Brian Lenihan Jnr (Dublin West, Fianna Fail)

I will take this matter on behalf of the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the question as it provides me with an opportunity to outline to the House the improvements made to the nursing home subvention scheme. The scheme was introduced in 1993 to assist with the cost of private nursing home fees. A subvention may be paid where a person has been assessed as needing nursing home care by the Health Service Executive and where he or she has satisfied a means test.

Since 1 January 2007, there are no longer three separate rates of subvention. Persons who apply may receive any amount up to a maximum of €300 per week. Additional funding of €55 million was provided for this purpose in budget 2007. The change in the rate means that as many as 1,800 people not previously eligible for subvention may now qualify for a payment. In addition, the HSE has finalised national guidelines for the standardised implementation of the nursing home subvention scheme. These were circulated on 29 January 2007 to all subvention officers working in local health offices.

Nothing in the guidelines shall operate in a way that is inconsistent with the proposed new scheme for 2008, A Fair Deal. Furthermore, nothing shall worsen an applicant's overall position in 2007 by comparison with 2006. Under the guidelines, the assessment of means will now be carried out using a national standard financial assessment method. This should address past complaints about inconsistency in the administration of the scheme and the amounts of subvention paid from place to place.

The guidelines detail a number of improvements to the subvention scheme, all of which are consistent with the proposed new scheme, A Fair Deal. First, the means assessment process will ensure that a remaining spouse or partner is not left with less than the current maximum rate of the non-contributory State pension. A further improvement is that the HSE will cease imputing income from the principal private residence where it has already been imputed for three or more years. This is again consistent with the new scheme. In addition, the HSE will not automatically exclude individuals from applying for subvention, and consequently from the means assessment process, on the basis of the property or asset thresholds. Everyone will be eligible to undertake the means assessment process.

In addition to the increased rate of basic subvention, additional funding of €30 million has been made available in 2007 for enhanced subvention. This is a supplementary subvention that may be paid by the HSE to a person in or entering private long-term care. The amount of enhanced subvention paid is at the discretion of the HSE and varies according to the cost of care and the circumstances of the applicant. The additional enhanced subvention will be used to develop a consistency between the payment of subvention during 2007 and the new nursing home support scheme for 2008, and to work towards equalisation of the level of support paid to people in different areas, taking local prices and a person's means into account.

The HSE guidelines provide that it is not necessary to qualify for a basic subvention payment in order to apply for an enhanced subvention payment. However, an applicant for enhanced subvention will be subject to the means assessment. In light of the above improvements, the HSE is reassessing all those already in receipt of a nursing home subvention. I advise people in private nursing homes who do not currently receive a subvention payment to apply to the HSE for an assessment.

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