I thank you, Sir, for allowing me to raise this matter on the Adjournment and I thank the Minister of State, Deputy Moffatt, for coming in to the House to respond.
The means test for nursing homes subvention is unfair. All sons and daughters of an elderly person must be means tested before the subvention is decided. If a member of a family does not co-operate with the health board, the subvention is not paid. In such circumstances, health boards usually state the subvention is refused on the grounds that insufficient information was submitted. The subvention is also refused if a member of the family is over the income limit. If a means test must be carried out for the subvention, it should be done on the members of the family living with the elderly person concerned. If all members of the family must be means tested, income limits and allowances should be increased. With a maximum payment of £120 per week, it is obvious that extra funding must be provided by the family. I understand the cost to the State of geriatric care in a health board hospital is in the region of £300 per week and health board hospitals are free of charge.
The Ombudsman commented on this issue on 7 November 1997. He referred in particular to the regulations laid down under the Health (Nursing Homes) Act when it commenced in 1993. He stated:
The Minister's regulation defined the term "circumstances" as the ".capacity of a son and/or daughter, aged twenty one years and over residing in the jurisdiction. to contribute towards the cost of nursing home care of his or her parent." On the basis of the interpretation of the regulation relied upon by most of the health boards, the practical consequence has been that subvention decisions take account of the capacity of a son or daughter to contribute to a parent's nursing home costs. The subvention otherwise payable is reduced by the amount by which a son or a daughter is considered by a health board to be in a position to contribute. And this line is generally taken irrespective of whether the son or daughter wishes to contribute, is actually contributing, or is contributing at a rate less than the health board's figure. In effect, the regulation is being generally operated as if the adult children had an obligation to contribute to the parent's nursing home costs.
As far as I am aware there is no statutory obligation on children to support their elderly parents. The Health (Nursing Homes) Act does not create any such an obligation. Nor is there anything in that Act to suggest that the term "circumstances" should be defined in the way it has been defined by the regulation.
I understand the Ombudsman is continuing to examine the matter and I hope he will make a recommendation in due course.
Families are making financial contributions towards the cost of nursing home care because the maximum subvention is only £120 per week. What happens if people are not entitled to the subvention? Is it possible to review an application after a number of months? It is difficult for families to contribute to nursing home care for many years.
The Ombudsman went on to state that some injustices had become endemic in the public service and were alienating citizens from the State. People are particularly alienated if, say, all ten members a family must be means tested under the nursing homes subvention regulations. I know of many such cases in my constituency in east Galway. I would like the regulations governing the means test changed.
