Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I support amendment No. 2 in the name Deputy Twomey, which seeks to address the issue of long term care for the elderly and the need for the Minister to prepare over a three month period a plan for the funding of care for the elderly in public and private nursing homes. We should look at access to long term care on the basis of need. I regret that throughout the Bill we see a reflection of financial consideration as the primary consideration, which shows the heavy influence of the Department of Finance continues under her Ministry as it was clearly intrusive in decision-making by the former Minister, Deputy Martin.

Like Deputy McManus, I too have had amendments disallowed on the basis allegedly that, in the opinion of the Ceann Comhairle, they involve — there is no might about it — a potential charge on the Revenue. I was seeking to include the words "the state of health of the person", as one of the critical reasons that should be taken into account in assessing a person's entitlement in any regard under any of our health Acts, yet section 1 of this Bill provides that the Health Service Executive shall have regard to the person's overall financial situation.

There is no mention of a person's state of health or his or her health needs. Clearly, financial considerations are predominant and the prevalent thought on the part of the draftees of the Bill and, with respect, the Minister and her colleagues who are failing to take on board the state of health of the person concerned. Some of my amendments included this but they have been deemed by the Ceann Comhairle to involve a potential charge on the Revenue. We are talking about the provision of health care, either medical cards or access to long-term nursing care. It is surely not on the basis of financial considerations that we should make these judgments but on the basis of the health needs of an individual citizen. Until such time as need alone becomes the guiding principle in the determination of future health policy, there will be a serious dichotomy in this Chamber. The difference between the Government's position and that of the collective Opposition has been demonstrated on many occasions.

Deputy Twomey's amendment proposes a timeframe of three months for plans for funding the care of the elderly. I referred to a case on a previous occasion in the House when the Minister was absent but the Minister of State, Deputy Power, was present. He may recall I instanced what I regarded as a grossly unfair and wounding decision in respect of an elderly lady and her family. Her children were forced by the North Eastern Health Board to sell her house because she was not in a position to make that decision. They were forced to sell their small terraced home in my home town of Monaghan in order to finance her stay in a private nursing home.

I wish to recap on the detail of this case because Deputy Twomey's proposition would require that the Minister and her colleagues take into account the reality ordinary people are facing by virtue of the strict and uncaring code applied by health boards and now the HSE. The lady concerned had small life savings and was advanced in years. Her savings amounted to €11,000. She was a mother who had brought up two families in a small terraced home. She had sought access to the State-run nursing home available in County Monaghan but she was refused subvention and access because she was the owner of this small home.

The lady concerned has four children. While none of them lives with her, it has always been their home. They have visited it from the day they left to go out into the world. It is where they grew up and all their childhood things are kept in their respective shared rooms. They have come back either from England where some are now domiciled or other parts of Ireland to visit their mother on a regular basis.

The lady concerned stayed for more than 100 days in a local hospital as the health board argued her care was her family's responsibility. This was outrageous. The poor woman and many like her would be described by those who give little thought to the circumstances in which she found herself as a "bed-blocker". It is outrageous to shift the blame and responsibility to the poor elderly person concerned who seeks, deserves and has every right to access long-term nursing home care. I reject that term because it quite clearly removes the focus from where the blame deserves to be placed, on the failure of the system to recognise the need of the woman concerned and the needs of all other women and men. That is where the blame must rest.

The family concerned has been forced to sell their home, valued at €150,000 in today's terms. This money has been set aside to pay for her care in a private nursing home. While their mother is alive, the family members have been forced to go through the entire grieving process. They have been forced to dispose of their home, all of their personal effects from their childhood, everything that was dear and important to them in coming home to visit their mother. It is all gone. When their mother does pass away, they will have nowhere to bring her in order to grieve, mourn and wake her, which is still very much a part of the culture of rural Ireland, not only in small towns and rural locations but also in a greater part of Irish society. They will have nowhere to go but an impersonal nursing home facility and perhaps one of the new funeral homes in advance of requiem Mass and burial. This is absolutely awful. I can only imagine how any of us would react if we were faced with the same set of circumstances.

There is a bounden responsibility on the Government to take such situations on board. I have to recount the case in the House again because it hurts and pains the family concerned and the wider community, the members of which know the hurt and pain the family have suffered.

I hope the Minister will adopt Deputy Twomey's amendment which is reasonable. I ask that she take into account the circumstances of the dear lady concerned and her family and many countless others throughout the jurisdiction. The widest concentration possible is necessary for the Minister and her colleagues, the Ministers of State in the Department of Health and Children, and their officials to be fully cognisant of the reality with which people in our communities are dealing. I have only given the House one example. I can only say the hurt and pain caused in this case have been quite severe.

I have a reasonable proposition for the Tánaiste. I ask her to undertake within a reasonable period such as the three months suggested in the amendment — I have no doubt the matter could be revisited — to carry out a study and report back to the Houses of the Oireachtas on her plans for the future funding of the care of the elderly. That is what the House needs to hear, discussion and debate in order to produce a set of regulations or commitments — Government policy in the main — to ensure we can erode the injustices which people continue to suffer on a daily basis. The situation, as it stands, is based on financial considerations, not on the needs of individual patients and applicants for residential care in public nursing homes.

See this speech in context