Paul Connaughton Snr (Galway East, Fine Gael)

I am delighted to get this long awaited opportunity to speak on this Bill in which I have a great interest.

I suppose all one could say at the outset is that this legislation is like the curate's egg in that it is good in spots, but I have serious reservations about part of it. The Minister of State, Deputy Hoctor, and her senior Minister are selling this as being accessible, affordable and anxiety free. It is all three for a certain category of person. It is surely that for someone who does not own a house, who has less then €36,000 in personal belongings and who owns no land. By and large, the person to whom I refer has no means other than his or her old age pension. I must admit it is a good scheme for such a person.

If one scrutinises the next category, then the scheme becomes extraordinarily involved and difficult. I do not want to see legislation going through the House that will have the effect of splitting up families. The Minister of State, Deputy Hoctor, comes from a rural constituency, as I do. I do not want to see the slightest possibility of a family having a row about an asset they thought was theirs until the State gets its hands on it and proves that it was not. I will try to explain what I mean.

No doubt the system had to be changed. There was terrible trouble about the inconsistencies in and the unfairness of the subventions as applied right across the country. Those, like me, who came from the old Western Health Board area felt that others were getting a much higher subvention than we could get. This scheme treats public and private patients equally and from that point of view, it is to be welcomed.

The old scheme had to be changed. One aspect I noted — on this issue I have considerable experience, as much as anybody else in this House — is that in so far as keeping elderly people in a nursing home was concerned we had reached a point where there were only two or three fundamental points to be addressed. Deputy Hoctor will know this better than most. We are speaking about people who had the maximum old age contributory or non-contributory pension. That is what they had in their hand every Friday, approximately €200. In our case the subvention was €300 making a total of €500 under most conditions. That was all right when the bed in the nursing home was €550 or €600. If they had relatives or family members, they might be able to come up with the balance. Over the past couple of years, however, as the House will be aware, we found that the figure of €600 rose to €700 and €800, and by and large there was no such increase in the pension or the subvention. The wedge that then came in between was so great that many families just could not afford it. That was a real issue, as the Minister of State well knows from all the representations I am sure have been made to her and to all Members. Obviously, there was a need to change that.

The new scheme will work well for certain categories of people but the Government is creating havoc with regard to people who own property. I want to bring the Minister of State back for a moment to these deferred contributions. I hope I have scrutinised the Bill fairly well. We hope that every person in the country is entitled to his or her own home. That is a concept in which I always believed. That is enormously important in everybody's life, especially as people grow older. What is happening is that there is a 5% surcharge for the first three years, but it is all dependent on how the sums are calculated. The Minister of State is saying, in effect, that the maximum will be three years on the house, even if the person is in a nursing home for ten. However, that does not seem to apply to other assets, such as land. The rural constituency I represent is very similar to the Minister of State's. There have been multiple cases of people who own a house and, perhaps, 40 acres of land. The family might be gone, in the professions and so on and perhaps it might not have suited them to come back, so the land was never transferred, for whatever reason. In the back of their minds, however, the elderly folk would have somebody in mind to continue the family name, which is enormously important in rural Ireland.

However, 40 acres at the moment, even at the depressed values of €10,000 an acre are worth €400,000. The holding would have been worth a good deal more a few years ago, but that is today's value, with the average price per acre at around €8,000 to €10,000. A person might be charged €800 a week in a nursing home, which is not exorbitant. Even bottom league prices, so to speak, are coming close to this and as many colleagues have said, some have gone way over that. In the event, that works out at €40,000 per annum, and if the person spends ten years in the nursing home, it is €400,000, equivalent to the value of the land at today's prices. In other words if the patient remains in the establishment for ten years, there is no land left. The Government has said the patient will only be charged for the cost of the care, or €800 a week. However, it ultimately means that there is no land left to be transferred to anyone else. I do not know whether that was what the Government had intended, but it will happen. There have been several cases of that, already.

I want to talk about the house for a minute, the family home. People talk glibly about the 5% deferred payments on the house. A house might be worth, say, €75,000. Until recently one could get nothing for €75,000, although one might, perhaps, be able to buy a small Land Commission-type house for that figure now. Over the three years, €11,250 will be taken off that. In other words somebody must come up with that amount. I shall deal, in a minute, with how it is taken off.

Deputy Sherlock mentioned this a few moments ago, and I understand that this will come about by means of the ancillary State support. I understand the Revenue Commissioners are involved in this. If one takes the mythical 40-acre farm I was talking about, I assume that at the end of the ten years the State will expect to get its money back. At that stage the Revenue Commissioners will apply to the Land Registry to say, in effect: "As far as we are concerned the burden of debt is so great on that particular folio that we now own it." At that point, when the State or the HSE seeks to realise the assets, will the Minister of State say whether the property will be sold on the open market? The family at that stage will be in no position to come up with the money and according to the legislation, it appears to me that the Revenue Commissioners have an asset on behalf of the State and in order to realise it, I assume the land will be sold.

I shall be obliged if the Minister of State will specifically deal with this when replying to the debate. In the event, I assume that the Revenue Commissioners will sell to the highest bidder. If land values appreciate to where they were two years ago, will this mean that the estate of the elderly person would benefit by the difference between the sale price and the asset value? There is a reference to interest being applied, in the legislation. Will the Minister of State say where that interest is? Does it mean, in effect, that not alone are we talking about the €10,000 per acre but interest on it every year as well? What will the interest rate be? Suddenly one finds that the Revenue Commissioners will be seeking a great deal more money than anyone had anticipated at the beginning.

That brings me back to what Deputy Sherlock mentioned. Will we reach a stage where it will become extremely difficult for the Exchequer to keep on paying? Remember, there may not be much of an appetite in rural Ireland for some of those sales by public auction. Some family members, for instance, might object on the grounds that this was where they had been born, not wanting to see the Revenue Commissioners selling the whole place over their heads. I hope somebody has thought this through because it is a real issue in rural Ireland. I wanted to have the opportunity to put that before the Dáil this evening. I hope this has been well thought out but I do not believe it has.

I wanted to mention another matter. As regards the assets, as such, when a person is going into the nursing home, will this involve a legal commitment, and will he or she have access to his or her own solicitor, in the event? Will each person or family be allowed to have their own legal representative present, beside that of the HSE, and who will pay for the cost of such legal proceedings? It would be very unfair if only the HSE legal representative was present in processing the deal. As the Minister of State knows, it is very important to have a balanced legal approach in matters such as this. Most parties have solicitors to work on their behalf.

In so far as nursing homes are concerned, by and large they are doing an excellent job, and fulfil an enormously important role. It is not the only role, as we know. We talk of primary care and helping the elderly to stay in their own homes. If I live to be 100, I hope I shall die in my own home, not that I have anything against the nursing homes. We understand that they exist for a particular purpose, but from my viewpoint, I hope to finish up at home, and I believe a great many people think as I do.

I was misrepresented here some time ago when talking about the checks on nursing homes, which I entirely agree with. I pointed out that none of the nursing homes in Galway with which I am familiar was anything other than perfectly run but for some strange reason the news was reported in a slightly different manner. I have no evidence that any nursing home in Galway with which I am familiar is anything but properly run. I base that statement on the advice of the relatives of patients in these nursing homes.

In so far as this scheme is concerned, the inspectorate will be important. I hope inspections will take place without advance warning and at any time. That is important in regard to every person who depends on medical care, whether in nursing homes or hospitals. I like what I hear in regard to the inspectorate, provided the funding is in place to ensure it is strong enough to act. It is easy to determine how a nursing home is being run at 3 p.m. but it is another story at 3 a.m. The people who run great homes will have no problem with inspections but if another Leas Cross exists, it has to be discovered. A nursing home is no place for an elderly or vulnerable person unless he or she is receiving the best of care and attention.

This legislation has had a very long gestation period. I have seen few other Bills hang around as long as this one. When it is finally passed and the Minister of State has responded to the issues raised by Deputies on all sides, I hope there will be no more false dawns. I do not want to hear in six months time that the money has disappeared. Legislation is no use if a cap is put on its provisions. Deputies will be aware of the trouble farmers are experiencing in regard to the farm waste management scheme. If something is promised, the resources should be made available for it even in these difficult times. Whatever else we do, let us avoid playing around with the elderly because that would not be fair.

I do not have time to address the issue of medical eligibility other than to speak about rural bachelors in their late 50s and 60s who have nobody to care for them and may be living a bit rough. There may be nothing physically wrong with them but they can be lonely and are often unable to access activities. It would be a disaster if these people are made ineligible for places in nursing homes because where else will they spend the remainder of their lives? A case could be made for their eligibility on mental health grounds alone.

See this speech in context