Colm Keaveney
Question:83. Deputy Colm Keaveney asked the Minister for Health his plans to address the ongoing delays in accessing the fair deal scheme; and if he will make a statement on the matter. [42996/14]
View answerTuesday, 11 November 2014
Questions (83)
Oral answers (8 contributions)
The fair deal scheme is currently in crisis. Up to 2,000 vulnerable people are waiting for the processing of applications under the scheme. Will the Minister of State explain why this inordinate delay is being imposed on the public in the context of the need for care in geriatric services?
I thank the Deputy for tabling the question. Waiting times on the nursing homes support scheme placement list are now running at approximately 15 weeks. This is a matter of concern for me, and my Department and the HSE are working to ensure the available resources deliver the best possible outcomes for older people. This will require an integrated approach across community, residential and other service areas.
The HSE controls the release of funding to manage the financial allocation available across the year. Funding is released to approved applicants according to their place, in order of their approval date, on the national placement list. Over the couse of the year to date, demand has exceeded what could be funded and the national placement list has increased as a result.
In July this year, the HSE allocated €5 million for an initiative to improve access to appropriate care for older people. To date, this has funded more than 300 transitional care beds for patients in acute hospitals from the placement list for the nursing homes support scheme and more than 200 home care packages to assist patients in acute hospitals who require a home care package to be discharged.
The Government has provided additional funding of €25 million in 2015 to address delayed discharges. This funding will be targeted at hospital and community services that can demonstrate initiatives to address the specific needs of delayed discharge patients most positively and, therefore, improve timelines for admissions from accident and emergency departments and waiting lists. These will include measures to place patients in more appropriate settings through the use of home care packages and intermediate and long-term care. It will include provision for an increased allocation to the nursing homes support scheme. Planning for this initiative is well advanced. Details will be finalised in the HSE's service plan later this month, with a view to their early implementation.
The review of the nursing homes support scheme, which is under way, will consider the future funding and sustainability of the scheme as well as how community and residential services are balanced. This review will be completed in the coming months, following which the Government will consider how best to meet the needs of older people in the future.
The crisis has targeted the most vulnerable people. I would like the Minister of State to explain to the House the reason there is a 15 week waiting time in respect of the processing of applications under the fair deal scheme.
The Minister, Deputy Varadkar, in the recent past blamed the crisis on his predecessor.
The Minister is on record in that regard in terms of his comments that this money was being diverted to other locations within the budget. What plans does he have in terms of immediate intervention to ensure families whose loved ones are stepping down from an acute setting get their rights in terms of supports under the fair deal system? The costs they are experiencing in terms of the absence of that support, often up to €1,000 per week and the 15 week waiting period in respect of the processing of applications, are all resulting in great concern for families of elderly citizens.
I thought I had explained in the course of my response how the increase in the waiting time had occurred. The argument is being constantly made that the Government should not have moved the €23 million from the fair deal budget to the enhancement of home care packages. Not everyone wants to go into long-term care. The list has increased. As the Deputy rightly points out, and which we have known for some time, the waiting time now stands at 15 weeks. This is unacceptable. We are currently addressing how to bring waiting times down to a more acceptable level. We are very conscious that a number of years ago, because there was no control in relation to not only who entered the scheme, but how money was dispersed, that the scheme ran out of money very early on in the year. We are determined to ensure this does not happen again. We are equally determined that into the future the scheme is managed in a way that will ensure that those who need long-term residential care will get it and that the resources to ensure its availability are in place.
I agree with the Minister of State that long-term care is a last resort. However, the traditional care structure has been shattered by the Government's approach with respect to the carer's allowance, home help hours, respite grants and so on. Will the Minister of State agree that delaying or adjusting budgets in this manner, as has been done in the area of mental health in terms of the time delay in respect of a critically important appointment as set out in the HSE service plan last year, is having a devastating affect on families who need the support of the fair deal scheme, particularly those with elderly family members who are stepping down from illness in an acute setting? The Government's decision in this regard is impacting greatly on such families.
I do not agree with the Deputy that social infrastructure in this country has been devastated by the Government. The same 2,500 people are not always on the waiting list. Some 515 people move to the fair deal scheme each month. In other words, there is a roll-over system in place. People are moved onto the scheme in a chronological order, which is the fairest way. That is the way in which the scheme was written and is the reason it is such a good scheme. The Government has not devastated the social infrastructure of this country. It is wrong of the Deputy to say that. I believe people are determined to keep their frail, elderly parents and relatives at home. We are working on the issue. If we do not work on it and put a good plan in place, then the waiting time for the scheme will increase. We do not intend to allow that to happen.