Seán Power (Kildare South, Fianna Fail)

I thank Deputy Cowley for raising this matter on the Adjournment. On behalf of the Tánaiste and Minister for Health and Children, Deputy Harney, I wish to outline to the House the current position regarding enhanced subvention in the western area.

Deputy Cowley and all Members of the House will be aware that the nursing home subvention may be paid towards the cost of private nursing home care where a person is unable to meet the cost or where he or she has been assessed as needing nursing home care by the Health Service Executive and where the person has satisfied a means test. The amount of subvention will depend on the degree of nursing home care required, that is, medium, high, maximum, and the amount of the person's assets including property, stocks and shares, savings etc. The rates of subvention payable are as follows: for medium dependency there is a payment of €114.30 per week; for high dependency the payment is €152.40 per week; and the amount for maximum dependency is €190.50.

The nursing home subvention scheme was introduced to assist with the cost of private nursing home charges and was not intended to cover the entire cost of nursing home care. However, I am very aware that the gap between the rates of subvention being paid and nursing home costs has widened considerably in recent years.

The Health Service Executive may, in accordance with article 22.4 of the Nursing Home (Subvention)(Amendment) Regulations 1996, pay more than the maximum rate of subvention relative to an individual's level of dependency, for example, in cases where personal funds are exhausted. The application of these provisions, however, is a matter for the HSE in the context of meeting increasing demands for subventions.

The average rate of subvention paid by the HSE generally exceeds the current approved basic rates mentioned above. Spending on the nursing home subvention scheme has increased from €5 million in 1993, when it was introduced, to a figure in the region of €140 million this year.

When a person applies for a subvention it is subject to a means test and a person's assets are taken into account, but the test currently being used is very much in need of a change. If person's house is valued at more than €95,000, it would rule him or her out but one would have to travel a good distance before one would find a house worth less than that. When one considers that the average price of a second-hand house in Dublin is close to €400,000, it gives some indication of the necessity to change the guidelines. We will be announcing changes in that regard in the near future.

The Department has been informed by the HSE that the position in the western area is that every person in receipt of nursing home subvention and enhanced nursing home subvention is being paid and will continue to be paid. There is a heavy demand for enhanced nursing home subvention. Each individual application for enhanced nursing home subvention will be reviewed by the local health office manager in each county in the HSE western area and each case will be considered individually. Also, as part of the 2006 Estimates process, proposals have been put forward by the HSE for additional funding for the western area.

A working group chaired by the Department of the Taoiseach and comprising senior officials from the Departments of Finance, Health and Children and Social and Family Affairs has been established. The objective of this group is to identify the policy options for a financially sustainable system of long-term care, taking account of the Mercer report, the views of the consultation that was undertaken on that report and the review of the nursing home subvention scheme by Professor Eamon O'Shea. This group is expected to report to the Tánaiste and to the Minister for Social and Family Affairs in the very near future.

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