Pat Breen (Clare, Fine Gael)

Nursing home subvention levels are payable by the HSE. The subvention is means-tested and there are considerable problems associated with the means by which applicants are measured. The most substantive issue, however, is the subvention amount. Prevailing market conditions among private nursing homes makes the means-testing and the subvention amounts meaningless.

I have received many complaints about this. In Ennis, I have one instance where an individual is paying €1,500 a month to a nursing home. Despite the resident being on the top level of subvention — €400 of this is for a special bed — he must pay an enormous sum to make up the deficit. For a person on a modest salary, paying €1,100 a month for a relative in a nursing home is the equivalent to paying a sizeable mortgage.

I have examined nursing home charges in County Clare. With the exception of public nursing homes, the amounts charged bear no relation to the subvention amounts paid. Six private nursing homes in County Clare charge between €560 and €657 a week for a private room. The cheapest rate I could find in the private sector was €540 a week for a twin room. In contrast the amounts payable by the HSE for subvention are €114, €152.40 and €190.50 a week, according to the level of dependency of the patient. Nursing home charges, therefore, amount to between three and four and a half times the subvention rate, without the luxury of a private room. If the modest old age pension of less than €200 a week is applied, there is still a considerable shortfall which very often has to be met by hard-pressed relatives struggling with their own financial problems. If one is paying the more expensive nursing home charges being levied in the cities, such as in the Minister of State's area of Dublin, the gap widens even more.

The Government's continuing failure to tackle the accident and emergency crisis has led to some people opting to stay at home to die rather than face the drudgery of the health service, as highlighted in last week's "Prime Time Investigates" programme. Furthermore, due to the costs of private nursing home care and the State's failure to provide more realistic subvention levels, people are being forced to stay at home in more problematic conditions. Hardship cases cannot be taken on directly by the State because of the lack of sufficient numbers of public nursing home beds. Only applicants with nursing home needs can make it through the assessment criteria even though they must often wait a year or more before a place comes up. Those who are particularly vulnerable are bachelors and spinsters with no near relatives. Even if they have assets such as land or a home, for one reason or another they often cannot realise them. These people end their days in poverty. They may not be in ill health but cannot cook for themselves or carry out some basic tasks and they fall through the State safety net. This year is the 90th anniversary of the 1916 Rising and it is astonishing that elderly people are still treated in such a shabby manner. It is appalling that those who built the State should have to end their days in such conditions.

I was amazed to learn that despite the huge rises in nursing home care costs, the Minister has not deemed it necessary to increase the subvention levels or to relax the means testing criteria in recent years. The Minister should also look at the discretionary hardship payments from the HSE. In County Clare, it is €65 per week. This is not just discretionary it is subject to budgetary constraint and varies from region to region. Why is it not standardised and separate from budgetary conditions?

I implore the Minister to look at this area, which is of great concern to the people of County Clare and other areas, and to increase subvention levels or authorise the HSE to provide finance to allow for the relaxation of the means test and standardisation of the discretionary hardship payment. The money should be spent where it is needed, not on wasteful projects such as electronic voting.

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