Peter Kelly (Longford-Roscommon, Fianna Fail)

I thank the Deputy. The Bill provides for a clear legal framework for a scheme to repay recoverable health charges which were wrongly imposed on fully eligible persons for publicly funded long-term residential care. A significant and long-standing feature of our health system of publicly funded long-term care has been the principle that it is fair and reasonable that people should make some contribution to the cost of their long-term care.

Most families in my constituency were happy with the long-term care their relatives received in County Longford in both private and public nursing homes. They had no problem making a contribution towards that long-term care because the care in Longford, in public and private nursing homes, is second to none. I am sure the standard is good throughout the country but the standard in my constituency is probably the best in Ireland, with a good quality and delivery of service, good accommodation, good food, good care and good medical attention. That said, I fully accept the Supreme Court decision which found the charges unlawful. We will make that right. Almost all involved told me they were happy with the care and service and did not mind having to make some contribution towards the cost of the service.

The Bill will enable full repayments of public long-stay charges to be made to all those who were wrongly charged and are alive today and the estates of all those who were wrongly charged and died since 9 December 1998. It will also allow anyone wishing to put money into various health services to do so from their estates if they do not wish to take up the money. The repayments will include both the actual charge paid and an amount to take account of inflation with reference to the consumer price index. All repayments to living persons and their spouses will be exempt from income tax. I welcome the important provision that repayments will not be taken into account in assessing means for health and social welfare benefits.

The normal tax and means assessment arrangements will apply to those who benefit from repayments to estates, as is only right. As I said, the scheme includes a provision to allow those eligible for a repayment to waive their right and have the money assigned to fund one-off service improvements for older persons and those with disabilities. The application process will be as simple and, importantly, user-friendly as possible, while also providing appropriate safeguards against fraud and the exploitation of those who cannot manage the repayments they will receive.

My experience of health care in my constituency is that those administering it, from management through to nurses, doctors and other staff, provide a user-friendly service. That is also the experience of patients availing themselves of the various services. We recognise both that there is a great deal of pressure on staff in the Health Service Executive and that one has a very trying and tough time when one is ill. It is hard enough to be on top of one's form when one is in the best of health, but being sick makes one vulnerable.

The patients are very considerate and understanding people and accept a great deal. Sometimes relatives may be a little impatient or hard, and we must recognise that those who work in the health services are due some consideration too. We must advance care for the elderly, with everyone working as a team. Everyone must understand everyone else and work together for a health service of which we can be proud. We can certainly be proud of all those involved in it.

The background to the long-stay charge was that on 16 February 2005 the Supreme Court found the Health (Amendment) Act 2004, which contained provisions to introduce legislation to provide a legal basis on which to charge medical card-holders for the maintenance element of inpatient services in long-stay care, to be unconstitutional. Like everyone else, I believe we must observe, obey and respect the courts of the land.

The main elements of the Bill address the application process for repayment, how an application is determined, the payment of settlements, the donation of repayments to fund improvements in specific health services, and the operation of patient private property accounts. I hope we do not encounter too many difficulties with that and that common sense will prevail, with relatives, management and the HSE reaching a suitable arrangement to avoid more disagreement.

As in everything else, I welcome the inclusion of an appeals process. A special account will be established to facilitate repayments. I also welcome the Government's audit of the scheme. It is estimated that up to 20,000 people still alive, and a further 40,000 to 50,000 estates will benefit. The cost will be approximately €1 billion. Some €400 million has been earmarked for 2006, and the balance will be required in 2007-08.

I am glad that the care and service that people receive in public and private nursing homes have improved, although they were always good and very well run in our constituency. People may seek more public beds for the elderly, and perhaps we should try to create more, or work with the private sector so that it designates a certain percentage of such beds in all new private operations.

Regarding the elderly, it is important to highlight the many positive developments in their care recently. In case anyone gets the wrong idea from having listened to a previous speaker, we must state that older people are a core priority for the Fianna Fáil-led Government. We are committed to developing a comprehensive range of services for them and will ensure that they can live in dignity. Where necessary, we will provide for them to receive care at home too.

I am sure all Members attended on budget day. The Minister referred to the €150 million package in the 2006 budget for new care services for older people, which is the largest ever and will mean a major improvement in home — and community — based support. Thousands in need of care will receive new services and support in 2006.

When I tour my constituency or visit the elderly, either at home or in nursing homes, I find they are the happiest people in the country. They are an example to us all, being patient, friendly and courteous, displaying great faith, hope and charity. They are very understanding and undemanding, in most cases content with their lot, and have great peace of mind. They have lived their lives and have seen everything, gaining vast experience. They are quite content and not avaricious or greedy. Once they enjoy a certain standard of living, they are very happy. Most will remind us of expectations in their youth and middle age. They never thought they would see the day when they would be so content, happy and satisfied with the way the Government is treating them, particularly in respect of pensions. As promised, the €200 per week target will be reached and will be paid to these people who deserve it. They worked hard all their lives and made many sacrifices to educate their families. Without their sacrifice, commitment and dedication, we certainly would not enjoy the benefits we enjoy today. Everything comes at a price. Some must make sacrifices for the benefit of others. The elderly of today made major sacrifices so that we could enjoy the benefits.

I welcome the fact we owned up, said we were wrong and tried to rectify the situation as quickly as possible. As a goodwill gesture, the Government agreed to make ex gratia payments of up to €2,000 to those wrongly charged and who were alive on 9 December 2004. So far, the Health Service Executive has made payments in excess of €21 million to approximately 10,800 people. People in my constituency did not expect to get €2,000 as they were happy with the way they had been treated. When the announcement was made that the Government was prepared to make an ex gratia payment of €2,000, many people could not believe it because they felt they had received great care and attention and were looked after. Some 99.9% of people were happy with the system the way it operated. The only aspect about which they may not have been happy was the fact there were not enough beds and there were waiting lists.

When the Supreme Court decision was made, it was agreed the money received by the HSE as a result of the imposition of unlawful charges would be repaid. The legislation will allow repayments to be placed in patient private property accounts. These accounts need to be regulated given the significant amount of money which might be in them as a result of repayments of long-stay charges. Patients' private property refers to money and personal possessions patients have with them on admission to care. In the case of long-stay patients, the property also includes regular pension payments. Patient property accounts are operated by the HSE and formerly were operated by the health boards and support clients in managing their financial affairs and assist them in dealing with various aspects of daily living. The patient private property account system manages the private money of long-stay patients which may include pension income, maintenance charges, spending money or comfort payments to patients or clients and lodgments to accounts. This scheme will be operated in the most equitable and effective way possible.

The HSE said that in the circumstances it was necessary to put a new procurement process in place and subsequently placed an advertisement in the Official Journal of the European Union on 2 February 2006. We expect the appointment of a successful company at the end of April with repayments likely to commence in June 2006. The people can look forward to this happening.

I do not believe there are any dissenting voices. This Bill has the unequivocal support of all Members of the House. I do not believe anybody could disagree with this legislation since all those wrongly charged for inpatient services will be repaid in full. It is unfortunate people were wrongly charged. We cannot, under any circumstances, condone anybody not obeying the law.

I compliment the Minister of State, Deputy Power, and will continue to do so as long as he continues to do the great job he is doing. I fully support the Bill.

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