Nursing Homes Support Scheme (Amendment) Bill 2021: Committee and Remaining Stages

Sections 1 to 26, inclusive, agreed to.
SECTION 27

I move amendment No. 1:

In page 47, line 37, to delete "prepared."." and substitute the following:

"prepared.

(4) The Minister shall, in conducting this review, include a consideration of matters relating to financial abuse, including any measures which may be required in relation to the prevention of or safeguarding against such abuse.".".

As the Minister of State will be aware, I am supportive of the thrust and direction of what she is trying to do with this legislation. I will address my other amendments later, but their purpose is to try to highlight issues related to the situation that is being addressed by the Bill. Most of my other amendments relate to reports on important conversations we need to have. This amendment is a little different in that it is something I suggest will be included in the review mechanism, not as a stand-alone report but as part of the five-year review. The amendment raises questions regarding the Bill on an area that needs scrutiny. The other issues relate to topics that build on what the Minister of State is doing, but this relates to financial abuse.

In a situation where one is setting up new financial mechanisms, where there is the appointment or naming of successors, for example, and the transfer of assets in the case not simply of a home but of companies and farms, it involves businesses, income and how it might be allocated from those businesses and farms. In many cases, in this legislation we are dealing with vulnerable persons, who are particularly vulnerable to the point where they may be in need of long-term residential care. It is important in all those situations that we would have extra vigilance, scrutiny and attention on issues concerning financial abuse.

In two of my former lives before the Oireachtas, I worked with Older & Bolder, which is a network of older persons' organisations throughout the country and for the Older Women's Network as part of that. As I will come to later, I also worked with the National Women's Council. I became aware during my work with all those organisations of the prevalence of elder abuse, in particular financial abuse. Sometimes it is subtle, but there can be elements of coercion and the application of pressure or bullying. I accept there are standard measures in the Bill that are appropriate safeguards under which people must appoint their successor or a person who is their care representative, but it would be appropriate that at the point of the five-year review, regardless of whether the Minister of State can accept this amendment, that there would be a careful eye to examine those questions of how these powers and mechanisms have been operated and if complaints, concerns or issues of financial abuse have arisen.

The Minister of State will be aware of the Civil Engagement Group, which is my group, and that in the previous Seanad, Colette Kelleher championed this area. The Minister of State knows her well and worked closely with her on vulnerable people, including in the area of dementia and others. The former Senator, Colette Kelleher, championed the legislation on adult safeguarding, which we are pressing for again. My colleague, Senator Black, will focus on the area of adult safeguarding in the autumn.

I hope that this will not just be part of the five-year review, but that the Minister will be supportive of adult safeguarding legislation, which the Law Reform Commission and others have sought. That legislation may have the potential to almost reach back into this legislation and related legislation on the fair deal and other financial processes. It would be useful if that legislation was the way we would tackle the issues of safeguarding within this and other legislation.

There are a few ways in which the Minister of State can support and engage with the amendment, and I hope she will be open to that. It is so important that we be vigilant to recognise, address and safeguard in every way we can against financial abuse.

I think anybody familiar with my work on older people over the past five years, when I was the main Opposition spokesperson for older people, will recognise that I constantly raised issues relating to safeguarding, premature entry into nursing homes, capacity issues and challenges and the fact that, for example, 70% of people in nursing homes have dementia. Everybody will recognise that I have a history in that respect.

I acknowledge concerns about safeguarding in nursing homes and the potential vulnerability of nursing home residents. The nursing home sector has been severely challenged in the past 16 months and I think everybody recognises that. Once again on the floor of the Seanad, I express my deepest condolences to the families of the more than 2,051 people in nursing homes who lost their lives. In recent weeks, there has been media coverage of neglect in nursing homes, and to that end, in the past two weeks I met representatives of HIQA, residents of Ballynoe Nursing Home in Cork and their families. Much active work on nursing homes is ongoing, although people might not be aware of it.

I recognise that financial abuse of older people is a serious issue. The majority of nursing home residents exhibit high levels of dependency and some form of capacity limitation, including dementia. The assumption within the Bill, which is reflected in the Assisted Decision-Making (Capacity) Act 2015, is that individuals in the scheme have full mental capacity until the contrary is established. In such a case as a person is established not to have full mental capacity, a care representative can be established. The Bill sets out the method by which a care representative is appointed and the function he or she can perform in making decisions related to the person’s care. The care representative must be appointed by a court. Furthermore, the full implementation of the 2015 Act is expected to have an impact on this function, given that it is the Department’s intention to ensure the fair deal legislation is aligned with this new legislation.

A range of other individuals, including the care representative, can act as a specified person on behalf of a person in care. Only the care representative, however, can represent a person in applying for ancillary support, that is, the nursing home loan, or in seeking the relief provided by the Bill in terms of appointing a successor to a productive asset. That is because these processes involve the placement of a charge on the land. Appropriate structures, therefore, are in place to ensure safeguards in the case of individuals without full capacity.

The Bill, as drafted, will require the Minister to carry out a review of the operation of its provisions no later than five years after it comes into effect, which will be laid before the Oireachtas. The terms of this review are not set out in any more specific detail. We might expect, however, that it will cover any operational challenges, the policy impact and the cost to the State, as well as any unforeseen consequences in regard to areas such as financial abuse. It would not be appropriate to extend the scope of this review far beyond the terms of the specific amendments to the legislation we are debating, nor would it be appropriate to single out financial abuse as the only specified issue for this review to consider.

Turning to the adult safeguarding policy, the existing framework of standards, policies and procedures for the safeguarding of adults who may be at risk of abuse, harm or exploitation within the health sector includes the joint national adult safeguarding standards developed by HIQA and the Mental Health Commission, MHC, the significant inspection and other regulatory powers of HIQA and the MHC, and the structures and processes established by the HSE to support and further develop its national operational policy on safeguarding.

Further measures are being developed to strengthen the adult safeguarding framework in the health system, including the revision of HSE operation policy and the development of a national policy on safeguarding in the health sector covering all settings. This will address potential policy and legislative gaps, provide national direction and address relevant cross-sectoral issues such as information sharing. Significant policy development work has been undertaken on this policy. I acknowledge the work of my neighbour when we were based in Leinster House 2000, the then Senator Colette Kelleher. An inter-sectoral steering group has been established, stakeholder consultation has been carried out and a large volume of evidence has been commissioned and gathered. While I recognise the concerns raised by the Senator, I cannot accept the amendment.

In spirit, I agree with the amendment. Nevertheless, while the review will be some time away and we will see who is in charge at that point, the Minister of State will have built sufficient protections into the Bill through the work she is doing on capacity and in other areas. Financial abuse of the elderly is certainly something for which we need to be watchful, but with the HSE's safeguarding policy that has been in place since 2014, the requirements are already included in general policy and application. Furthermore, movements are being made in respect of the commencement of legislation including the amending Bill that the Minister of State is bringing through.

Financial abuse is not the only area; other areas, too, need to be considered. To single out one area would be to highlight it disproportionately, given that there are other means by which the elderly and vulnerable need to have the assurance of respect, and not merely in financial abuse. From that point of view, focusing on one would almost elevate it above others, when in fact we need to ensure that any review will deal with everything with regard to respect for, and the well-being of, the vulnerable people at the core of the Bill.

We will engage on adult safeguarding in the autumn, an issue that needs to be progressed. As well as the review and the body of evidence, we will need legislation on that. Financial abuse is highlighted in the amendment because it is setting in place a different financial mechanism for successors and capping. Safeguarding with nursing homes, as was mentioned, is a key issue, as is capacity. I am glad the Minister of State is engaged and has a personal passion for those areas.

The issue of financial abuse is a little wider because it is not simply about capacity; it is also about issues such as coercion that are not about capacity but the particular vulnerabilities in households, and some of my later amendments will come to that. It may be about the person being pressed to name somebody as his or her successor, or a spouse or a sibling who finds himself or herself in financially vulnerable circumstances and subject to exploitation. There is an entire area of financial abuse where people might well have capacity but not the independence, and they may be vulnerable in those other senses. That is why there is a general reference to other kinds of abuse. Financial abuse is an important part, given that, unfortunately, finances can be used as a tool of coercion and control, and that is why it needs to be highlighted.

Overall, this is a progressive Bill. It will allow farms and businesses to pass on. Nevertheless, a wealth of literature in Ireland tells us how fraught that can be, and how there can be casualties if we do not pay attention. Seamus Heaney wrote about the local wars in that regard and how important they can be. It is an area about which we need to be very careful because hurt can be caused. I understand that the Minister of State might not be able to accept the amendment, and in any event the Dáil has adjourned for the summer, so the Bill cannot be further amended for now, but I hope we can engage in respect of safeguarding and the wider area of financial abuse.

It is important groundwork. I thank the Minister of State for her engagement on this, although I know she cannot accept the amendment.

I thank the Senator for her interaction and positive approach. I know exactly the point she is trying to make. A key principle of safeguarding is that it is everybody's business and all healthcare professionals have key roles in the prevention and reporting of abuse. However, the essential role of social workers in safeguarding is recognised. The specialised safeguarding and protection teams in each of the nine community healthcare organisation areas are managed and led by principal social workers and staffed by social work team leaders with professionally qualified social workers. These teams provide a range of safeguarding functions from direct case management to quality assurance, as well as oversight and support to all service providers, including those funded by the HSE.

Community support teams, as recommended by the nursing home expert panel, will be implemented across each community healthcare organisation and each of these teams will have access to dedicated social worker resources through enhancements of existing community safeguarding teams. As I mentioned, I will be working closely with the Minister, Deputy Donnelly, on the safeguarding Bill. The Department is at an advanced stage in developing its national adult safeguarding policy for the health and social care sector. I have no doubt we can continue this conversation at that point.

Amendment, by leave, withdrawn.
Section 27 agreed to.
Sections 28 to 32, inclusive, agreed to.
NEW SECTIONS

I move amendment No. 2:

In page 59, between lines 34 and 35, to insert the following:

“Report

33. The Minister shall, within 12 months of the passing of this Act, lay a report before both Houses of the Oireachtas making further recommendations in relation to the financial assessment of persons applying for financial support in respect of long-term residential care services or such matters as may be considered in terms of that financial assessment including potential provisions in respect of education and training.".

This relates to a set of concerns that the members of the committee which deals with disability matters have engaged on. It relates to the implementation of the United Nations Convention on the Rights of People with Disabilities. The Minister of State is aware of the report from the Ombudsman entitled Wasted Lives and the disgraceful position of young people with disabilities placed in long-term residential care. The committee heard some strong testimony and one important aspect was almost that we should stop digging by having more people placed in such care. There were 18 or 19 people transitioned from such care but another 20 went in last year.

This is a somewhat small ameliorating measure. I do not know if the matter can be addressed through regulations either. There is the question of what can be deducted in terms of financial assessment for those who are in the fair deal nursing home support scheme. When a person is being assessed for the contribution, there are elements that can be subtracted and where funding can be reserved. In some cases, all the income may go in, but with some very small points of reservation. There is an anomaly where a deduction is allowed in order to pay for the education of a child. There is no deduction allowed for a person's own education or training, however. That is an anomaly. There may be older people who want to pursue education and training but for a young person in particular who is in this scheme, there is no allowance to hold back money for his or her education. This could be done if the person in question had a child but it cannot be done for one's own education. It is kind of an anomaly. It exists because it was never envisaged we would have young people in this scheme but we do. There are over 1,000 young people in it and it is really important their education and payment for their education should be an eligible deduction in the financial assessment and how much income they must contribute towards upkeep in a residential care home.

This is a small matter but we should deal with it while we are addressing the need to decongregate these people. Looking at the questions in the Wasted Lives report, we should at least ensure that those young people who find themselves wrongfully in this position of long-term residential care in nursing homes should at least be able to take steps towards the next part of their lives. It would be small gesture of hope and allow people to make plans for their future and not just that of their children.

I thank the Senator for proposing the amendment and I understand her concerns about individuals and particularly those who enter care before the age of 65. The Government has committed to addressing the matter and there is a clear Government commitment to provide a pathway to eliminate the practice of accommodating younger people with serious disabilities in nursing homes. I met my colleague, the Minister of State, Deputy Rabbitte, to discuss this matter on a couple of occasions since the publication of the report from the Ombudsman.

The HSE is currently engaging with community healthcare organisation areas to identify people who could take part in a pilot project aimed at facilitating younger people currently in nursing homes and moving them to an alternative housing option in the community. In tandem with this, the HSE intends to initiate a service reform project aiming to gather baseline information on the population living in nursing homes and carry out full assessments of care within the current placement.

Projects such as this will provide us with a better picture of the care and support needs of those under 65 living in nursing homes and give a sense of the scale of the task involved in meeting the Government commitment. The first transitions are expected to take place in the second half of this year and I know everybody will welcome that pilot project.

In budget 2021 the Government allocated over €2.2 billion for specialist disability services, with €3 million of this funding earmarked to assist in transitioning 18 people currently placed in nursing homes to more appropriate housing options in the community. We are also providing an additional 40,000 personal assistant hours, with a total target of 1.74 million hours, to support people with disabilities to live self-directed lives. The Government is committed to implementing the disability capacity review published yesterday in order to meet growing demand for person-centred services over the coming decade. My colleague, the Minister of State, Deputy Rabbitte, oversaw the publication of the review, which was welcomed by all sectors.

As I stated on Second Stage, it is important to note that my Department is working on developing a statutory scheme for the financing and regulation of home support services that will provide equitable and transparent access to high-quality services based on a person's assessed care needs. This will also provide transparency around service allocation while ensuring that the scheme operates consistently and fairly across the country. The system of regulation will ensure public confidence in the services provided, as well as safeguarding service users.

The provision of home support on a statutory basis is key to giving younger people with complex disabilities an alternative to nursing home care if it is the appropriate option for them and a real opportunity to live full and more independent lives. I said yesterday that funding has been received for this year and recruitment is under way to put in place 128 assessors of need throughout the country. The postcode lottery will no longer exist when it comes to being assessed for care in a nursing home, residential long-term facility or care at home with the correct wrap-around supports. The interRAI single assessment tool will be rolled out and there will be four pilots in place before the end of the year. We hoped to have that done by the summer but with the cyberattack and Covid-19 - we are all tired of hearing about them - this was very challenging. Work is ongoing to determine the optimal approach to the development of the statutory scheme within the broader context of the reform of our health and social care service as envisaged in the Sláintecare report.

The Senator has proposed an amendment committing the Government to producing a report on the question of how education and training are accounted for in the assessment for the fair deal. I appreciate the concerns raised by the Senator and I will request the Department to consider the matter. However, it is not necessary to include a legislative requirement to report on this in legislation. Nevertheless, I give the Senator a guarantee that I will have the Department look into this. For that reason, I cannot accept the amendment.

I echo the comments about the work being done by the Minister of State, who has mentioned the efforts of her colleague, the Minister of State, Deputy Rabbitte.

I am sure, however, that we all know people who have been impacted in this way. I dealt with one very tragic case in County Wexford involving a young woman with a range of needs. Her family's circumstances were such that they were not going to be able to support her and as a result she was going to be placed in a nursing home. The Minister of State, Deputy Rabbitte, was able to intervene and provide the necessary supports to enable that young woman to live independently within a supportive community. That is only one example of several. Regarding the approach being taken, I hope we never have to hear about the kind of report that was undertaken by the Ombudsman, Peter Tyndall. The Minister of State talked about the figures. I know some of the people impacted and a real difference is already being made. It is important that we see such a transformation.

I agree with Senator Malcolm Byrne regarding the commencement of decision-making capacity provisions. I appreciate that and all the Minister of State is doing. I was going to speak extensively on this aspect yesterday, but I was unable to be here for the debate. The overturning of the assumption of who is at the centre of circumstances such as these and who has the ability to make decisions in this regard is going to bring change. I refer to an assumption of there being a choice of being directed towards education and a future. We are on a better trajectory and the announcements this week have accelerated this direction of travel in a way that must be applauded. I commend the Minister of State and what she is doing is appreciated. Given that the gathering of information is under way, an amendment in this regard could be inserted into the legislation the Minister of State is proposing. We could also liaise in this respect with the Department of Further and Higher Education, Research, Innovation and Science and undertake something in the context of the review of the Student Universal Support Ireland, SUSI, grant system as well. Given time, we could explore many such aspects. It is a worthy element of this legislation. When I read the amendment first, I wondered what its intention was, and then I remembered the context. It is a reasonable proposal. However, a better proposal in this regard would be to ensure that no younger people are caught up in these circumstances at all, and we are well under way in that direction now.

I thank the Minister for indicating that she will talk to the HSE. We will return to the issue of statutory entitlement to home care in the next amendment. I helped to run the Make Home Work campaign seven years ago. Change in this regard has been a long time coming and I hope it happens soon. It is in the programme for Government. We will come to that point in a moment. Another aspect concerns decongregation and moving people out of these unsuitable situations.

Turning to this amendment, I thank the Minister of State for indicating that she will talk to the HSE. In the meantime, we are trying to do better as a State, a Government and legislators. It is an important point. There is also the aspect of trying to map the level of the existing problem and then trying to chart a path away from it. We must also, however, consider individual rights and opportunities for all the people concerned in this regard, not all of whom will be in the pilot scheme. Some people will be present only as the statistics that will inform us of the prevalence of the problem and the challenge facing us in addressing it. The years to come should not be wasted years for these people. We must ensure that younger people are not being placed in these situations.

Recent figures tell us that 18 people transitioned out, but 20 more went in. We are losing ground even as we are trying to gain it. Therefore, I urge the Minister of State to talk to the HSE in this regard. I do not know if something can be done via regulations, the addition of another scheme on top of what exists or through some kind of deduction. We must, by whatever means we achieve it, ensure that younger people and everyone under 65 going into these situations, as described in the report from Peter Tyndall, have educational, training or other similar opportunities in the next year to allow them to prepare at the same time as the State is trying to create a better statutory living situation for them.

The Minister of State, Deputy Rabbitte, is doing much work to try to get this pilot scheme up and running and move the administration from each CHO. We must start somewhere. It takes time, but she can certainly build on it. It is important to record that the original Act from 2009 refers to maintenance expenses. Provision in that regard is made for maintenance expenses in respect of a child under 21 years of age, which is interpreted as including education expenses. If a parent is in a nursing home, then that situation is covered under the existing Act. I understand the point the Senator is making, however.

I chaired the Joint Committee on Business, Enterprise and Innovation in the last Dáil and we did a great deal of work on apprenticeship schemes. I am heartened to see that there will be 10,000 new apprenticeships this year. The Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris, has been working hard on this initiative and there are now great opportunities for people with additional needs to transition into an apprenticeship model. We are digressing a little from the topic at hand, but there were only 200 female apprenticeships when we did that initial work on this subject. I am delighted the number has grown greatly in recent years. We will agree to talk again on the specific issue at hand, however, and I hope the Senator might be able to withdraw the amendment in that context.

I withdraw the amendment and I look forward to further engagement on this matter.

Amendment, by leave, withdrawn.
Section 27 agreed to.
Sections 28 to 32, inclusive, agreed to.
NEW SECTIONS

I move amendment No. 3:

In page 59, between lines 34 and 35, to insert the following:

“Report

33. The Minister shall, within 12 months of the passing of this Act, lay a report before both Houses of the Oireachtas in respect of situations where a person applies for financial support to be made available to them in relation to residential care services and where that person subsequently transitions to a different care model. This report may set out legislative measures or procedures which might be implemented to facilitate such persons in their exit from the Nursing Homes Support Scheme, including provisions which may be made in relation to the removal of an interest, or farm, or a relevant business.”.

We will not have to go over some of this issue again when debating this amendment, because it relates to the subject we just discussed. I refer to statutory home care, the promise of and need for such home care in different situations and the imperatives under the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, to ensure decongregation and deinstitutionalisation. We must also move towards a statutory model of home care for older people. Things can change and circumstances can alter, and this is the aspect we must consider. Rules are in place in this regard, but a strong assumption is also inherent in the way the nursing home support scheme is designed and conceived. It is evident when people try to find information on changed circumstances and options in that regard.

It feels very much like a one-way street. Once people become part of the fair deal nursing home support scheme, it is hard then for them to see what the route of it might be. People sometimes enter schemes such as this after suffering catastrophic health events, but their circumstances may later change. One concern in this regard involves people who may have entered the scheme because of having developed a disability or experienced a serious health event. Normally, those people would have transitioned to community care. The impact of Covid-19, however, has meant that such care may not have been available and people might have found themselves in residential care instead. A particular vulnerability has emerged in that regard in the last year.

People in such situations might well decide later that it is not the model of care they want. Circumstances may change. A son or daughter may return from abroad or someone else might become available who could be a carer and that would alter the situation. Community care and statutory care provision might also become available soon. When such changes of circumstances occur, then, how do the people concerned get out of this scheme? How is it possible to exit it? Where an asset is involved, whether a farm or a business, how do they exist that aspect as well? What mechanisms are available in that regard?

It happens sometimes that people leave the scheme. People have managed to do it, although not often. It is not, however, always a transparent option and it is not always clear that such an option is even on the table. People might not know such a possibility exists. If people did, they might derive a great deal of comfort going into this scheme to be aware that in one or two years' time, they could potentially exit the programme if it turned out not to be the best model of care for them in the longer term.

There should be a clear mechanism or way so people know how that would work and what are the expectations. Again, that is in line with the UN convention on rights for people because it is not just about a choice on care at one point. It is about the ongoing right to change your mind, to choose again and choose differently. A person may become particularly vulnerable, have a health event, have a disability, his or her spouse may die, he or she may find themselves at a point of vulnerability and his or her family may be under pressure. In all of those particular circumstances, as Senator Malcolm Byrne described, nursing home care might seem like the only or the best option but it would be really good if it was clear there was a route out. An actual specific mechanism in relation to the statutory entitlement to home care will be necessary. While people have a statutory entitlement and there is a scheme in place in the form of the nursing home support scheme, people do not have the same options on the table where home care is concerned nor do they - this is the last thing I will say on this - have the same options where personal needs assistants are concerned. These are different from home care support and it is the other direction we must be travelling in, so that people can have personal needs assistants available to them to allow them to live independently and fully.

This was really a report to ask how we build those exit doors, how we build them properly and how we mind the person as well as how we disentangle the asset, in the case of a farm or a business.

We need to bring this conversation back into context a little. I understand where the Senator is coming from. There is absolutely no impediment in legislation or practice to prevent a person who is receiving care under the nursing home support scheme from leaving nursing home care and returning home or to a different setting.

The nursing home support scheme was put in place in 2009 to ensure there would be no financial barrier to anyone who needed long-term care. I will give an indication of how seriously the Government takes this. Last year the cost of the nursing home support scheme was €1.4 billion and approximately 22,500 people availed of the scheme. The amount of financial aid that came in from costs people paid to support their care was €350 million. We will be turning our eye towards the budgets very soon. When I look at my budget, there is €1 billion gone out of it to support the scheme. It is a very good scheme that has worked very well.

What we are doing today is correcting an anomaly that came from the 2009 Act whereby farm families and those with small business were not treated as fairly as people who had a principal private residence. That is the nub of why I stand before Senators; it is to correct that anomaly. Many organisations like the IFA, Teagasc and Agriland have been raising the matter of the anomaly for many years. That is the whole purpose of this Bill. There is also an amendment that was included in the Bill in the Dáil on Wednesday. It is a really important one and there has not been much conversation around it. It provides for a situation where a person moves into a nursing home and their house is sold in the meantime. Previously, if a person stayed in the nursing home beyond three years, the 7.5% he or she had to pay was not capped at three years. This amendment has been included now and we have been working very closely with the Department of Housing, Local Government and Heritage on it. It means that when a person is in a nursing home and his or her house is sold, there is no impediment to selling the house. We know 37% of people who enter nursing homes are there for six or seven months. Not everybody is in a nursing home for a long time. There are some people who are but not everybody. That is important. We also must put this in the context of the majority of people who go into nursing homes being very sick, very old, having complex care issues and some of them are vulnerable. They need that support of 24-hour nursing care and because of the nursing home support scheme they are able to get it. It is not common, but a number of people do regularly leave nursing home care to return home, move into different nursing homes, or into different care settings.

Over the last 12 months people have actually decided to stay out of residential care because of Covid and because of the visiting restrictions. They opted to stay at home more and to try to get supports through home care and also privately in order to do that. That should be acknowledged as well. In cases where there are financial challenges, it is worth noting access to the scheme is predicated on a care needs assessment which determines whether long-term residential care is necessary for the individual in question based on their clinical needs, community supports and overall level of dependency. There is a nursing home loan as well that 15% of people in the nursing home support scheme avail of. Without labouring the point, the scheme is here to support older people who need nursing home care and it means anybody who needs nursing home care is able to afford it. That is the point that must be made.

As I said earlier, work is ongoing in the Department to determine the optimal approach to the development of the new statutory home care scheme within the broader context of the ongoing reform of the health and social care system, as envisaged in the Sláintecare report. As I said, the work encompasses the development of the regulatory framework for the new scheme. The pilot of a reformed model of service delivery is due to commence in 2021. Regarding the development of a regulatory framework for home support services, I am pleased to say the Government gave approval in April to draft a general scheme and heads of a Bill to establish a licensing framework for publicly-funded for-profit and not-for-profit home support providers. I intend to progress this general scheme and heads of Bill as a priority with a view to bringing it through the Houses at the earliest opportunity.

It is also a Government priority to ensure older people have sufficient housing options in place to meet their needs. Last Tuesday myself and the Minister of State, Deputy Peter Burke, were in Navan where the Age Friendly Ireland healthy homes approach was launched. Nine local authorities throughout the country are taking part in a pilot programme where 4,500 people will be assisted to "rightsize" their home, that is, not to downsize their home but to rightsize it. That is the new buzzword. Supports will be given to a person if he or she needs, for example, advice on how to get a solicitor if he or she needs to sell his or her home, or a person might need advice on property tax. It covers all these things older people may find hard to navigate if they do not have a family member to support them. Age Friendly Ireland is doing phenomenal work and I congratulate the people involved on the work they are doing. We want to support older people to remain living in their own homes or in a home more suited to their needs through the provision of targeted supports. The most important thing for older people is - one finds this if one talks to older people - the option to live in their own home for as long as possible, with the correct wraparound supports. That is what we all aspire to. There is always going to be a small minority of people who need nursing home care. It is great that we have the facility and that there is a scheme to support financially any person who wants or needs nursing home care.

I accept and appreciate the issues that have been raised about the up to 1,700 people under the age of 65 years who have been placed in nursing homes, maybe because of disabilities, acquired brain injuries or reasons like that. I accept the report that was there although I thought the sample was very small, in that it referred to 17 people out of 1,700. As I said, we will continue to work with the Minister of State, Deputy Rabbitte, to do the very best we can. It is important for the House to accept there is a huge amount of work going on. I do not think it would be appropriate to introduce a legislative amendment to this Bill, which is focused on family farms and businesses, focused on this question. I therefore cannot accept it. I understand there are many wider issues which I will be returning often to the House to debate but today this Nursing Homes Support Scheme (Amendment) Bill 2021 is purely intended to change an anomaly that was there since 2009. Many colleagues in both Houses have spoken about this for many years and I welcome all the positive comments on it.

I was happy to support all of the early sections we flew through because I support the Bill. It is doing something important. Addressing the question of the three-year cap is really constructive and the amendments on a house being sold are positive also. There are many very good measures in the Bill. This is not challenging those measures. It is addressing a scenario. I am highlighting an issue. There is the idea that people stay in their homes for as long as they can. I worked with older people throughout the country. I went into residential care homes when we were discussing universal healthcare. I met older people in residential care homes throughout the country when I worked for Older & Bolder. There was an idea that nursing homes were not the future of healthcare. I asked the people in them what they would like. Something people spoke about was that they want other options. They did not state that they held on for as long as they could in their homes and now were in nursing homes. People would like new options even though they are in a residential care home. This is not to critique the scheme. I would prefer a statutory home care scheme. I have been very clear on this and I know the Minister of State knows it.

A care needs assessment is fine once but perhaps we should be looking at a new care needs assessment two or three years down the line. When we have statutory home care coming on stream in a proper way, perhaps it will require a new care needs assessment for people in residential care homes who may want to move to it. It does not have to be a one-way street. This is an empowering message and something we can do. It is about looking at the care needs assessment. People can move away but they are nervous about how they do so. There is the issue, for example, of how we manage financial vulnerabilities. I know people will only be charged for the amount of care they have had. Will that charge be upfront? Will it be later? If it is attached to an asset will it wait? If people move into a statutory home care system that requires them to make a different contribution in a different way how will it transition? I am signalling these issues with regard to giving people personal choices in an ongoing way and ensuring there is no financial obstacle. They may be financial logistical obstacles to these transitions and, if so, they need to be addressed. I will not press the amendment but I signal that we need to tease this out. The more of this we do in advance, the better the impact we will have on statutory home care and the better life options there will be for those in residential care.

As the Minister of State pointed out, what we are dressing here is an anomaly relating to the 2009 scheme. The Bill will be a real game changer for people. As the Minister of State has said, the amount of representation we have received over the years on rectifying this, particularly from the farming community and the small business community, has been significant. I have already received representations from people via email and text stating that they are very happy with what is happening here today. It creates another sound option for them.

I noticed something this year, and perhaps it was a result of Covid. In the counties I am involved with most, namely, Galway and Roscommon, two elderly people in difficult situations were heading for nursing home care, which is not what they or their families wanted. Grants for older people and disability grants meant the families were able to bring the homes up to a safety standard that enabled the people to stay in their homes. Senator Higgins made some very valid points but the real issue is to get rid of the roadmap that is there. I did not have an opportunity to speak earlier. The Minister of State has done incredible work in this area, which is acknowledged and recognised. It was not easy. This is a major step forward.

I support the Minister of State in her comments on what is being debated here, which is the Nursing Homes Support Scheme (Amendment) Bill. I do not think we should confuse this or the work done on progressing the Bill. As the Minister of State alluded to, a significant amount of work is being done in the Department on the Age Friendly Ireland programme. Measures are being taken separately to support people in their own homes. I thank the Minister of State for being in Navan this week to launch the programme. It will help 4,500 people to "right size" their homes. The Healthy Age Friendly Homes programme is a unique collaboration between Sláintecare and local government. Crucially, it puts local government at the heart of what is being done. It is about people living longer and healthier lives in their own homes. Over the next two years, it will reach up to 4,500 homes in nine local authority areas. This is an exceptional piece of work. The Bill before us is dealing with a particular issue and we should remain focused on it. Both measures complement each other and I commend the Minister of State, Deputy Butler, in this regard.

The point I continue to make is that there is no impediment in legislation or in practice to prevent a person who is receiving care under the fair deal scheme from leaving a nursing home. Recently, I worked on the case of a man leaving an acute hospital whose house was being reconfigured to support him with a downstairs bathroom and bedroom. He entered a nursing home for eight weeks and was then able to go home, which was great. This does not happen very often. I do know that. I have dealt with many people who go into a specific nursing home because their nursing home of choice may not have capacity at that particular time. They then moved to that other nursing home after 12 or 18 weeks when a bed becomes available. I would hate the message to go out that there is an impediment. There is not. People can leave. It does not happen very often because sometimes when people go into a nursing home they discovered they are very happy there and content. This is great to hear.

To go back to statutory home care, the successful development of the scheme is a key priority for me. It is a key priority in the programme for Government. My predecessor, Jim Daly, did a lot of work on the matter. When I do my job on a daily basis, it excites me. The two words I remember every day when I speak about older people are "voice" and "choice". Older people have a voice and they also have to have a choice. This is the most important thing we can do. This is why the statutory home care scheme will make such a difference.

Funding was secured in 2021 for the HSE to progress the roll-out of the interRAI, which is the standard assessment for care needs in the community. When somebody is assessed it is normally by a public health nurse or a GP. They then support the family with regard to where the person might be placed. The interRAI for care needs in the community will be standard in every CHO area and every county. We are recruiting 128 assessors at a cost of €9 million. That funding was secured in the budget.

We are also establishing a national office for home support services. This will be very welcome. It will be up and running before the end of the year. I hope it will be in the third quarter of the year. To have a national office for home support services for anyone with a loved one receiving home supports is very welcome. I want to mention something I secured in last year's budget which was very important. A total of €250,000 was ring-fenced for dementia specific care hours. This was the first time they were ring-fenced. It is very important to support people with dementia, especially younger people, if they want to stay at home.

Earlier, I spoke about the four pilot sites. A total of 230,000 hours of home support will be provided in these four pilot sites. I also secured funding for setting up an ICT solution for the continued roll-out of interRAI. A person receiving home care might have to go into an acute hospital or a nursing home. I want to have a system whereby we can log in to see where that person is. This came into sharp focus over the past year. There is no point in people turning up to deliver home care if the person has gone to hospital.

I did a great deal of work on the roll-out of the vaccine to the housebound and the same concerns arose. Some 3,900 people were referred by their GPs for a vaccine. The National Ambulance Service went throughout the country. It was a difficult situation. In more than 700 cases, when members of the ambulance service arrived at a home, the person concerned was already vaccinated, had passed away, was in a hospital or a nursing home or did not answer the door. A lot of time was wasted. If this IT system was in place, that would not have happen.

The IT system, the recruitment of interRAI assessors and the home care office are all key enablers for the statutory home care scheme. This is a great opportunity for me to come in here, talk about this Bill and inform Senators that an enormous amount of work is being done in the background between the Department and the HSE. We all want the same thing. We all want the Sláintecare vision that the right care is provided at the right time and in the right place. We all want to see that. I again thank the Senator for her constructive amendment, which we will discuss at a later point.

I commend the Minister of State on the dementia hours she has secured because I know it is something that she and former Senator Kelleher campaigned for in the last Oireachtas. I also commend the former Government Senator, Deputy Colm Burke. The regulation of home care legislation he put forward as a back bencher, and which I strongly supported, was important and good legislation. I urge the Minister of State, as she considers the roll-out, to look to that regulation of home care legislation brought forward by the Deputy because it is excellent.

The Minister of State and I will be able to engage on these issues in other ways. It will come to the fore when statutory home care becomes a stronger option. I am happy to withdraw the amendment for now, with the agreement of the House.

Amendment, by leave, withdrawn.

I move amendment No. 4:

In page 59, between lines 34 and 35, to insert the following:

Report

33. The Minister shall, within 12 months of the passing of this Act, lay a report before both Houses of the Oireachtas outlining any trends or impacts identified in relation to the Scheme in terms of its intersection with the implementation of Directive 2010/41/EU of the European Parliament and of the Council of 7 July 2010.”.

This amendment is related to amendments Nos. 5 and 6 but they are marked as being taken separately so I will address them separately. This issue came to my attention when I worked with the National Women's Council of Ireland and Older & Bolder. It is an issue that affects older women in particular but can also affect many others. The issue relates to economic vulnerability and the financial independence of older women in Ireland. Many women are not visible in the social protection system.

EU Directive 2010/41/EU was transposed by Ireland at the last moment in 2014. It sets out the provisions whereby social protection PRSI stamps will be paid for a family member working on a farm or in a business. That has particular relevance for spouses. Spouses, other family members or those who used to be called relatives assisting can be invisible in their work. They are not an employee nor are they the owner of a business. They are not self-employed in the classic sense of owning a business or a farm. They can fall into a place where they lack financial independence and that can create imbalances of power. It can create situations for the financial abuse of power and vulnerabilities that I discussed earlier.

This is not a uniquely Irish phenomenon. These issues arise everywhere. Everybody knows of families and businesses that are doing incredible work. Only one family member may be the owner but other family members carry a considerable burden of work in a family business or farm. The aim of EU directive was to try to ensure that every member of a family who is working and contributing gets recognition and their own social protection safety net. Unfortunately, that directive, while it has been transposed, has not been taken up. We have not seen those safety nets implemented. Many of those relatives assisting, family members or spouses have not been able to develop their own safety net in terms of social protection. Many of those people will not qualify for a contributory pension or non-contributory pension or, if they do, they will receive a reduced rate pension. Many women in Ireland are on reduced-rate pensions and could be begging as little as €100 per week if they are on contributory pensions. Many do not qualify for the non-contributory pension because their household means test makes them ineligible. They are, therefore, left vulnerable in terms of their financial independence.

We will not have to talk for as long about amendments Nos. 5 and 6 because they are coming at the same issue in a slightly different way. The reason this amendment is important is because this Bill includes the business owner and farm owner. Issues around succession are addressed. The successor may well be the eldest son or daughter while the spouse, who may well be living in the home, is left in a potentially vulnerable situation. I want an examination of this new mechanism as it relates to a property that is also a business or farm passing to a successor. What happens to the siblings? What happens to the other people who also keep the farm going? Where are they catered for in this legislation?

There are two levels at which we need to look at how they are supported. The first relates to the period of time when the farm or business owner is in residential care. The second relates to the point afterwards. In a scenario where a farm or business is sold, which I realise is exactly the situation this Bill is trying to avoid, there is an inheritance moment when an asset is dissolved and persons are entitled to certain amounts. In a scenario where a successor is able to keep the business or farm going, which is obviously good for many reasons, there is not the same kind of inheritance moment. There is potential difficulty for a spouse or sibling who assists or contributes to that business and who may or may not have PRSI contributions.

I refer to social insurance measures in amendments Nos. 5 and 6. I am referring to the directive in amendment No. 4. There is potentially a positive opportunity here. We could, for example, create a scenario whereby deductions in terms of PRSI become eligible deductions. It could be that the deductions that are needed for a spouse in terms of their PRSI or the deductions that are needed for a family member who is contributing, those PRSI contributions of the supporting or contributing family member, may be eligible as one of the deductions when financial assessment is conducted. It may be an opportunity to allow people to build up some social credits while their spouse is in residential care if they have not done that previously. If they are in a situation where those social insurance payments are already being made, it is, of course, important that they would continue.

Those are the measures I suggest. All of these issues intersect with health and social protection but the positive measures in this Bill came out of the identification of a social need, a social situation that arises, and I want to make sure that all of the people in that situation are recognised. A family-named farm might go from one generation of, to pick a name at random, the Kenny family to another. We must ensure the other people in the mix do not get forgotten and that we do not only look to the owner and the successor. We must also look to those around them.

Many of the matters Senator Higgins raises are very important in the context of the debate. There are serious issues around succession on farms, the role of women in agriculture, young people and so on. I would respectfully suggest, however, that they are not central to what this Bill is about.

As the Minister of State has outlined, this Bill is about righting an anomaly. It is complex legislation but what it is doing at its core is righting a very specific anomaly whereby farm families and small businesses were discriminated against. I am not disagreeing with the points the Senator is making but her amendments are not relevant to the Bill. While we need to have a broader debate about issues such as succession and inheritance on farms, and the huge challenge of the ageing farm profile, this Bill is very specifically dealing with an anomaly in the system. The Senator's amendments do not assist in any way in that regard.

I agree with my colleague, Senator Byrne. Senator Higgins is conflating a successor and an inheritance. The mechanisms created under the Bill for the appointment of a family successor are strictly in place for the purpose of calculating a person's contribution to long-term care. They have no other role. That is their only role. The successor may not inherit the farm. The successor can be the wife or the husband but that is not to say that the son, daughter, daughter-in-law, son-in-law or whoever will not inherit the farm. That is what is being conflated. In order to apply for this cap to be implemented, on the day this Bill is enacted, a person can appoint a successor. Doing so will ensure that the farm or small business is kept within family ownership for the next six years. The HSE will do one check over that time and this rule will mean that the farm or business will be kept within the family. The successor may not inherit and has no legal right to inherit. He or she is just a successor so that a person who enters long-term care can avail of the cap after three years and does not have to pay 7.5% on the value of his or her house, properties, outbuildings, pub, small restaurant or whatever business he or she has. We need to be clear on that. The whole purpose of the successor is to ensure that the farm or small business is kept within the family. That is why we did not include land that was leased out, as that would go against the thrust of what we were trying to achieve.

I understand the concerns relating to the status of spouses on farms where succession arrangements are made, with regard to social insurance. I appreciate that concern and I will raise it with my colleagues in the Departments of Social Protection and Agriculture, Food and the Marine. However, it is important that we accept and appreciate that issues of social insurance contributions and so on do not form part of this Bill. They are very important issues and all we want to do is support people in order that they will have the financial means to live at home or to enter a nursing home. I reiterate that if someone's father, mother, aunt or uncle has been in a nursing home for two years, from the day a successor is appointed those two years served will be included and they will only have to spend another year in the nursing home for the cap of three years to apply. If a person has already spent four years in the nursing home, from the day a successor is appointed and agreed, within the terms and conditions of the Bill, that cap will apply immediately. We tried to make this as workable and as family friendly as possible.

The issue was raised with us of sons or daughters who had gone away to Australia, America or Canada but who had always been part of the farm family. Initially they would have had to prove that the farm had been in family ownership for three of the previous five years but if they have been gone for three years, through no fault of their own for work or whatever, they can still become the successor. As I said, they just have to prove that they have a link with the farm and that they will farm it for a reasonable amount of time. They do not have to provide any financial statements or anything to prove that they are getting an income from the farm because we all know how it goes with small farms and small businesses. I was part of a small business for 17 years. We had the corner shop where I lived and I ran it with my father and then with my sister when he passed away. We all know that families help out in small businesses, whether that is a pub or a farm. One of my staff members went home today and she said she would not be seen for the weekend because they are cutting silage for the entire weekend. It is as simple as that. It is all hands on deck.

I do not think this issue is sufficiently connected to the scope of these amendments and the nursing homes support scheme in general to merit the introduction of this amendment. On that basis I cannot accept it but I have given a commitment that we will raise the issue and I understand where the Senator is coming from.

I will push back a little bit on this. I am constructive and reasonable. Let us be clear: nothing I am putting in this amendment counteracts what the Minister of State is doing or undermines it. We should remember that legislation is legislation. Legislation does not just belong to the Government. It is not just what the Government would like to be discussed. Legislation is what others see as relevant to it and my amendments have been deemed as relevant. I have suffered many times at the other end of the scale when they were not considered relevant but they are, in fact, relevant. They may not relate to the areas in which people are particularly interested or which are their main focus but they are what I am interested in and they are relevant to this Bill. I will point out exactly how.

This is the Nursing Homes Support Scheme (Amendment) Bill. It is about the nursing homes support scheme. The Long Title refers to the provisions "... for the financial assessment of persons applying for financial support to be made available to them..." and those "... who have, or had, an interest in a farm or relevant business..." and provide for related matters and the conditions attached. Some of the areas I have highlighted tie directly back into that. This Bill provides that businesses and farms will stay in the family and will not have to be sold, and I have said that is a good thing. It will make it easier for a business to stay in the family. However, when a business stays in the family there is not a moment of dissolution of an asset, where an inheritance event takes place and certain shares might go. Instead, there is a continuum. The asset is not dissolved and there is continuity of income from an ongoing business or farm. Obviously it is better if we keep farms and businesses going and in the same family but it is important that we address the fact of how income is generated and what will happen in the future. That is relevant here.

It is also a strong principle of feminist economics that we support financial independence. I make no apologies for saying that. In fact, it is a principle that is meant to be supported in our social protection system. We should be trying at all points to ensure the financial independence of all family members. That is a principle at European level and that is why that EU directive exists specifically in relation to farms and those who work on farms. I did not dream this topic up. It was an imperative from Europe because Ireland and many other countries are not very good at recognising the contribution of spouses - women in many cases, but it may be any other spouse on a farm - and ensuring they are visible within our social protection systems. I identified a positive opportunity here to increase that visibility in how financial assessments are done and to recognise the people who do not own the business. They may have to pay PRSI but they do not own the business and are not employees so PRSI is not being paid on their behalf. That is a particular circumstance that arises with farms and family businesses.

How will that PRSI be paid? It there a guarantee it will continue to be paid during those periods? Those are relevant questions to consider in the financial assessment and the capping of the income from the farming business to cover the cost of long-term residential care. Those are relevant factors. We discussed the cost of children's education being a relevant factor that might be excluded. PRSI in respect of a contributing spouse is also something that should be included in those areas of deductions set out in the Nursing Homes Support Scheme Act, which this Bill amends. Those are relevant issues. Many women who are qualified adults or adult dependants, which was the term used in the past, do not have financial independence and may not feature in our PRSI records even though they have worked all their lives. I make no apology for taking any opportunity to strengthen their position but that is not to oppose the purposes of the Bill, which I support. I seek to address this important issue and suggest we examine this. When we change how things are done and create benefits we may also create vulnerabilities. It is appropriate to consider what steps we might take to monitor or ameliorate those vulnerabilities.

Legislation does not belong only to the Government. That is why I worked constructively on Committee Stage in the Dáil with some Deputies who were not members of the Government and who had brought forward amendments. I took on board three amendments. The first of those proposed that when the Bill is signed into law, it will be enacted within 90 days. The second amendment proposed that when a person who might be going into a nursing home would have to go for an interview with the HSE, he or she would be allowed to bring another person with him or her to support that person. I thought that was an important provision. It was one I was minded to include myself. The third amendment related to the notification of a successor, for example, in the event of an awful tragic accident or of somebody passing away. We are all conscious that farm fatalities happen and people can pass away. The Bill provided the HSE would have to be informed of the change to the scheme within ten working days. On foot of working with the Opposition, I changed that period to 20 working days, which is a month. Once the HSE is informed there is a change to the successor, one still has six months to make any changes. I was conscious of such events, hopefully that will not happen but there is always an opportunity it could happen. I accept the Senator is supporting the Bill and wants to start a wider conversation. Social insurance contributions are eligible deductions for the financial assessment already. Therefore, they are included.

I am referring to social protection contributions in respect of another person. That is why I mentioned that directive. I am referring to social protection contributions in terms of a person, a family member or a spouse assisting the person concerned. That is the missing piece of the puzzle. I hope we are able to tackle it; perhaps in the social welfare Bill when it comes before us in the autumn. It is one aspect we might need to address.

Is the amendment being pressed?

No. I will withdraw it.

Amendment, by leave, withdrawn.

Amendments Nos. 5 and 6 are related and may be discussed together by agreement. Is that agreed? Agreed.

I move amendment No. 5:

In page 59, between lines 34 and 35, to insert the following:

“Report

33. The Minister shall, within 12 months of the passing of this Act, lay a report before both Houses of the Oireachtas outlining any provisions, procedures or measures implemented in respect of pay related social insurance contributions made for spouses on farms where a farm is being assessed for financial contribution to the Nursing Homes Support Scheme, which report may include recommendations regarding further potential provisions, procedures or measures.”.

I am surprised amendments Nos. 5 and 6 were not included as part of an earlier grouping as they are similar to earlier amendments. I am engaging in the same area, specifically on pay related social contributions made for spouses on farms. Perhaps that is the issue, namely, whether there is a category and an allowance for PRSI contributions to be deducted. Perhaps it simply needs to be extended to ensure the interpretation of it will extend to relevant family members in terms of spouses or family members who qualify under that EU directive. There might be scope to provide that. Currently, the legislation is very much framed as if those individuals are responsible for making those contributions when, effectively, the making of those contributions has to come from the income of the farming business. Perhaps it is a matter of teasing out how that is interpreted. There may be scope to address the problem in that regard.

With respect to social protection entitlements of family members of the person concerned, a related issue in terms of qualified adults may be tackled in that respect. Sometimes they are independent payments and sometimes they are attached payments. I have not tabled these amendments simply to have a conversation on this issue. I tabled them because I worked with older people, older women in particular, for three or four years and I saw how they were impacted by inequalities in our pensions system. I subsequently worked with the National Women's Council of Ireland and saw how that gets deeply embedded. This is a chance to address that. When we talk about the family as a unit, family members are not all of the same mind working seamlessly together. As I said, much of our literature would not be what it is if that were the case. There are power dynamics and imbalances within families. There is an entire field of sociology related to household bargaining and how that works. As legislators, we should try to ensure the best possible grounds in that respect. That is why we should try to make something that is good for the family and the farm as good as possible for all the members of the family, not only the successor and inheritor but potentially the others who will come after them. That is where I am coming from in tabling these amendments. It is an important discussion and it also will be important to monitor the operation of this new measure. I hope as this unfolds, as the new mechanism comes into place and more of those with family farms and businesses avail of the nursing homes support scheme because of the measures that made it much more workable, possible and effective, that these issues will be monitored to take account of any patterns that emerge and that suitable measures will be taken, be it through regulations, further amendment of this Bill, the review or separate legislation, to address any further concerns that arise.

When considering how couples are treated under this Bill, fairness has always been the guiding principle. This is particularly relevant when considering the appointment of a family successor in respect of both members of a couple regarding the same productive asset in cases where both members of the couple are living and in cases where one member of the couple is deceased. I will address the issue of couples. When the Bill went through Committee Stage in the Dáil, I flagged my intention to bring forward a number of Report Stage amendments to provide for and protect the second partner in a couple. It is important to point out that when a couple are assessed and whether that couple are in a nursing home - there are occasions when a couple can be in a nursing home at the same time although they may not be in the same nursing home but it can happen - normally the assessment is 80% of one's income and 7.5% of the value of one's home, farm or business for three years, which, thankfully, is what will be provided for when this Bill is enacted. In the case of a couple it is 40% of their income and 3.75% of the value of their asset. There are also a number of questions pertaining to succession and inheritance arrangements and ownership models of assets that will need to be completed before the Bill is operationalised. The laws of succession are complex and the Bill will need to reflect the various scenarios that can occur when one member of a couple dies.

In the case of a surviving spouse, this person has clear rights under the Succession Act and the appointment of a family successor under this Bill cannot in any way usurp these rights. The successor is appointed for the purpose of the Nursing Homes Support Scheme (Amendment) Bill is there for one reason only, to ensure the farm stays in family ownership. The surviving spouse has clear rights under the Succession Act and there is no way a family successor can usurp that. Although the family successor is expected to actively work the farming business, it is not necessary under this Bill that the family successor ultimately inherits or has any rights at all to the farm or the business. That needs to be made very clear. This is not a condition of receiving the relief offered under the legislation.

Therefore, nothing in the Bill could prejudice or negatively affect the rights of spouses of those who enter care services and seek assistance towards the cost of their care under the Bill.

Accordingly, while I recognise the concerns raised and will be sure to raise them with my colleagues in government, the issue is not sufficiently closely linked to the Bill, which is focused specifically on the operation of the nursing homes support scheme and the assessment of farms and business assets, to justify the inclusion of the amendment. As a result, I cannot accept it.

I am very relieved to hear what the Minister of State said about the Succession Act. It is perhaps unhelpful that it is the same term, but it is a matter to be teased out. I would appreciate if she could provide me with a note on successors and the Succession Act. It would be useful and reassuring to people. In the context of those inheritance issues, the recognition of the role of spouses is hard won and anything that could erode that would be a concern. It is good that the Minister of State has outlined the primacy of the Succession Act over the successor role set out in the legislation before us.

It is good that the same asset can be used for both members of a couple but as my concerns relate to a scenario where one spouse remains at home or on the farm, there are still measures to be teased out. I do not think the Bill will create an inequity but rather because of how it intersects with succession and inheritance, it creates a need for care and vigilance. Having this conversation is useful in that regard, as will having further engagement on it. Succession and inheritance is complicated, as the Minister of State noted, and it is important to have an eye to anything that intersects with those issues and the complexities we all know examples of unfolding.

I look forward to engaging further with the Minister of State on the issue.

Amendment, by leave, withdrawn.

I move amendment No. 6:

In page 59, between lines 34 and 35, to insert the following:

“Report

33. The Minister shall, in any review of the Scheme or the operations of this Act or the Principal Act, include an analysis of the impact of the amendments of this Act and a review and recommendations in respect of social protection entitlements of family members of the person who has entered into the Nursing Homes Support Scheme.”.

Amendment, by leave, withdrawn.
Section 33 agreed to.
Title agreed to.
Bill reported without amendment.

When is it proposed to take Report Stage?

Is that agreed? Agreed.

Bill received for final consideration.

When is it proposed to take Final Stage?

Is that agreed? Agreed.

Question proposed: "That the Bill do now pass."

I am sure the Minister of State is delighted that the Bill is going to pass today. Much effort was put in to ensure it would be taken now as opposed to in September, and she championed it and ensured that would happen. It will make a big difference for many people. I invite her to say a few words on the passing of the Bill.

I acknowledge the help and support the Cathaoirleach gave me over the past two weeks to ensure the Bill, which only passed Report Stage in the Dáil on Wednesday, would be taken in the Seanad on Second Stage yesterday and on Committee and Remaining Stages today. I thank all the Senators for their contributions to the debate and for their time, yesterday and today. Many of them have waited until the end of the debate even though it is the final sitting day before recess. I watched all my colleagues go home yesterday at 3.30 p.m. but I was delighted that the Seanad could sit late on a Friday evening, so I thank Senators very much for that.

It has taken some time to get to this point. Since I was appointed Minister of State with responsibility for older people and mental health, I have pursued the scheme's implementation as an absolute priority. Family farms and small businesses perform a vital role in providing employment and enhancing the future development of rural Ireland. For communities and families, they are not only an essential means of making a living but may also represent priceless assets, a link passed between generations and a connection to the land itself. I acknowledge my predecessor, the then Minister of State, Jim Daly, who got the ball rolling. It would be remiss of me not to mention him. The legislation was in progress when I took up the role and I recall discussing the Bill and statutory home care with him, among other matters.

It is essential that farms' value be protected in case people must enter long-term care in order that they remain viable and sustainable for families long into the future. The legislation will ensure that the fair deal scheme will operate more fairly for these families. It will mean farm families and business owners will not be afraid to go into long-term care because of what it might mean for their plans to pass on property. I am sure it will be welcomed throughout rural Ireland. I am delighted to have brought the legislation through the Houses and I extend my thanks to all those who have played a role in getting us here - Senators, Deputies and my colleagues in the Government - for providing the drive and challenge to move the agenda forward.

I thank the Attorney General, who has been very supportive to me. We have had many conversations because although the Bill sounds simple, it is highly complex. I thank the stakeholders representing older people, farmers and business owners for their input into the legislation. I thank also the officials in the Department of Health, the HSE and other State agencies for working tirelessly to develop the complex legal mechanisms behind the reform. I thank Ms Fiona Larthwell and Mr. Neil Kavanagh for their tireless work and for the hours and hours that have gone into the Bill, as well as their interaction with the Attorney General and officials. Lastly, I acknowledge the farm-owning and business-owning families of Ireland, in whose name this has been done.

I thank and congratulate the Minister of State.

The Minister of State has thanked and congratulated everybody for their role in bringing forward the Bill and they all deserve our thanks, but it is the Minister of State who has championed the Bill. I recall speaking with her soon after she was appointed, when she said she was going to get this done. She had a meeting with Alice Doyle from Wexford and told her that the Government was going to get this completed.

This will be transformative. We often talk in the House about the impact that legislation has, but for farm families and business-owning families, this will be truly transformative. In the course of a year, through the work she has done regarding mental health and older people, the Minister of State has shown her mettle but also her empathy. She noted that this is complex legislation. The people she has had in mind throughout the process are those farm families and individuals who are affected and the Bill will make a big difference. To her, her officials and all who have been involved, I say "Well done". Everybody in the House wanted to ensure the legislation would be passed before the summer break, so I thank the Cathaoirleach and Mr. Martin Groves, Ms Bridget Doody and all the team in the Seanad Office. May we all have a peaceful and enjoyable summer.

I echo the sentiments expressed by Senator Malcolm Byrne. The Minister of State has done a great job with the Bill. She spoke about the support structure around her, comprising officials and stakeholders such as farm families and business-owning families. As many of us in the House come from business or farm backgrounds, we know how important this is. The Bill will make a difference to the lives of older people and we have got it through the Houses in 12 months. We are here to make a difference to the lives of citizens. I hope the Minister of State will have some time off over the summer because there is much work to be done in September. I thank also the Cathaoirleach, Ms Bridget Doody and Mr. Martin Groves for their tireless work.

I thank the Minister of State for making sure this legislation was passed. It was in the programme for Government. All of us were lobbied, especially the rural Members, by the IFA etc. to make sure. We gave commitments to them it would be done before the summer recess and it has. I have a small business at home myself. Please God I will not have to go into a nursing home in the short term but it gives a sense of comfort that there is a safeguard. That is what we do in business: try to build up a business our kids will have, please God, and perhaps can make a living out of. We have seen and know of instances where family farms had to be sold. Well done to the Minister of State and her officials on getting it through. It is an important day, particularly for rural Ireland and for rural farmers.

I thank the Cathaoirleach, Martin Groves and all the staff. Enjoy the summer recess.

Well done to the Minister of State. I commend her on the Bill. I know from the previous Oireachtas the real care she brings and the work she has done for those who are most vulnerable, their families and those around them. This is a very positive Bill and a very positive step forward. I commend her on that and look forward to engaging further on the issues we highlighted. I think the Minister of State understands they will be key, important parts around changing the perspective and experience of those who are older in Ireland, and of those with disabilities and their families, in terms of care. There is a whole set of pieces and this is one very good and constructive part of a new jigsaw. I commend the Minister of State and her officials on it. I thank the Cathaoirleach.

I thank Senator Higgins and all those who tabled amendments. I know that Senator Higgins submits a lot of amendments, sparks a lot of debate and discussion, and gets people, including Ministers and officials, thinking. That is why amendments are tabled and why we have debate. That is why legislation changes as it goes through the House. Ideas and issues arise because of amendments being submitted by Senator Higgins and many others. I thank them all for the effort that is put into drafting and submitting those amendments.

I join all my colleagues in complimenting the Minister of State and her officials on their hard work. From talking to the Minister of State, I know she appreciates very much what her officials have done here. This Bill is huge for counties like my own, Roscommon, as well as the Galway region and for all rural areas. I knew about it before I came into the Oireachtas in 2016, but once I came in, it was a massive issue. Deputy Butler is a most caring Minister of State and I am delighted she got this through here today. I also welcome the debate from every side of the House. The debate over the past two days has been very important and, of course, the Cathaoirleach has played his own part in accommodating getting this through, which is very important. Well done to the Minister of State and her officials. I thank Martin Groves, Bridget Doody and all the staff here as well for all their help over recent months. I wish them a good and happy summer.

I join colleagues in complimenting the Minister of State on getting this very important legislation through. I also acknowledge my former colleague from Cork South-West, former Deputy Jim Daly, who did so much to make sure the legislation came to where it is today. It is very important legislation which will give peace of mind to so many families. I compliment the Minister of State and her staff on bringing forward the legislation. It is the fair deal again. It is the deal we want. It is the deal for Ireland, for rural people and for those in society of an age who need to be supported. There were issues with the Attorney General and issues which were very complex. I was made aware of them during the past two or three years. Getting through those important legal issues is a craft and I acknowledge the Minister of State and her staff for getting through them. Now, it is a case of getting the legislation enacted and moving forward in the next 90 days when that legislation comes into law. Then we will truly have a fair deal for a generation that needs it.

There are not too many farms in my home constituency, but I do have family from Mayo and it has been an issue with neighbours and people known to us. I congratulate the Minister of State on this. It has been a lot of hard work in the past year and by the previous Minister of State, former Deputy Jim Daly before that. It is part of addressing sensitively a whole suite of measures for older people and the vulnerable in our community. We need to ensure we are looking at family carers. Getting the Assisted Decision-Making (Capacity) Act into being is my big thing, and the amendments.

As well as the announcements of this week, home caring is very important. There are people who do not have someone to speak up for them. They laugh at me because I have my name on my mask, but it is because I go out to people's houses who have family who have emigrated, whose families are all around the world and who have no one to advocate for them. I do things public representatives do not normally do. It could be that their landline is gone or simple things like that because there is no one there for them. I tell before I visit them that my name will be on my mask and they should not be afraid to open the door. We are on a fantastic trajectory under the Minister of State's leadership. I thank her and congratulate her. I hope she enjoys this moment because it is well deserved.

Having worked with the Minister of State in the previous Dáil when she was a Deputy, I know her work ethic. She was our spokesperson on older people and I know this has been an issue on her agenda. When she was appointed Minister of State, I know what it meant to her. Today is another milestone so I congratulate her on her success in getting this important legislation through that we were all looking for. I also thank her officials.

Finally, I thank Martin Groves and all the staff over the year. I especially thank the cleaning staff who knock on our doors quietly and come in and clean the handles and all around us to make sure we are safe. Well done to the Minister of State; I congratulate her.

I commend the Minister of State on having the Bill passed this evening. She has been committed to this issue for years. When we were in opposition, she advocated for a long time for the need for these changes, recognising their importance to families. It is to her great credit and that of her officials that she has come here, a year into office, and successfully completed that work.

As I said earlier, it is only one aspect of a series of reforms she seeks to address. I mentioned our meeting in Navan this week and how she would ensure people would remain in their own homes for as long as possible. This is alongside the work she is doing with local government and chief executives such as Ms Jackie Maguire. As the Minister of State goes home on this beautiful summer's evening, it is successful for her but more so for the people on whom this will impact - the farm families. I congratulate her and her Department.

I spoke yesterday on Second Stage. I join others in complimenting my Waterford colleague, the Minister of State, Deputy Butler, on ensuring this legislation passed all Stages before the summer recess. It is fantastic that such positive legislation will have an impact on so many families right across the State, in both rural and urban Ireland. This is not just about farm families but also business owners and the passing on of businesses to the next generation. As I said yesterday, when we look to a jobs-led recovery after Covid, we need to look at the next generation of young people taking over business assets and driving the country's recovery on.

I genuinely compliment the Minister of State, Deputy Butler, and her predecessor, Jim Daly, on all their work. I thank her officials and the Oireachtas staff, particularly the Cathaoirleach, Mr. Martin Groves and all the Seanad Office staff. I hope everyone has an enjoyable recess and we will see everybody bright and ready to go in September.

Question put and agreed to.

I again congratulate the Minister of State. When is it proposed to sit again?

At 2.30 p.m. on 21 September, here in Leinster House.

The Seanad adjourned at 6.10 p.m. until 2.30 p.m. on Tuesday, 21 September 2021.