Health (Medical Entitlements in Nursing Homes) (Miscellaneous Provisions) Bill 2019: First Stage

I move:

That leave be granted to introduce Bill entitled an Act to provide for the continued access to medical card entitlements under the Health (Nursing Homes) Act 1990 for residents in nursing homes; and to provide for related matters.

I wish to introduce the Bill on behalf of Deputy Ó Caoláin and on my own behalf. This Bill will ensure that residents of private nursing homes receive their full medical card entitlements and have recourse should a nursing home attempt to deny them those entitlements.

I have heard numerous cases in my constituency clinics where elderly people are being charged for basic medical equipment and therapies, despite having a legal entitlement to them free of charge under the medical card scheme. Items and services for which people have been charged include wound dressings, prescription pain-killers, bed sore creams and services such as physiotherapy, speech and language therapy and occupational therapy. In one case, a resident was billed more than €2,500 for these services over a 15-month period. This is an outrageous cost to families.

To add insult to injury, there appears to be little or no accountability on the part of nursing homes that engage in these practices. There is no recourse for residents or their families. I have spoken to families who have contacted nursing homes to question these charges and who told me that they were told in no uncertain terms that if they did not like the services offered, they could go elsewhere. This is unacceptable. Telling residents to pack up and go elsewhere is an outrageous response.

Earlier this year, the Competition and Consumer Protection Commission, CCPC, raised this issue publicly when it published guidelines for nursing homes outlining the entitlements of residents. During media interviews on the matter, the CCPC said that it could not investigate individual complaints as it did not have those powers under the law. Our Bill aims to fill the gap relating to which body is responsible for investigating individual cases and to clarify and strengthen existing laws and regulations.

This Bill has three main functions. First, it will require the Minister for Health to compile a report on the effect that putting existing regulations on a statutory footing would have.

If the report shows that giving residents their medical card entitlements would impose a cost on the State, then so be it. The State cannot give people an entitlement to certain medical items and treatment and then decide it does not want to pay for them because that person happens to live in a nursing home rather than their own home.

Second, the Bill will give the Competition and Consumer Protection Commission, CCPC, additional powers and oblige it to investigate complaints against a nursing home by residents or their families. Third, the Bill creates a new offence under the Competition and Consumer Protection Act 2014 where a contract of service between a nursing home and a resident is broken. The Bill also puts forward penalties that are in line with the Companies Act 2014.

Cuirim fáilte roimh an mBille seo. Tá sé tábhachtach go bhfuil cearta ag daoine atá faoi chúram cosanta go láidir i gcónaí.

I thank my colleague, Deputy Munster, for her work on this legislation. If the Government accepts this Bill, and I hope it does, it will offer serious relief to patients in private nursing homes and their families. Many are already paying large amounts in fees. The services and procedures specified in this Bill can mean that the monthly bill is increased greatly and with little predictability. They are all procedures associated with the provisions of the medical card scheme and therefore should not have to be factored into the planning of care.

This Bill also seeks to tackle the very obvious question that arises out of the current situation, namely, how is this allowed to happen? It establishes a clear line of responsibility and commensurate punishments for the breach of existing regulations. This may not appear to be of equal importance to issues such as the review of the fair deal scheme or the efforts to have home care provided on a statutory basis. It is, however, a matter of making rights real. Rights contained in existing primary and secondary legislation that are rendered inert by a lack of regulatory bodies to enforce them are effectively rights denied.

This Bill will identify and empower those entrusted with ensuring these rights are real and exist for patients of nursing homes. We remain committed, in the words of the Democratic Programme of the First Dáil Éireann, to the care and support of Ireland's aging population, "who shall not be regarded as a burden, but rather entitled to the Nation's gratitude and consideration". I commend the Bill to the House.

Is the Bill opposed?

Question put and agreed to.

Since this is a Private Members' Bill, Second Stage must, under Standing Orders, be taken in Private Members' time.

I move: "That the Bill be taken in Private Members' time."

Question put and agreed to.