be an actual extension to the runway at Weston. This would constitute an unauthorised use of the facilities and would be contrary to the planning permission granted.

The letter then goes on:

Against this background, it would be entirely inappropriate for this Department to enter into formal discussions with Weston with a view to agreeing procedures, which might then be seen to legitimise the use and operation of what we understand is an unauthorised development or unauthorised use of a facility. In the event that Weston did apply for planning permission or retention for its runway extension, I understand that the GOC Air Corps, in his role as Director of Military Aviation, would have a major problem in relation to the larger aircraft which could then land, and more particularly, take off from Weston, as their requisite flight path would compromise the safety of the flight paths currently used by the Air Corps into Baldonnel.

Since this letter was sent to Kildare County Council, a High Court order has been issued against Weston Limited with which it has not complied. When airspace is widened, different ground support services are required. Neither of the two local authorities concerned has been consulted. In a landmark decision of 8 December 2005, An Bord Pleanála ruled that if larger aeroplanes were to operate at Weston Aerodrome or the use of the aerodrome were to be intensified, further planning permission would be required.

The local view is that none of the agencies involved in the matter — the two local authorities, the Departments of Transport, Defence and the Environment, Heritage and Local Government; and the Irish Aviation Authority — is taking control. It appears to local people that if a company has enough money, wants something badly enough and forges ahead with its plan, it will eventually receive what it is looking for. As a result, there is considerable anger in the communities surrounding the aerodrome.

Minister of State at the Department of Transport (Mr. Gallagher)

I am aware of the concerns of local people about developments at Weston Aerodrome. However, I must deal with the facts and address this issue primarily from a transport perspective and, in particular, from a safety perspective.

It is not appropriate to say the Irish Aviation Authority, the Department of Defence and Weston Limited have combined to consider this matter. These are three separate bodies with very different roles. Weston Limited, as the owner of the aerodrome, is fully entitled to make proposals to the Irish Aviation Authority concerning the regulation of airspace at the aerodrome. The Department of Defence has an interest in the matter because of the close proximity of Baldonnel Aerodrome to Weston and the need to ensure the safe management of flying at both aerodromes.

The Irish Aviation Authority is the body responsible for issuing aerodrome licences and is responsible for the regulation of safety at civilian aerodromes and the general safety and efficiency of aviation in this country. The authority deals with these matters independently in accordance with its statutory mandate. As the statutory body responsible for airspace design, the authority received the airspace change proposal from Weston Limited. The proposal requested a change in the airspace from class G to class C. I understand the basis of the application is that it would enhance safety in the airspace involved. The classification of airspace as class C requires permission for entry from air traffic control and, when operating within such airspace, all flights are subject to air traffic control.

The airspace change proposal was developed by Weston Aerodrome. In its role as safety regulator, the authority facilitated discussion between the various air traffic services in the Dublin area and dealt with queries and other matters in connection with the application. This is a normal feature of the authority's role to ensure that the highest standards of aviation safety are achieved. The Irish Aviation Authority has recently completed public consultations in respect of this proposal. It is not legally obliged to consult on airspace changes but it considered it appropriate to do so on this occasion in the interests of transparency.

I understand the matter received wide publicity in the media and that a large number of submissions were received on foot of these public consultations, including from local residents' interests. The IAA is currently assessing and considering the content of the submissions received. Whatever decision it may take in respect of the airspace change proposal, it will not relieve Weston from complying with the full range of planning requirements.

South Dublin County Council and Kildare County Council are responsible for land use and planning at and in the vicinity of Weston. Planning decisions take account of the nature and extent of operations at the aerodrome and their impact, including noise, in the locality. Environment impact statements are also part of the planning process administered by the local authorities. My Department has no statutory role in any of these areas.

School Enrolments.

Ms Burton

To date, more than 20 children who applied for places next September have been turned away from St. Ciaran's national school in Hartstown, Dublin West, where overcrowding has reached crisis proportions. An excellent school, it appears to have allocated places on the basis of age. Consequently, all children under the age of four years and nine months have been told there are no places for them next September. Children must be four years of age before 31 December 2005 to get a place in September 2006, which is a new policy that parents were not told about until ten days ago or so.

The children in question include some who have older siblings in the school. Parents bought houses in the area on the expectation that their children would be accommodated. As the Minister of State knows, the other schools there are fairly full to the door. Unless the Minister addresses this situation, these children will have no places in September. St. Ciaran's is the most overcrowded school in Dublin 15. Of its 24 classes, 19 have 30 or more pupils, which is completely unacceptable and a damning indictment of the Minister's failure. She must take responsibility for the considerable distress caused to teachers, parents, the principal and the whole community.

Last night, the Minister of State at the Department of Education and Science, Deputy de Valera, singled me out for "trying to create panic over this matter". She continued: "This is despite having been told of these plans time and again by the Minister, Deputy Hanafin. It may be colourful and headline grabbing...". I do not know whether the Minister of State has ever had the opportunity to set foot in Dublin 15 or if she knows that a ground-hog day of sorts occurred when school after school turned away hundreds of pupils. Like me, the Minister of State, Deputy Brian Lenihan, is probably worn out by firefighting exercises to try to get extra places. I resent the cheap shot remarks that tried to blame this problem on the Opposition. The Government has been in office for nine years but has sat on its hands and done practically nothing to address the crisis.

A feature of St. Ciaran's and other schools is the large number of international children catered for, particularly in junior classes. Many immigrants settling in west Dublin have children of primary school age, the majority of whom need intensive language support. As such, the pressure on schools to cater for Irish children and the special needs of international children is enormous. To date, it has been the dedication of principals, teachers and parents that has enabled schools to cope. However, they cannot continue without significant additional resources. While welcome, the Minister's promise of a couple of extra schools in recent years is too little, too late.

I have repeatedly made positive proposals for a long-term solution to these ongoing crises, including a round table conference with all of the interested parties, a proper assessment of needs in line with expected new housing during the next five to ten years and the immediate purchase of sites for housing in Dublin 15. Currently, the Government only seems to serve the interests of the developers and their cronies. I have a list of this week's Dublin 15 planning applications to Fingal County Council, which includes applications for no fewer than eight prefab classrooms in two schools under intense pressure. This says everything about the Fianna Fáil Government. Despite 15,000 extra houses in Dublin 15, the only solution is the old sticking plaster approach of prefabs — so much for the Celtic tiger and the hard-working parents being tortured by the Government in this regard.

Mr. B. Lenihan

I thank the Deputy for raising this matter in both general terms and in respect of St. Ciaran's national school in Hartstown, as it gives me an opportunity to outline to the House the extensive actions being taken by the Department of Education and Science to address the school accommodation needs in the Dublin 15 area, including those of the school in question.

The Department is aware that Dublin 15 is one of the most rapidly developing areas in the country and, as a result, there has been a marked increase in the demand for primary school places. Incidentally, the catchment area of St. Ciaran's national school is not a rapidly developing area, but there has been a marked increase in the demand for primary school places.

I am pleased to inform the House that a number of significant interventions have been made by the Department to tackle the general issues to which the Deputy referred. These include measures to increase the capacity of existing schools and the development of new schools to meet the growing demand. All building projects arising from these interventions are awarded a band 1 priority rating under the Department's prioritisation criteria for large-scale building projects, which means that they will be delivered in the fastest timeframe possible. There is no point in having round table conferences when the Department has already awarded a rating that means the Department, the Minister and I recognise the fact that this is an emergency area requiring constant attention.

In the Littlepace-Castaheaney area, a new school building has recently been completed at Mary Mother of Hope national school, with an additional project under way with a target delivery date of September 2007. Half of the prefabricated accommodation to which the Deputy referred is intended to ensure that the community has additional classroom space until the building is ready. A new primary school campus is planned for a school site in Ongar, which will have a minimum of 32 classrooms. Part of this project will provide a permanent accommodation solution for Castaheaney Educate Together national school, which also has a target completion date of September 2007. Over and above this provision, significant additional school places will be available this coming September through the expansion of existing provider's facilities.

Discussions took place between Educate Together and the Minister in regard to a possible additional class of junior infants at Castaheaney Educate Together school. The Minister has fast-tracked the recognition of a new primary which will commence operation this year under the patronage of the Catholic Archdiocese of Dublin.

In the Diswellstown area, St. Patrick's national school has recently moved into a new 24-classroom school. This will facilitate an annual three-stream intake. As an exceptional measure, the board of management has agreed to take a fourth stream of junior infants this year. In addition, the board of management of St. Mochta's national school, which has an intake of three junior infant classes, has agreed to enrol a fourth class for September 2006. An extension project to cater for this development will also be expedited. Other developments in the Dublin 15 area include the planned expansion of St. Brigid's national school in Castleknock and the extensions to St. Brigid's boys' and girls' national schools, Blanchardstown.

In Tyrrellstown, a new Educate Together school opened in September 2005. The Department has approved the provision of six additional classrooms for September 2006 to cater for new enrolments and special education teachers. It is anticipated that this school will enrol three junior infant classes. Under the scheme for devolved grants, the Church of Ireland national school at Castleknock will also acquire two additional classes.

With regard to St. Ciaran's national school at Hartstown, the Department was put on notice last week that it may require additional accommodation for next September to facilitate an extra junior infant intake. However, in light of all the interventions made by the Department in the Dublin 15 area, the board wanted to be definite that potential enrolments would materialise. It is important to realise that it is common practice in areas of rapid population development for parents to enrol their children in more than one school. However, as Deputy Burton has stated, and I agree with her, several of the parents affected by the restriction on admissions to St. Ciaran's national school at Hartstown lived in the immediate area.

Ms Burton

All of them live in Hartstown.

Mr. B. Lenihan

The board was aware of this phenomenon and decided to carry out a comprehensive survey in its area to determine whether there is an actual shortfall in junior infant places. The Minister is impressed with the school's attitude to the position it has found itself in and welcomes the approach it has adopted. We should all be equally sensible and await the outcome of the school's survey before talking about a crisis situation that may not exist.

The board has been in communication with the Department of Education and Science about the provision of additional accommodation. The Department will respond positively and quickly to whatever the needs of the school, as identified by the board, might be this year. Furthermore, it will review the school's long-term accommodation needs for the purposes of expediting the provision of permanent accommodation if significant extra enrolments are going to be a continuing feature.

I commend the school on the measured and calm approach it is taking in this matter. I appreciate its willingness to play its role in meeting the demands in its area and I assure the board and the parents that the Department will not be found wanting if extra accommodation resources are required.

I thank the Deputy for raising this matter and assure her that just because significant interventions are now being made in Dublin 15 does not mean the Department considers that its job is finished. Departmental staff are well aware that more accommodation may be needed in Dublin 15 and are engaging with the key school patron authorities that are active in the area in this regard.

The Dáil adjourned at 5.25 p.m. until 2.30 p.m on Tuesday, 23 May 2006.