Dáil Éireann Debate, Tuesday - 23 November 2004
185 Mr. Penrose asked the Tánaiste and Minister for Health and Children the position in relation to the provision of nursing home care for persons who are over 70 years of age and who hold medical cards; if this will be provided free under the terms of the Health Act 1970, as amended; the steps she is taking to ensure that those who have paid for the service to date will be refunded their payments; and if she will make a statement on the matter. [29950/04]
View answerEligibility for health services in Ireland is primarily based on residency and means. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board other than for persons aged seventy years and over, who are automatically eligible for a medical card. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship. However, central to our system of publicly funded long-term care is the principle that it is fair and reasonable that those who can afford to contribute to the cost of their long stay care should do so. The health strategy reinforces this point and states that:
It is recognised that quality care is expensive and that the bulk of the cost of providing a high standard of quality care should be borne by the Exchequer. Nonetheless, it is fair that all those in receipt of publicly provided residential long-term care should make some payment towards accommodation and daily living costs, if they can afford to do so, just as they would if they were living in the community. This principle supports the aim to provide as high quality a service as possible and to make the most equitable use of resources and thus to help maximise the availability of these services.
The current position reflects this approach.
Under the Health (Nursing Homes) Act 1990 health boards may pay a subvention to assist a person in meeting the cost of private nursing home care. It was never envisaged that this subvention would cover the full cost of nursing home care. The Department of Health and Children has established a working group to review the operation and administration of the nursing home subvention scheme. The health strategy outlined in the document Quality and Fairness — A Health System for You acknowledges the need to clarify and simplify eligibility arrangements and sets down a commitment to introduce new legislation to provide for the introduction of clear statutory provisions on entitlement and eligibility.
A review of all existing legislation in this area has been carried out in my Department which will inform the approach to the drafting of new legislation in this area. As part of this exercise, my Department will attempt to resolve the current differences in approach in the consideration of the ability of individuals to pay under the various regulations in this area. Arising from concerns about the current practice of charging for long-stay care in health board institutions, the matter is being examined with regard to advice from the Office of the Attorney General with a view to clarification of the situation at an early date.
