Catherine Byrne (Dublin South Central, Fine Gael)

I welcome this Bill. It has been a long time coming. Since 2006 we have heard the Minister promising her "fair deal" but it will be late 2009 before we see any real progress with this scheme. In the meantime, many elderly people and their families have spent thousands of euro on nursing home care, and have struggled with the financial burden this has caused.

As daughters and sons, we all want what is best for our parents, grandparents and elderly family members. They have waited a long time for a fair deal on nursing home care. Now that this Bill has come up for debate, we must ensure it is in the very best interests of all our elderly people. They have paid their way and worked through the hard times, supporting this country when it was on its knees. They cared for their young families with little or no support from the State, all the while paying high taxes. They laid the foundation for prosperity and gave this small country a place on the world stage.

When it comes to the time in their lives when, for one reason or another, they can no longer care for themselves or live independently, they must pay to go into a nursing home and live in a strange environment, miles from home. Not only are they forced to pay, they have to give up their savings and, in some cases, even their home and land. These people have always paid their way and never asked for something for nothing. They are at a stage in their lives when they need help and support to live out the rest of their days with pride and dignity. They must be given the best possible care and this cannot and should not be sacrificed because of budget issues.

In my ten years in public life I have been often struck by deep upset and heart-rending anxiety felt by families who make the very hard decision for a loved one to be cared for in a nursing home. No son or daughter wants to see an elderly parent go into a nursing home but they often have no choice in the matter as they not may be in a position to properly care for their mother or father full time. When the time comes, we naturally want the best and highest standard of accommodation.

Therefore, we expect no less from the Minister for Health and Children and the Government than to implement an accessible and high quality care package and to show true respect for our elderly population. It would be nice to have a free nursing-home care package for all. It would be a small repayment for the years of service they have given to society. However, we all live in the real world and we know this is not possible. Some contribution must be made if the scheme is to work, but this must be done fairly with no unnecessary burden being placed on families.

Up to now, the scheme has had many flaws. It was difficult to get a nursing home subvention due to strict criteria and means tests. That is why I sincerely hope the new fair deal will improve the situation for our elderly population. I have read and studied the Bill to the best of my ability. I agree with some, but not all, of the measures being introduced in the legislation. I accept that people must contribute to the cost of nursing home care, but I question the requirement on patients to devote 80% of their weekly accessible income to paying for such care. They will also have to make annual payments equating to between 5% and 15% of the value of their assets, including family homes. This is excessive, especially in the case of elderly people who save a small amount every week with the intention of leaving it to their children or grandchildren after they have passed on.

My elderly next-door neighbour is in great health at the moment. When I was talking to him the other evening, he told me he is going into hospital for some tests. He is concerned about what will happen to him after he leaves hospital. If he needs to go to a nursing home, and is lucky enough to get a place, he will be asked to surrender 80% of his pension. That would leave him with less than €50 a week, which is nothing more than pocket money. What can one buy with €50? Perhaps one can afford a few cigarettes, a newspaper, some toiletries and a bottle of lemonade. Elderly people value having a few euro in their pocket because it gives them independence. My 88 year old mother, who is ailing, asks for her purse each morning when she wakes up. She needs to find her purse and make sure her money is still in it before she can get on with her day. Under the fair deal, elderly people will have to undergo care needs assessments before they go into nursing homes. What if they are not considered eligible, on foot of such assessments, because they do not meet the Minister's criteria? Who will care for them in such circumstances? Where is the fair deal in such cases?

The recent home help cuts, which shocked us all, will mean that fewer supports are available in the community. A crisis is developing in local communities as a result. I am contacted every day by elderly people whose home help hours have been reduced recently. I have received many calls telling me about the fear being experienced by elderly people who used to get two or three hours of home help, but now get just an hour. I know a girl with five children who had a stroke three years ago. She used to benefit from eight hours of home help, but that was recently reduced to two hours. I was shocked when she told me last week that her eligibility for a medical card is to be reassessed. Such cases are frightening, worrying and upsetting for everybody. Those who provide home help give generously of their time. They often stay longer than required because they have developed a good relationship with those they care for.

Families also have a caring role. We need to bear in mind that family members who are carers are on duty 24 hours a day, seven days a week. I have already mentioned my ailing mother, who is 88 years of age. Her needs have totally changed over the last three months. She needs constant care. Each member of the large family she reared is able to give some time to her. She depends primarily on my brother, who remains at home. He keeps an eye on my mother every hour of every day. He feeds, washes and dresses her. Above all, he gives her care, understanding and love, which is most important. Most people want to keep their elderly family members at home, where they feel safe and comfortable. It is important, therefore, to improve the conditions in which elderly people live. When one tries to get a local authority to do the necessary work to adapt elderly people's homes, thereby making it easier for people like my brother to cope, one encounters unacceptable delays. Last week, my brother was told by an inspector that he might have to wait eight or ten months for a new shower to be installed in my mother's bathroom. We decided last weekend to put on our boots and do the work ourselves. It took us four hours to manage to install the shower, which is easily adapted by family members. As a result, my mother will not have to wait eight or ten months — she might not be around by then — to enjoy the comfort of the shower.

The new primary care centres that have opened throughout the country, which have been promoted by the Minister, allow people to be looked after in a familiar location. They offer an ideal environment in which elderly people can be cared for without having to leave their homes. The centres ensure that people stay in the community, where they can be visited by their neighbours and friends on a regular basis. Plans for a new primary care centre in my local parish — St. Michael's in Inchicore — have recently been agreed. Fifty management units, in which people can live independently, will be provided as part of the scheme. I think it will be a real success. I thank the Minister for her inspirational vision in this instance. Similar projects should be rolled out throughout the country. As I have said, it is important to keep people alive and well in the communities with which they are familiar. I see the people who live in centres of this type on a daily basis as they go to the shops and to mass.

When elderly people are placed in pre-selected nursing homes, families do not have any alternatives. An elderly person can end up in a nursing home which is far away from his or her family members. Such people can become isolated, which puts extra pressure on family members who have to travel long distances to visit them. I have a list in my office of people who want to go into care in the Cherry Orchard institution in Ballyfermot. The facility in question is ideal. Many people from my constituency and other areas have contacted me to see if I can help them to get a care place for their elderly or infirm parents. The Cherry Orchard centre has a wonderful reputation in Ballyfermot, Inchicore and other parts of Dublin South-Central. The care people receive at the institution is beyond belief. It is an example of the HSE getting it right. Families who wish to visit their loved ones, for example, to spend time with them as they pass from this world, can come and go in a warm and friendly atmosphere.

I am concerned about the assessment of an elderly person's assets which were transferred in the five years before he or she entered nursing home care. An elderly parent may have given a family member some money to help him or her buy a house or to assist him or her at a time of debt or illness, for example. I do not agree that such moneys should be considered during the financial assessment. This provision will cause huge worry for elderly people who want to help their families but may be afraid to do so. How can money which is given in good faith, with a generous heart and without any expectation of anything in return, be assessed in such a manner? As a parent, I do not want my children to fall victim to this assessment process in the future.

I accept that a person in a nursing home should make a payment equivalent to 5% of the value of his or her home. I welcome the safeguards that are in place to allow such a person's spouse to continue living in the home. I agree that the 5% payment should be capped at 15% after three years. However, I do not agree with the decision not to impose a cap on the 5% charge on assets, including land. I have lived in the inner city all my life. When I was growing up, there was a pig farm near my home, funnily enough. It was run by a dedicated farmer who got up at 4 a.m. each day, to our annoyance, to look after his little plot of land and his pigs. An elderly farmer contacted me last week when he realised that the new criteria meant he would no longer be able to avail of the medical card to which, as a person over the age of 70, he had been entitled. Farmers who have tilled the land and worked hard all their lives should be able to pass their land on to their children without having to worry about them being assessed. This provision is grossly unfair.

The standard of nursing homes is another important issue. Up to now, there have been no regular inspections of public nursing homes. Standards must be improved in all nursing homes. Cases such as the Leas Cross scandal cannot be allowed to happen again. If we entrust our loved ones to residential care, we must be assured that they are in a clean and comfortable space and are treated with care and respect. I was recently telephoned by the mother of a 40 year old woman who is in long-term care because she has the mental ability of a two and a half year old. The harrowing stories she told me, which I confirmed with the HSE, led me to believe that there continues to be significant problems in some residential care units. Such circumstances should not be allowed to develop. I am gravely concerned that the Government will run out of money for the nursing home scheme during the current economic downturn. The scheme is currently costed at €920 million. If the Government cannot deliver the medical card scheme for people over the age of 70, what chance does it have in this instance?

Neither is the Government prepared to deliver on the cervical cancer vaccine. Cervical cancer is the worst form to suffer from according to my doctor. I had to take my daughter to see him this morning because she is sick. He was appalled to think the Government would not provide €10 million for the cervical cancer vaccine and voted against our motion last night. Even though I am a mother and a woman, I know little about this form of the disease but my doctor related harrowing stories to me earlier. In his 36 years practising, he has dealt with four women who had cervical cancer. He said it is the worst cancer to die from and he was appalled to think the Government has decided that young girls aged 12 now may have to visit his surgery when they are 18 or 19 and be told they have cervical cancer. I was shocked and horrified by his stories. There was plenty of opposition to the Government's cutback during the Private Members' debate and even a Government backbencher would not vote on it but the Government's amendment was passed.

The Minister and the Government need to listen to the issues my colleagues and I have raised because some day we will be all old and we all ask our children to support us and mind us. If this is a fair deal, it should be a fair deal for everybody.

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