Liz McManus (Wicklow, Labour)

I echo the concerns expressed by Deputy Twomey. There are many questions about this legislation. Generally, there is not an argument about having some kind of rational, fair, humane system of assessing subvention across the country because at present it is quite clear there are variations that militate against individuals living in different parts of the country. However, the one aspect we cannot accept is a regime that will be harsh on people who are vulnerable already.

We must remember that the Government record on protecting the rights of the elderly, and making sure they feel secure and safe, is not good. The illegal taking of money from residents in public nursing homes and public welfare homes extended over a number of Governments. Nobody argues that point. However, the record of Fianna Fáil and the Progressive Democrats is particularly shameful, both in terms of when this matter was first raised at a Cabinet meeting by a previous Government, the incoming Fianna Fáil Government dropping the entire issue, and then the former Minister for Health and Children, Deputy Martin, not reading his brief, or stating he did not read it, and nobody around him seeming to have the capacity to read a brief either, resulting in the bill increasing significantly and the taxpayer now paying the price.

It should be pointed out that the Minister for Health and Children, Deputy Harney, insisted on essentially privatising the payback scheme. I was given a letter, which my colleague, Deputy Quinn, wrote in response to a constituent, which clearly shows that the payback scheme — one must remember this is elderly people getting back the money which was robbed from them — is not operating in an open and accountable way. The letter Deputy Quinn wrote showed clearly that when a Member of this House went looking for simple answers about a scheme for elderly people, it was impossible for him to get the information and he wrote back to his constituent stating "I really do not know how to help you because I cannot get the answers." This person wanted to know when payment would be made. In particularly tragic circumstances where the individual who is in a public nursing home is very ill, there is a certain urgency on it and none of the family can get answers. That is quite disturbing.

This is the Government that refuses point blank to publish a report on Leas Cross nursing home, which it promised would be published. There is nothing to stop the Minister from publishing this report. It should have been published long ago. It was given to the HSE in May. Under the Health Act, the Minister has the power to publish.

The record is not good. When we come to this legislation, there are legitimate concerns being raised by Deputy Twomey, others and myself about how people's income will be assessed and whether or not somebody with a family home is being penalised. Given the provisions in the Bill, that is exactly what is happening.

We should be clear about this. Organisations which exist as advocates for elderly people are also expressing grave concern that this legislation will lead to elderly people being forced to sell their homes in certain circumstances. One must remember that these are not necessarily elderly people who will remain in a nursing home forever. They may become sufficiently well to move out again, but will not be able to do so because the family home has been sold to pay the bills. Quite apart from compassion, there is no logic in that kind of scenario unfolding.

It is important to put on the record what Age Action Ireland has to say about this Bill. The Minister of State can say he is looking after the interests of the elderly but we must look to the advocates of the elderly who have a great deal of experience and a good track record and reputation in making sound judgments. Age Action Ireland is urging that this Bill be amended because, if implemented, it will force a number of people to sell their homes or enter into equity release arrangements against their will. The organisation makes a bald statement, with which I agree: "Nobody should be forced to sell their home in these circumstances". The head of advocacy and communications of Age Action Ireland states:

Older people, many of whom have paid their taxes for 40 years, did so in the belief they had a social contract with the State which included provided for their basic health needs. That contract cannot now be torn up. In many cases, older people have spent their entire savings to pay their nursing home bills and their home is their last asset.

Age Action Ireland believes that people of all ages should be treated equally by the State when it comes to health care. If a person in their 30s or 40s were to become to seriously ill, leaving them in need of nursing home care the rest of their lives, the state would not force them to sell their home. Neither should older people in need of nursing home care.

Only five per cent of older people are resident in nursing homes. Many of these would prefer to live in their homes, but are unable to do because of inadequately funded community care.

It is important that we get this right and recognise there must be a fair system, which does not force people into taking actions contrary to their will. However, there must also be a good, sound appeals system to make sure where somebody has not secured the right decision, he or she has the capacity to come forward and trust the appeals system in place. The issue of the family home pervades the legislation, whether that relates to somebody else living in the home or the thresholds that apply to the value of the home, which are ridiculous. It makes no sense that the threshold in Dublin is €500,000, while the equivalent in Galway city is €300,000. Deputy Wall and the Minister of State are both from Kildare and the threshold of €300,000 for that county makes no sense. I live in Wicklow and a similar threshold applies but one would not buy a house for that amount in the county. Once the value of the house exceeds the threshold, the entire valuation of the house is taken into account.

I support the amendments. They try to pin down a fair regime, for which the Government has not provided, but the core issue of the family home has not been addressed. We need to deal with that if the legislation is to be fair. We need to recognise the contribution made by elderly people and the necessity to provide services for them so that they can remain at home and, where they are unable to stay at home, to make sure they receive residential care. Patients will be charged for residential care but proper safeguards will not be provided regarding inspections and a statutory-based system of safety. That is not good enough and the Minister of State must take responsibility for where he is now.

See this speech in context