Brian Cowen (Laois-Offaly, Fianna Fail)

The review does not terminate the relief schemes. We are reviewing them this year and we will make decisions for the future. They continue to operate as heretofore until that review is completed. That is the way the system works.

It would be wrong to suggest that we have a situation which is outside a regulatory framework. There is the Health (Nursing Homes) Act 1990. Where we have a private sector in regard to the provision of health care, we have a regulatory regime in place.

The substance of amendments Nos. 12 and 15 was considered by the select committee as a result of a similar amendment tabled by Deputy Burton and we had a wide-ranging discussion on the issue. I indicated on Committee Stage that the nursing homes involved are those which come within section 2 of the Health (Nursing Homes) Act 1990 which are registered under section 4 of that Act. Section 6 of that Act also provides for the making of regulations by the Minister for Health and Children in regard to the standards of these nursing homes. In particular, the regulations provided for under section 6 of the 1990 Act govern adequate and suitable accommodation and they allow the Minister for Health and Children to, among other things, prescribe requirements as to the design, maintenance, repair, cleaning, cleanliness, ventilation, heating and lighting of nursing homes; the accommodation, including the amount of space in bedrooms and wards; the washing facilities and the sanitary conveniences provided; and the food provided for dependent persons in them. Such regulations issued in 1993 as the Nursing Homes (Care and Welfare) Regulations 1993 (Statutory Instrument No. 226 of 1993). Accordingly, there is a regulatory system already in place in regard to the registration and operation of these nursing homes and the standards they must meet. This regulatory system was in the past administered by the health boards and will in future be administered by the Health Service Executive.

It is important that we do not engage in double thinking on this issue. Deputies would acknowledge that if we did not have such an increase in nursing homes we would have a serious problem. This relates to what I said earlier. We need to be pragmatic. We will continue to invest in public nursing home provision. We have been doing that and we are required to do so because of demographic trends in terms of the need to care for the elderly going forward and to plan ahead. There will always be nursing home places in the public sector. There are also nursing home places in the private sector.

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