Jack Wall (Kildare South, Labour)

The Minister of State has not given much leeway on any of the proposed amendments to this Bill, but there is no reason he should not consider accepting this particular proposal. A person who applies for a nursing home subvention must fill in forms and endure various tribulations so that his or her level of dependency may be assessed. Under the provisions of this Bill, any such persons may be liable to have their application reassessed after only one week of care. This is unacceptable. Amendment No. 15 seeks to rectify this by affording some level of freedom and security to the person in receipt of the subvention and to their families and others providing support.

I raised the issue of the three rates of subvention when the Bill was first introduced. This tripartite scheme is irrelevant because nursing homes do not recognise those rates but instead specify a fixed charge of €600 or €700 per week, for example. The specification of three separate rates only causes suffering for those seeking subvention for nursing home care. Those who do not meet the criteria for the highest rate must make up from their own resources the difference between the rate charged by the nursing homes and the amount they receive in subvention.

There is no logic in determining rates of subvention according to whether a person can shave his own face, for instance, or must rely on someone else to do it for him. Such considerations make no difference to the rates charged by nursing homes. The specification of three different subvention rates, based on varying degrees of dependency, assumes that the Department of Health and Children has control over nursing homes to the extent that they can be instructed that a person who adheres to a particular dependency level must be charged the appropriate rate. The Minister of State knows this is not the case.

The issue of assigning one of three subvention rates according to the level of dependency is not relevant in the current situation. If a loved one of mine were admitted to a nursing home tomorrow, it would be pointless for me to claim that he or she should be charged a particular rate because, for example, he or she is able to use the toilet and get breakfast unassisted. The legislative provisions in this regard are illogical for the simple reason that nursing homes charge fixed prices. That is the way the system works.

Amendment No. 15 will offer some relief to subvention recipients and their families by specifying that the level of dependency cannot be reassessed for a period of 12 months. It is highly unlikely that a person taking up residence in a nursing home will remain there for a shorter period. It is generally the case that these people's families and GPs are of the view that they will require long-term care. I ask the Minister of State to accept this amendment in the interests of fair play. Providing some leeway in regard to reassessment will involve a minimal cost to the Exchequer. There is no reason that he should not accept this proposal, which will give some solace to those in receipt of nursing home subventions and their families.

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