Jack Wall (Kildare South, Labour)

I have spoken strongly against this Bill since its inception. I remain of the opinion that one's home is one's castle and that there should be no interference by the Government or anybody else which serves to undermine that ownership by predetermining what costs should be placed against it. The Bill is fundamentally flawed in this regard.

I recently asked the excellent staff in the Oireachtas Library to conduct a survey into what home and land ownership meant to people since the foundation of the State. I was amazed to discover the effort and dedication shown by families over a long period to ensure that what they had was retained within the family. As I said, people's homes are their castles and they have the right to pass them on to members of their family or otherwise, as they so wish. This should always be upheld, according to the Constitution. There is absolutely no reason to encroach on this principle in any type of legislation. As I told my constituency colleague, the Minister of State, Deputy Seán Power, when he introduced the previous Bill dealing with these matters, I could not fathom how the Government could seek to undermine this first principle.

I am the first to recognise the need for more hospital beds and long-term stay beds. My mother has been in long-term residential care in St. Vincent's Hospital in Athy, a wonderful facility, for nine or ten years. I see the pressures on staff in that hospital on a daily basis in seeking to accommodate those in need of long-term and respite care. A former colleague of mine, Councillor Jim Keane, is currently in respite care at St. Vincent's. He too would acknowledge the wonderful work being done in that facility. When one sees what can be done, one must question why the Government would seek to move away from the universal principle that all citizens of the State are equal and are entitled to equal treatment under any legislation that is put through the Oireachtas.

The threat to the principle of universality of health care, for reasons of cost reductions, is the basis of the Labour Party's objection to the Bill. This will undermine the automatic right of senior citizens to long-term care and will mean they are treated differently from the rest of the population. People who suffer from dementia may be uncertain of their own health status and unaware of events happening around them. However, they will generally be able to engage in conversations on what is happening on the home front. If one can get their attention for any period, all they are interested in is what is happening at home.

The vital question in all this is whether this Bill is an acceptable reflection of how we should care for senior citizens. Whether in their worst or best moments, most of these people will focus on their one possession, that is, their home. This legislation will mean, in many instances, that the children of parents in long-term residential care will have to sell the family home because they will not otherwise have the resources to pay for that care. Many people would struggle to secure a loan in the current economic climate. I find it repulsive that this legislation threatens a right for which Irish people fought over a long period. The research conducted by the staff in the Oireachtas Library confirms the general and long-held view that one's home is one's castle. It is to the forefront in this legislation.

Age Action Ireland stated that the Bill sounds the death knell of the public bed for those who need a residential home bed. It also means the introduction for the first time in the Irish health service of a charge beyond the grave for essential health care services. Age Action Ireland is a vibrant group that looks after senior citizens. I have seen the organisation take action time and again when negotiating with State agencies to provide a better standard of living for senior citizens. It has provided better comfort on a range of issues and has changed the lives of senior citizens. When a body like Age Action Ireland comes out with this statement, it shows the concern that this Bill is causing senior citizens. I am sure that the officials in that excellent organisation did not provide this off the top of their heads, but would have received it from its grass roots.

Age Action Ireland has provided safety facilities, lighting facilities and so on for the many senior citizens under its remit. It also promotes age action weeks and such like, so it has a hands on experience of the situation. The organisation stated that we must be concerned when legislation like this is introduced because we are effectively treating elderly people differently, depending on the conditions from which they suffer.

The Labour Party is committed to a universal health care system. These people have given their all to sustain the State in difficult times and provided homes for their loved ones. Life in Ireland has changed since the 1950s, 1960s and 1970s, when everybody stayed at home and nobody bought homes before they got married. Everything was done within the family. These people provided those homes, which is why they recognise the importance of not interfering with the family home. It is also why Age Action Ireland and other groups feel that this interference should not exist.

The current Government has stated that elderly people can take one option or the other. However, either way people will have to provide the cost in some shape or form. Deputy Kenneally spoke about the number of people in a home, where somebody is a carer or where there could be three or four bachelors looking after a loved one in the home. What happens if that cost is put on the family home? What will happen to those people? Why should that financial worry be transferred to people who looked after the elderly, sometimes for 30 or 40 years before they had to be put into a nursing home?

I know of a case where a man in his 60s who was living in local authority accommodation was found in a poor condition and had to be hospitalised. Tremendous pressure had to be applied on the HSE to get him two weeks of respite care. He had a small amount of money that he received in a will from his late parents, and that was used to give him another few weeks in a nursing home. He cannot get a long-stay position anywhere, and the cost of the short stay is €750 per week. He only has €249, while the health board will provide €370. They are around €200 short, so who will pay for it? That man will soon be put back into uninhabitable conditions, because there is no public bed for him. When I inquired about an enhanced grant for that man, I was told that there was a waiting list and that it was possible he would not get any such grant in the foreseeable future. He therefore has a weekly bill of €200 that is building up, yet nobody seems to care about how he will address it. This is the situation in which we find ourselves, because section 5 of the Bill states that this is way the subvention scheme will operate.

When somebody comes to me asking about nursing home subventions, the first thing I think of is the person's income related to the cost of the nursing home. If there is no link, then the HSE must increase the subvention to ensure that the person can get into a nursing home. However, that is not the case. The reality is that the cost of keeping the person in the nursing home, such as that man in Athy, will develop into a huge bill. After a certain point, the nursing home management will state that as it is running a business, it cannot afford to care for this man anymore. The HSE has stated that it has no long-stay bed for him. He will probably end up in the accident and emergency department and will take up a bed there. The whole idea of nursing home subvention is to get away from that, but it will not happen unless a proper plan is put in place. The first aspect of such a plan should be the provision of long-stay beds in public hospitals.

Universality is the most important aspect in the provision of services. The senior citizen will then be protected and there will be no need to worry about the family home. There is no doubt that this new scheme will cost more, in spite of the fact that the person involved may be an ordinary citizen with little income. For example, Mr. Doyle is a widower who lives in Kildare in his own home. He bought his council house under the tenant purchase scheme, which has a current market value of €200,000. His sole income is the contributory pension of €230 per week. If he enters a public nursing home now, he will pay €120 per week, but if he enters after this Bill is enacted, he will pay €341 per week. A cost is immediately placed on his estate, which is why a universal health service is so important to the Labour Party. Unless we get more clarity on it, we cannot support this Bill.

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