Dan Neville (Limerick West, Fine Gael)

The aim of the amendment is to enable the HSE to allow patients receive subvention for a specified period. The difficulty is that the payment of a subvention can be queried almost immediately, within months or days of a person receiving it. This situation does not apply in other areas, so why should it apply here. Decisions are made to grant medical cards for a minimum period of from a year to five years, depending on circumstances. Therefore, the HSE could surely examine all circumstances of a person and grant subvention for a period of not less than one year. The subvention could be applied in the same way as medical cards are applied. It has not been unknown for a medical card to be granted for life because of a person's circumstances and the understanding those circumstances would not change for the lifetime of the person.

Deputy Healy has a good point and perhaps the Bill should be re-examined. There is much disquiet on the issue of the calculation of the value of the family home. One of the exemptions covers a relative of an applicant in receipt of a contributory old age pension which is the relative's sole income. We could have a situation where a 79 year old brother and his 80 year old sister live together and the sister goes into the nursing home. The brother who is on a contributory pension may also have an occupational pension and therefore the calculation would come into play and 5% of the family home would be taken into account. In those circumstances that person might be forced to sell his home.

The situation is similar in cases where children care for their mother or father over many years and receive the carer's allowance. If the parent goes into a nursing home, the carer may return to employment. I know people who left jobs to care for relatives and who, though at pension age, will not get a contributory pension because they did not make contributions while working as carers. Although the carer may have spent 20 or 30 years caring, if he or she has returned to work to provide a livelihood, the house will be calculated as means to determine the income of the nursing home resident.

I foresee difficulties with the application of this principle. The Minister of State has said the previous level of discretion will remain, but that will not happen. He knows as well as I do that we deal with officials who are very careful to ensure they act in accordance with legislation. Not to do so, would put them in a position where they might be questioned about decisions they made contradictory to the legislation. Any ignoring of section 7B by any official of the HSE would be tantamount to saying the HSE does not accept the decision of the Oireachtas that this regulation or approach to means testing should apply.

We hope, at budget time there will be an examination of the issue of nursing home subvention because difficulties that did not exist previously have arisen for families. I know a person who returned to Ireland after being forced to emigrate and work all his life in England. After a while at home the person had to enter a nursing home and now all his money has been spent and the nursing home is putting pressure on him to leave.

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