Dan Neville (Limerick West, Fine Gael)

I support the amendment to require the Minister to have a strategy to deal with funding for the care of the elderly. The Tánaiste will accuse me of repetitiveness but it is urgent that the issue of nursing homes is addressed. This is highlighted above all by the differences in the level of subvention being paid in the different health board areas. The enhanced subvention, for example, varies from €50 to several hundred euro between health boards. The wording of a reply I received from a health board in response to a parliamentary question I tabled indicated that the enhanced subvention could be as much as €650, although this figure may have related to total subvention.

We must have a policy on dealing with people who become infirm. Too often, as public representatives, we are contacted by families in difficulties because an elderly member has become infirm as a result of hospitalisation and the hospital wishes to force a decision on his or her future. Often, the family and the person's consultant or the hospital authorities will discuss a range of matters, including whether the person should move to a public or private nursing home, and the elderly person concerned is the last to be consulted. Elderly people in this position should be consulted on their preferences, even if they may not always obtain them, because their wishes must be taken into consideration.

Seven or eight years ago the then Minister for Health and Children issued a special code of practice on dealing with patients in hospital. Demographic changes caused by people living longer due to advances in medicine and an increase in the number of elderly people require that we introduce a code of practice on taking decisions about the future of elderly people, some of whom will have lived in an area or house for 50, 60, 70, 80 or 90 years. This code should apply to consultants and hospitals and should require them to ensure that elderly people in this position are put at ease, informed, understand what is happening and are assisted in every possible way.

The nursing home subvention needs to be urgently revisited. Public representatives are being contacted by an increasing number of families who have loved ones in nursing homes and can no longer afford to make up the difference between the subvention and pension, on the one hand, and the nursing home charges, on the other. Finding the balance, which is becoming ever greater, is causing increasing difficulties for the families concerned.

The State has recognised that the calculation of a person's means relates to the income of the person in question, rather than his or her family. Families also have a degree of responsibility to take care of an elderly person in accordance with their means. However, I know of a person in receipt of old age pension who must contribute €60 or thereabouts per week towards the cost of nursing home care for her husband. In another case, a couple in receipt of a British pension faced extreme pressure to survive because one spouse had to contribute towards the cost of nursing home care for the other. The husband, who was in care, has since died.

I wish briefly to voice my concern about an issue unrelated to the amendment. The Tánaiste must ensure the Department of the Environment, Heritage and Local Government takes action on the special housing aid for the elderly scheme. I have spoken to elderly people who applied two or three years ago for grants to do work on their houses, for example, to stop rain leaking into the house. I have to explain to them that they are listed as priority 2 or 3 and the local health board only deals with emergencies. Last year, my health board did not deal with cases listed as priority 1, 2 or 3. Those in question are elderly people who live alone, which is a condition of the scheme. When elderly people live alone, the least that should be done is to provide them with decent windows and doors, preventing the rain and wind from coming in and ensuring some level of comfort. Many request heating in their homes. It is difficult to understand why individuals, many of them up to 90 years of age and living alone, do not have some form of heating. Rural Members encounter elderly people living alone in such circumstances. The sooner the various special grants such as those for essential repairs, disabled persons and special housing aid for the elderly are rationalised the better. A decent scheme that will take care of the needs of the elderly living alone must be introduced.

I appreciate difficulties arise with certain cases. However, the worst situation I encounter is when an elderly person, looking for repairs to his or her house, is taken off the grant list because his or her daughter gave up employment to come home and take of care of him or her. The individuals concerned are deemed not to be living on their own. This is a difficult rule to explain to an 80 year old who was promised the work would be carried out. We expected this issue to be resolved because of promises to examine the process made by several Ministers for the Environment, Heritage and Local Government. However, the examination has continued for four years. This is an area where elderly people can receive care in their homes, allowing them to remain there for longer periods.

See this speech in context