Jimmy Deenihan (Kerry North, Fine Gael)

Last night I discussed various aspects of the Bill. While welcoming the Bill I pointed out the existing inequitable system of payment support for those in long-term residential care and how the Bill offered vastly different levels of support to patients in the public and private systems. I also pointed out that while every resident in public long-term care has to pay the charges, these are capped regardless of the level of means, whereas the same individual availing of private long-term care may be entitled to a subvention to assist with some of the costs of care but this subvention is subject to rigorous means testing. Persons in private long-term care may therefore be deemed ineligible for the subvention and may be obliged to meet the full costs of care. In essence, the current system means that people on the same incomes can end up with vastly different care costs depending on what type of nursing home they use, whether it is public or private.

Overall, under the current subvention scheme, the State effectively meets only 40% of the estimated average cost of care in a private facility while meeting approximately 90% of the cost of care in a public facility. A number of examples were given to the House of patients in private care who now have no savings left, no house to sell and are in a very difficult and vulnerable situation. Only for the generosity of the owners of those private nursing homes, they would have no place to stay. It is the case that many patients are in private nursing homes who are not in a position to pay the full costs, which currently run up to €800 to €900 per week. This is the average cost of keeping a patient, paying the staff and making sure that medical and other needs such as food, are met. I hope the new arrangement will reverse this imbalance for the sake of our old people.

I refer to pressure on the acute hospitals sector. There are so few places available that patients with very minor ailments have to remain in hospital because there is nowhere else to send them. Sometimes families refuse to take relatives from hospital and this is putting significant pressure on the acute hospitals sector and is holding up beds that could be used for other procedures. This issue was raised by a number of previous speakers. I hope this new fair deal will free up additional places in hospitals for a greater number of people from the community at large.

Another issue referred to by a number of speakers is that of standards. I appeal to the Acting Chairman because I expect silence in the Visitors Gallery.

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