Joe Callanan (Galway East, Fianna Fail)

I thank the Minister of State for attending the Dáil to hear my call for extra funding for nursing home subvention in the western area, especially County Galway, where the level of enhanced subvention has been reduced. I will quote the difference in levels of subvention paid in the different areas. These figures were received from the association of nursing homes and include the full amount of basic and enhanced subvention. The rates are as follows. Those in the eastern area get €680, the southern area, €557 and the north-eastern area, €432, while the rate for the western area is €299 to €310. Clearly, the rates paid in the eastern area are more than double those paid in the west. I accept there may be a small difference in charges, but nothing like this.

Currently, there is a particular problem with the Galway area, where the enhanced subvention is capped at €85, giving a total rate of €275, leaving a major shortfall to be filled by relatives, even after taking old age pension into account. The annual budget for subvention in Galway last year was €9 million, but due to great demand, €11 million was spent. The HSE has now instructed the people involved that they must revert back to the figure of €9 million this year, so there must be a cutback. I call on the Minister of State to provide the money or to tell the HSE to provide the money for the increased enhanced subvention, especially in the Galway area, and to try to make the differences more appropriate so that payments in the eastern area are equivalent to those in the western area.

The criteria for improved enhanced subvention are also being curtailed. If a patient is on a waiting list for a public bed for which he or she is eligible, is offered a public bed and refuses, enhanced subvention payment ceases after a 28-day period. Where a patient's personal moneys have been depleted over the years while in a nursing home, enhanced subvention priority up to a maximum of €85 per week may be granted. This is subject to review. A patient must be resident in a nursing home for a maximum of six months to be in receipt of subvention prior to making an application for enhanced subvention. Exceptional cases will be reviewed by the general manager. This makes matters very difficult for patients in the western area. Nursing home charges have increased substantially in the past few years, but the biggest problem is that the basic subvention of €190 has not increased since the 1990s. This must be reviewed and a higher rate paid.

I thank the Minister of State for introducing the home care packages. I always believed home-based subvention should be brought in, but the home care packages are no doubt as close as the Minister of State can get to this. It means people can be treated in their own homes. I also felt the choice should be there. It is important that people can stay in their own homes and be treated there for as long as possible. I have nothing against nursing homes but if a survey were carried out, I believe most people would like to remain in their own homes for as long as possible. A time may come when that is not possible, but the home care packages are very welcome. I hope the scheme will be expanded to include more moneys in the future. I thank the Minister of State and ask him to review the situation, especially in Galway, and have the subvention rates increased to an acceptable level.

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