John Perry (Sligo-Leitrim, Fine Gael)

I am delighted to speak on this very important issue. It is great to see the legislation before the House, finally, since I broke the story initially on the issue of entitlement and the illegality of the deductions. Uncertainty as regards refunds to elderly people caught up in the nursing home care scandal and their families and how they will be repaid has been put to rest. That is certainly a good thing.

Some €1 billion will be paid to 20,000 people living in nursing homes who are directly in line for a refund and between 40,000 and 50,000 estates of those who died before their losses could be made good. Many of the people concerned were concerned that the refunds would be taken into account in future assessments of their social welfare and pension benefits. However, the Bill clearly states that in the case of living individuals the payments will be exempt from income tax and will not be taken into account when means testing benefits. That is very significant.

Of significance, too, is the fact that the modest State pensions of ladies and gentlemen in public nursing homes will no longer be raided to pay for their keep. No more than €120 a week out of the total pension of €193.30 will be withheld. At least patients occupying public beds will have a sense of independence. That is a major achievement and it is certainly needed.

We need more public beds to be made available for nursing home patients so that fewer people will have to liquidate all their assets to pay for private care, which is a commonplace occurrence. Fantastic facilities are available in Sligo in Ballymote, St. John's Hospital in Sligo town, Nazareth House and quite a number of private nursing homes which have State beds within them. Those are excellent facilities. Given the difficulties in the large public hospitals with people bed-blocking in some regions while space is available in private nursing homes, it is a pity that people cannot be moved into them, perhaps for periods of respite. The State should deploy more public beds in private nursing homes as well.

Unfortunately many people are not in a position to pay for private nursing homes. The subvention system is inequitable. Families in Sligo, for example, may have to pay twice as much as their counterparts in Dublin to keep loved ones in nursing homes. Nursing home fees can amount to €700 or €800 per week and discretion is given regarding subvention rates in the Dublin region. If a person in a nursing home is paying a fee of €800 per week, for example, after the subvention rate and pension the family may only have to pay up to €200 in Dublin but a family in Sligo will have to pay €400 for a facility that costs the same in Sligo, which is twice as much as Dublin. This is yet another case of Government bias towards the Dublin region and blatant discrimination towards the western sea coast. Families in Sligo have to pay hundreds of euro in additional fees. Because of this there are empty beds in many nursing homes in the north west due to the unfair rate of subvention. This matter must be examined.

A case was brought to the High Court in regard to nursing home charges for people with medical cards and the Government was forced into repaying this money. The Minister guillotined the Bill in 2004 which meant she fully intended only giving everybody a once-off payment of €2,000 with no intention of making it retrospective. At least the legislation now proposes to go back six years. The big issue goes back prior to the last general election and the decision to give everybody aged over 70 a medical card, regardless of means. The Health Act 2001 established the entitlement of people and showed the State was clearly wrong in deducting charges from people who had a full medical card.

Equally, another case is pending in regard to elderly medical card holders who have been forced into private nursing homes where they are paying top fees. A case is currently being taken on this issue. The families of those patients who have been forced to resort to private nursing home accommodation intend to challenge the Government in court on this matter. When this case is overturned the €1 billion which has been referred to may appear small in comparison with the possible level of claims.

Likewise, there may be claims from people who sought a contract bed. Age Action Ireland is fighting this case as well. There are cases where people over the age of 70 with full medical card entitlements had sought contract beds but, in spite of their entitlement to them, were forced to go to private nursing homes. They will have a justifiable case to take. There is no ambiguity about the entitlement that goes with having a medical card. I suspect that when this case is being decided before the courts a similar decision could be taken as when the Supreme Court decided in favour of the people who were illegally charged. People are now being paid back retrospectively up to a period of six years.

Having pushed this case is one of the political achievements in which I take great pride. It was fantastic that the Supreme Court upheld this judgment and brought the Government to task on this issue. One must remember that if the Government had its way, it would only have paid a once-off amount of €2,000 with one day's retrospection from the date in December 2004 when the Tánaiste introduced the emergency legislation, which went to the Supreme Court and proved to be unconstitutional. The President, Mrs. McAleese, would not sign into law the Tánaiste's legislation.

If the Tánaiste had her way none of this money would be paid back. It is important to put this on record, in addition to the fact the President would not sign the legislation into law and that it subsequently went to the Supreme Court which upheld that decision and resulted in the State having to make retrospective payments for a period of six years. It is regrettable it has taken so long to pay back this money despite the fact that within a week the Tánaiste could pay it instantly when she thought there would only be a once-off payment.

A total of 10,000 patients were paid a once-off payment of €2,000, which amounted to €20 million. It has been said that the delay to date is due to the fact this is complicated legislation. I have no doubt it is but what is now required is that the process should not be unduly drawn out in light of the fact the recipients of this money are elderly. The matter should be dealt with decisively. I hope the payments will start as quickly as possible.

A number of anomalies arise. Dealing with the estates of deceased patients will give rise to a number of difficulties. This was brought to my attention by a constituent in Sligo. He contacted the Tánaiste with regard to situations where people die intestate. He was concerned about the mechanism for the disposal of repayments due to those who died intestate. He wrote:

I think all will agree that this is a unique situation, requiring unique legislation. Notwithstanding the terms of the Succession Act, I am sure our legislators can draft particular legislation to deal with the disposal of repayments to those who died intestate. In virtually every such case the reason the deceased failed to make a will was that they were unaware they had any assets. [That would be the case.] Therefore, there is an onus on the Government to endeavour to right this wrong in so far as it can.

Perhaps the legislation could include some, or all, of the following with regard to the disposal of such repayments:

1. The onus be on a claimant to register their claim.

2. A time limit within which a claim must be registered.

3. In addition to their relationship to their deceased, the successful claimant(s) be required to prove they had regular personal contact with the deceased in (say) the five years prior to the death of the deceased and/or had financially supported the deceased in some way during their time in the nursing home. (This would disallow claims from relatives — close or distant — who had no contact with the deceased in many years, if ever).

4. Where there are two or more claimants, a body be established to decide the wishes of the deceased based on the grounds of probability, and the decisions of that body to be final.

In this particular case the patient at St. John's died in his 93rd year and clearly the probate could take years. It is disappointing to see all the possible gain lost in legal fees and searching for extended family members. I hope the Minister of State, Deputy Seán Power, will take on board the problems in regard to people who have not made a will and die intestate. The onus is clearly on the Government to draft legislation that will deal effectively with the possibilities of making those payments. This situation will demand careful consideration as up to €20 million will be paid out in Sligo and the north-west region alone.

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