Catherine Murphy (Kildare North, Independent)

We heard positive news today that the scheme is back on track. However, I have many questions. I would have preferred to have had a question and answer session rather than one in which Members make statements after the Minister's speech.

I gave conditional support to the fair deal scheme when it was introduced because of the absence of sufficient numbers of publicly funded nursing home places and because there were two levels to the subvention scheme. The first of these was inadequate as to cost. The second was rationed where it was focused on higher dependency and very often that posed its own difficulties. That scheme was available during the good years; we all know the economic straitjacket that exists today.

Prior to the introduction of the fair deal scheme many people were in acute hospital beds rather than in nursing homes. "Blocked" beds was a derogatory term that was very hurtful to people who had paid taxes all their lives. We were at risk of repeating that situation for people who had lost their independence but who had paid their taxes throughout the years, hoping services would be there to meet their needs when they became older. When a person is a long-stay patient in an acute bed his or her quality of life is very much reduced. The Minister will understand that point.

I have some questions and hope the Minister will be able to answer some of them. He stated he was unhappy with the information and historical data provided. If one designs an information system one does so against the system already in place. That tells me the system now in place is sick. All of us know that a computer system can only sit on the physical system provided. One must re-engineer the processes if one is to have a proper system that can deliver the kind of information which is needed. That must be addressed.

I am very concerned by some of the points the Minister made. Will physiotherapy, occupational therapy and other kinds of services be available to people who will now enter nursing homes? Where else might they be provided if not in nursing homes? I may have picked the Minister up wrongly but I believe he stated patients would stay for four years in nursing homes rather than two and a half years. My understanding of the fair deal scheme is that one pays for the first three years but not after that period. To me, this comes across as offering a "free year"; that one should not get in unless one is sick. Perhaps he might return to that point because it comes across badly, at least as I understand how it was articulated. When highly dependent people such as those with dementia go into nursing homes - that is what such homes are for - the quality of life of others in such homes can be badly diminished. The mix is important. I completely support the care of people in their own homes. A radical job of work needs to be done to deliver a fair system. The embargo will have to be dealt with in that context. I would like to hear what the Minister has to say about that.

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