Wednesday, 21 January 2015

Ceisteanna (10)

Seán Fleming


10. Deputy Sean Fleming asked the Minister for Health his views that the 300 extra places announced for the fair deal scheme in 2015 are sufficient to meet demand; when the review of the scheme will be complete; and if he will make a statement on the matter. [2409/15]

Amharc ar fhreagra

Freagraí ó Béal (7 píosaí cainte) (Ceist ar Health)

The budget for the nursing homes support scheme for this year is €948.8 million. The budget for 2015 reflects an increase of €10 million from the position in 2014. This €10 million increase has been allocated to the scheme as part of the initiative relating to the issue of delayed discharges and has allowed for the provision of an additional 300 long-term residential care beds. It has also reduced the time spent on the placement list from 15 weeks to 11 weeks.

My Department and the HSE are working to ensure the resources are available to deliver the best possible outcomes for older people. This will require an integrated approach across community, residential and other service areas. It is clear that even with this additional €10 million, the scheme will remain under pressure and the longer term position, therefore, needs to be carefully considered. The review of the nursing homes support scheme, as well as considering how the scheme has operated to date, is expected to identify some of the issues that will need to be considered and tested more fully into the future, including the future financing of the full range of supports for older people. Work is well advanced on this review and it is expected to be completed by the end of this quarter. As the scheme is statutory based, the implementation of recommendations arising from the review will require amendments to the Nursing Homes Support Scheme Act 2009.

I thank the Minister of State for that information. She claimed there will be a €10 million increase for the fair deal scheme which represents a 1% increase in its overall budget of €1 billion. That is insignificant. I would not even elevate it to a drop in the ocean as it will have no effect. The Minister of State stated it is intended to get the average waiting time down from 15 weeks to 11 weeks. I know many people who were on the waiting list for funding for 20 weeks. When they were finally approved for funding, they had to wait another 20 weeks before a cheque actually arrived to pay for the fair deal scheme. Despite the 1% increase in funding in 2015, we will still be 400 beds short compared to what was available in 2013. The Minister of State must address in her review the issue of the HSE's own community nursing homes.

I am also concerned that she said this review will require legislation. Will we even get to it in the life of this Government?

I always find it very difficult when people either misunderstand or choose not to listen. I am assuming the Deputy did not misunderstand but chose not to listen.

Rather like the Minister of State listened to the Minister for Agriculture, Food and the Marine, Deputy Simon Coveney, yesterday.

It is that type of talk - this €10 million is only a drop in the ocean - that got us into the position we are in today. As if €10 million did not have a significant impact for the extra 300 people who could avail of the scheme. It made a significant impact. This type of attitude towards public finances - that laissez-faire attitude that €10 million does not matter and throw in what is there - is what got us here.

We are very conscious that we must be careful about the difficulties in the provision of care for older people into the future. We are equally conscious that we do need additional resources. To be honest and straight about it, provision should have been put into the original legislation for this. I believe the fair deal scheme should be demand-led with tight access. We do not need new legislation - that is what Deputy Sean Fleming chose to misunderstand - but an amendment to existing legislation, namely the Nursing Homes Support Scheme Act 2009. The Deputy is long enough here to know that is not new legislation but an amendment to an Act.

An amendment to legislation will require a Bill to go through the House. That is new legislation in simple English. Legislation can be big or small.

Everyone welcomed the extra 300 places but there are still over 2,000 people waiting for the scheme. It is not even a drop in the ocean as far as those people are concerned. The Minister of State must address the issue of why she is seeking to privatise the scheme. We know about the differences between the Labour Party and Fine Gael, namely the latter is a privatisation party. I would have thought Labour had a bit more of the common interest and the good of the people at heart. I hope in this review the Minister of State will push for community nursing homes. We have spoken several times about Abbeyleix District Hospital and St. Brigid's Hospital in Shaen, Portlaoise, County Laois. For a small amount of money - a couple of million euro, not €10 million - 70 extra beds could be provided for the scheme which would be far cheaper than going the private route. It would also be far more economical to utilise the staff in those hospitals who are only dealing with respite care to provide services in the public community nursing home sector rather than privatising it.

It is the Government’s intention to have a combination of residences available to people in the scheme, a significant proportion of which will include the public sector. We have 129 public long-stay nursing homes residences. We cannot afford to lose any one of them whether it is at Shaen, Abbeyleix or Cork. We are in constant negotiation with HIQA, the Health Information and Quality Authority, about how that can be managed. We have made it very clear that we cannot afford to lose any of them. I am a great believer in public service and will continue to be. The public service provides a different service than that provided by the private sector. The private sector does an extraordinary job in certain circumstances but both are needed in this area. Both need to co-operate in this area too.

Written Answers follow Adjournment.