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Dáil Éireann díospóireacht -
Thursday, 26 Mar 1992

Vol. 417 No. 7

Ceisteanna—Questions. Oral Answers. - Nursing Home Payments.

Richard Bruton

Ceist:

4 Mr. R. Bruton asked the Minister for Health whether his attention has been drawn to the hardship being caused by the failure to provide a proper system of subvention to patients requiring long-stay care in nursing homes; and if he will make a statement on the matter.

Michael D'Arcy

Ceist:

58 Mr. D'Arcy asked the Minister for Health if he has satisfied himself with the present system of nursing home subvention where access to subventions vary radically from one health board to another and where, even in the best cases, the spouse at home is left on poverty income.

Séamus Cullimore

Ceist:

136 Mr. Cullimore asked the Minister for Health if he will outline the up-to-date position regarding new cash grants to cover annual nursing home payments under the Health (Nursing Homes) Act which will benefit many thousands of families with elderly relatives that are struggling under enormous pressure to cope on very small incomes.

I propose to answer Questions Nos. 4, 58 and 136 together.

I agree with the Deputy when the says great hardship is being caused. It is recognised that the present system of subvention in respect of dependent persons in long-stay care in nursing homes is unsatisfactory in many respects. The purpose of the Health (Nursing Homes) Act, 1990, is to establish a new framework for the regulation of the nursing home sector in Ireland and a new system for the payment of subventions to dependent persons in genuine need of nursing care.

Section 7 of the Act provides for the introduction of an equitable system for the payment of subventions according to standard criteria throughout the country. Under the Act a subvention may be paid by a health board to a person following an assessment of the person's level of dependency and of his-her means and circumstances.

The details of the new method of subvention will be set out in regulations under the Act. The drafting of these regulations is at an advanced stage. The draft regulations will be the subject of discussion with nursing home interests and bodies representing the elderly. When these regulations have been finalised the Health (Nursing Homes) Act, 1990, can be commenced. It is my intention to commence the Act later this year.

Would the Minister not accept that it is a scandal that we are still waiting for this system to be put in place? His predecessor announced that it would be put in place by the end of last year and it was first mooted in 1988, four years ago. It is unacceptable for the Minister to say that his departmental officials are still working on the regulations, given the discriminatory practices in relation to access to subventions as between the Eastern Health Board area and other health board areas and that many people who have a statutory entitlement to be accommodated in a public nursing home have to scrape and scrounge in a way that was not envisaged by the Health Act, 1970. Would the Minister accept that it is unacceptable to say that his officials are working on the regulations and that the Act will commence later this year? Would he give us a date today and stick by it, as he was prepared to do earlier in relation to the appointment of the consultant?

Yes, it should commence earlier, but if I make any more demands of that Department I am afraid that they will lock me out. Since I was appointed I have been pushing and pressing them. I am very concerned about this matter and I only hope that legal action is not taken against us over it. I agree with the Deputy but I have put the Department under a lot of pressure. I therefore ask him to bear with me. I can promise him that we will publish the draft regulations as soon as possible.

The Minister's predecessor said the very same thing, that the drafting of the regulations was at an advanced stage and that they would be published before the end of 1991. It now looks as if we will not have them before mid-1992. Like his predecessor, the Minister is not giving any clear commitment to give us a definite starting date.

I wish I could be more accommodating but I cannot. The Deputy will have to take my word for it when I say that the matter is being attended to with great speed. The matter is not as simple as we would like it to be. When I sat on the opposite benches I, too, made demands and I ask the Deputy to believe me when I say that the matter is receiving attention. While I do not think it will commence before the middle of the year, when I say "this year" I mean this year.

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