As a newly elected county councillor to the area, one of the principal problems I encountered related to nursing homes in Bray, County Wicklow. This extends as far as Greystones and probably further down the eastern coast of County Wicklow. There are at least 25 nursing homes in the Bray/Greystones area, the majority of which are situated in Bray itself. During my canvass and campaign of that area I found that the unanimous complaint from these nursing homes was about the delays in payment from the Eastern Health Board. I was rung up by one nursing home owner who complained about this and I confirmed the problem with every other owner and proprietor of a nursing home I came across in Bray. This causes extreme difficulty for nursing homes because it is impossible for the owners to plan their financial year or their future. I do not need to remind the Minister that these homes are looking after people of a very old age, many of whom are senile, some of whom have Alzheimer's disease. Many of them are incontinent and for many reasons are incapable of looking after themselves. They need constant attention and care of a very sophisticated variety.
The subvention to these patients is, I believe £39.55 per patient a week, given to them by the Eastern Health Board. The problem is that these payments are late; they are extremely late and are getting later. It is now July and has not only the June payment not been paid but, as of the day before yesterday, when I checked with some of these nursing homes, the May payment had not been made, the April payment had not been made nor had the March payment. These nursing homes are at least four months behind in their subventions from the Eastern Health Board. Even worse, when I checked today, one nursing home had received one payment and another nursing home had received two together.
I maintain that the Eastern Health Board's methods of payment are so chaotic that the very existence of these nursing homes is at risk. They do not know when they will get these subventions which are their lifeline and the basis on which they operate. I asked several nursing home owners what the situation was when they got in touch with the Eastern Health Board. They understood that the payments would be made maybe one month in arrears. They all said categorically that when they got in touch with the payment section in the Eastern Health Board they were put off. They were passed to someone else, their queries were deferred but they were never given an adequate answer either regarding the delay in payment or when they would actually get paid. They were given excuses. Some were informed that they had been told not to release cheques yet, others were told the cheques needed extra signatories, and some were given other excuses such as that it was not their responsibility. They were told anything to get them off the telephone, but they were not told when they would get the cheque to which they had a right. As a result of these appallingly erratic payments — and that is the most charitable way of putting it — the nursing homes in Bray and Greystones are working on very large overdrafts and are finding it extremely difficult to make ends meet. They have overdrafts of tens of thousands of pounds which result in very small profit margins, if they make any profit at all at this stage. It is unreasonable that the Government, through the Eastern Health Board, should be putting those involved in a very necessary and relatively unprofitable venture under this sort of pressure. Playing about with the patients' health should not be permitted by a Government or by the Eastern Health Board.
Another complaint I have heard but have not confirmed — maybe the Minister will be able to confirm or deny it — is that the Eastern Health Board pays smaller subventions to nursing homes than any of the other health boards. The rest of the country gets £7.02 per patient per day while the Eastern Health Board only pays out £5.65. Many of the nursing homes paid by the Eastern Health Board get assurances in writing every July that they will receive increases but they never materialise. As a result it is impossible once again for the nursing homes to plan. There is a breach of promise by the Government to those involved in a very vital health service. The Minister should realise this, even though the objective of most nursing homes is to make a profit and their proprietors who have wide experience in the nursing world also want to make a profit.
If the Government, through the Eastern Health Board, deny the nursing homes the possibility of making a profit, then the nursing homes will have to close. As a result the Government will inevitably have to take on that responsibility, will have to set up State nursing homes and will have to take on the responsibility for these geriatric patients, many of whom are totally incapable of looking after themselves. That is the doomsday picture but it may be the reality in Bray or Greystones if these people are not given assurances about the time and the amounts they will be paid. I would like the Minister to give me firm pledges, which will be kept, about these payments and tell me what the timelag will be.
At the moment the proprietors are living in wonderland waiting for their cheques. They are ringing the Eastern Health Board three, four or five times because the payments are three and sometimes five months overdue. The inevitable result of this will be that the patients' health will suffer, the banks to whom these nursing homes are in debt will sooner or later say they can go no further. I have seen the overdrafts some of these people are running on and I do not understand why banks have given them these overdrafts. They are given on the basis that there is a cheque coming from the Eastern Health Board. It is an impossible way to run a business and it is utterly wrong that any health board should pay out so erratically and so sporadically. I would like the Minister to tell me that in future these payments will be paid on time, and will be paid regularly.
