I propose to take Questions Nos. 324 and 325 together.
Charges for long-stay in-patient services were provided for under the Health (Amendment) Act 2005 and came into effect on 15 July 2005 under the subsequent Health (Charges for In-Patient Services) Regulations 2005. These Regulations have been amended on a number of occasions since then, most recently by the Health (Charges for In-patient Services) (Amendment) Regulations 2011, which came into effect on 23 July 2011.
The Act provides that the maximum weekly charge cannot exceed 80% of the maximum rate of the weekly State Pension (non-contributory). The Regulations made under the Act provide for two different classes of charges:
- Class 1- charges for those receiving in-patient services on premises where 24 hour nursing care is provided are based on income (subject to a current maximum of €175 per week) and
- Class 2- charges for those receiving in-patient services on premises where 24 hour nursing care is not provided are based on income (subject to a current maximum of €130 per week).
The maximum charge applicable since July 2011 for Class 1 (€175.00) represents just under 80% of the weekly State Pension (non-contributory) while the maximum rate for Class 2 (€130.00) represents almost 60%. These charges are structured to ensure that those paying charges retain a minimum income for personal use i.e. at least €33 per week for those paying Class 1 rates and at least €64 per week for those paying Class 2 rates.
A person in receipt of Disability Allowance at the current maximum rate of €188 p.w. would be liable, subject to a financial assessment, to a maximum charge under Class 1 of €155 p.w. and under Class 2 of €120 p.w.
Section 53(4) of the Health Act 1970 provides that the HSE may reduce or waive a charge imposed on a person in order to avoid undue financial hardship to that person. To assist in the fair application of the provisions of the Act and the related Regulations, the HSE has developed national guidelines for the determination and levying of charges for in-patient services, which include the need to have regard to the income of the person, the provisions of the Regulations and the patient's individual circumstances.
Subject to exceptions specified in the Act, charges are applicable to the maintenance element of in-patient services provided to a person under section 52 of the Health Act 1970 for a period of over 30 consecutive days (or an aggregate period of over 30 days during the preceding 12 months). Among the exclusions from these charges are persons who are subject to the provisions of the Nursing Homes Support Scheme Act 2009 ("the Fair Deal") and those in acute hospitals who require medically acute care and treatment.
The facilities to which the charges apply include all hospitals, convalescent homes and homes for persons suffering from physical or mental disability in which the HSE delivers, or arranges for the delivery of, in-patient services. I understand that the HSE at present arranges for and funds the delivery of services, including long-stay residential in-patient services, to a number of individuals in the facility referred to in the question.
The HSE is required under the 2005 Act to levy the appropriate charges on individuals in receipt of in-patient services, subject to any relevant exemptions, waivers or reductions provided for in the Act and the Regulations. The funding derived from these charges is directly applied by the HSE towards the provision of health services. Provision of quality public long term care is expensive and it is fair and equitable that those in receipt of such care should pay towards its cost in accordance with their means.
There are no proposals to extend the application of the Act or related Regulations from January 2013.
