Michael D'Arcy (Wexford, Fine Gael)

The position on the subvention in recent years was unsatisfactory. Arbitrarily, some people got different amounts depending on who made the determination. Whenever decisions are made like that, they create doubt and uncertainty and that leads to anger. There have been far too many occasions where one family paid much more than another family in similar circumstances. This will remove some of the uncertainty, a welcome advance.

I thank Deputy Browne for making many of the points I was to make on Wexford already but I will mention some of the services available there, services Deputy Kehoe has pursued since his political career began. St. John's Hospital is a fantastic facility with excellent staff and backup services. Every person I have seen there is satisfied with all that is done for them. Far too often the health services are not too good at telling us how well they do some things. We should pursue this and provide extra funding to ensure that something done well is replicated. Phase one of the hospital is reaching a conclusion with more than 100 beds in place.

Ely House, just across the bridge in Wexford, is also very good and the New Haughton Hospital in New Ross is excellent. Deputy Browne, however, mentioned Gorey District Hospital, which is the standard former district hospital that was built during the 1940s. Only a couple of residential long-stay beds are in place there and there are ten or 12 beds altogether. This exercises me because a huge number of people have relocated to north Wexford, many of whom did so to retire. Those people are in their late 60s and in ten years, if we do not extend services, there will be a domino effect. As good as St. Johns, Ely and New Haughton Hospital are, if we do not provide additional bed space for those who will need it in ten years or so, the entire county will experience major difficulties.

The population of Wexford has doubled in the past 25 years. If we look at the CSO figures, we can see many of those are elderly people who left to work in Dublin in the 1960s and have retired to Wexford. The savage loves the native sod and this is their native county but it is still a good staging post for contact with children reared in Dublin. The Minister of State must consider the extension of services for the elderly at Gorey District Hospital.

I can only speak about those nursing homes of which I have experience and while they are good, they are not as good as the State services being provided. Nursing homes exist to make a profit but they are being squeezed because of costs rising in recent years. Costs are declining now but I appeal to the Minister to consider Gorey District Hospital for extra funding.

It is unfortunate that an elderly person from my area can be transferred to State facilities a significant distance away. One gentleman from Coolgraney, close to the Wicklow border, was transferred to New Haughton Hospital in New Ross, almost 60 miles away. It was a traumatic experience because the man did not know anyone. Dublin is closer to Coolgraney than New Ross. This was the same as moving the man to a nursing home in Dublin. That is not good enough, we must allow people to stay in their local area if it is at all practical.

I have experience of the community volunteer sector in Wexford and it is outstanding. Volunteers provide a service that is much cheaper than would be the case under the HSE. Those services, particularly drop-in services, are vital because they help to keep people at home, interacting with other members of the community. We should facilitate this not cut it; many voluntary groups received a 1% cut in funding. That was not fair or reasonable, particularly when these sectors do the same work for less than the State sector.

The HSE refund scheme can cause problems. I have dealt with inquiries about overcharging and I did not find those working the scheme helpful. They were not facilitating people to make inquiries even though the money was obtained illegally by the State.

I hope the fair deal will give people the opportunity to enter a State facility safe in the knowledge that everything they have will not be consumed to pay for their care. I am concerned about assets and the inclusion of land and property, where a 5% contribution based on such assets can be deferred. In the case of the principal residence only, the deferred contribution will be capped at 15% of the value of the principal residence for a maximum of three years. That is one issue. Alarm bells always go off with me when I see a matter of interpretation.

Section 10 sets out the terms of the financial assessment of means. Under the terms of the Bill, the HSE is entitled to seek an assessment which will be conducted by a suitable person of its choosing. There is a lack of clarity as to whether this suitable person will be a staff member of the HSE who may or may not have the knowledge, experience or the ability to conduct the evaluation.

If the HSE wishes to establish the market value of an item, it is not bound by any valuation accompanying an application for State support but it is empowered to select a suitable person. Will the HSE employ a person from within its own ranks or will it appoint an independent third party? An independent third party should be chosen but there are concerns. If a valuer values for a seller or for a purchaser, there is always a disparate gap, which can be significant. We need to be careful about that. If independent valuations are to be done, there are sources of information we can use to ensure a correct current evaluation is available and that properties are not overvalued because of the State trying to acquire as much income as it can to defer the cost of people being in the care of the State.

If a discrepancy is found between the market value of an asset established by the HSE and that submitted with an application for support, the HSE is not bound to this valuation. If there is considerable disparity between the values identified, this could have significant implication for the applicant or for the State. As I said, somebody will be displeased. Under the legislation, there is no opportunity for recourse to find agreement on the issue. It is important that suitable provisions are put in place to deal with this eventuality.

Also, it is not clear from the section who is considered a suitable person and what is meant by "in such a manner and by such means as it thinks appropriate." That is open to legal challenge and much interpretation. We must get clarity and establish exactly what that means. We should do so in the House rather than let people pursue the matter in the courts which will cost individuals or the State significant funds.

Under section 10(5), the Minister must clarify who pays for the valuation and if this cost is incorporated into the repayment of ancillary State support. Again, we do not know the position in that regard. Section 10(7) states that any information and-or records requested as part of the assessment of means must be provided within 28 days from the date of the request unless otherwise specified by the HSE. Applicants might have to request documentation from local authorities, third parties or Government bodies and that might take longer than the four weeks in question.

Section 29(7) states a person may not request a financial review unless 12 months has elapsed since the most recent financial assessment and that the HSE must be satisfied of a material change in the financial circumstances of the person. Again, we are back to interpretation which we should thrash out in the House. The Minister should be able to come back to us before we complete the Bill so we know exactly what those sections mean. They are loose and open to interpretation. God knows, this process has been going on since December 2006. Loose wording such as this should not be part of the legislation.

If anything, the volatility of the financial markets over the past 12 months proves that a person's financial circumstances could fluctuate substantially within a short period of time and that a person's ability to pay could be seriously hindered. There is a significant reduction in house prices every quarter, contrary to what some of the auctioneering bodies are saying. Information is available to the State when properties are bought and sold. That is where people could lose out and be charged more than they should be. Equally, as we saw during the Celtic boom era, it is possible market values could be out of date. There is a need to bring clarity to the matter.

Section 31 provides for certain decisions of the HSE to be appealed within 60 days of notice of the decision being given to the appellant. The HSE shall appoint a suitable person to consider the appeal. The Minister has heard my views about loose language in the Bill; there should be none. Appeals should be conducted by an independent third party in order that a fair and reliable resolution can be reached with which both the applicant and the HSE are satisfied. It is important that this third party acts in good faith and to the best of his or her professional ability so that no party feels aggrieved. I do not expect the State to be done out of funds nor do I expect the State to do anybody out of funds in regard to the value of his or her property.

On the assessment of income, is money awarded under the nursing home repayment scheme considered? Again, there is no clarity in regard to that matter. Are income assets owned in 2009 assessed on their value or at what stage are they assessed on their value? Similar to the equity markets, if a person had shares in any of the banking institutions in mid-2007, at what stage will those equities be valued? Will it be at the 2007 or 2008 rate, or at their market value as at the date the person enters a State facility or a nursing home requiring funds?

There is a lack of clarity in regard to the assessment of cash values. We need clarity in this regard because we certainly do not need another version of the health repayment scheme in a number of years time. Stocks, investments, art collections and vintage cars all fall within the definition of cash values. Again, at what rate will they be valued, how will they be valued and who will value them? The encashment value of a product may be worth less than the actual nominal value. Will it be the market value on the day or the encashment value?

The Fine Gael position is that a financial review should be conducted by independent third parties in order that a fair and reliable estimate may be established with which both the applicant and the HSE are satisfied. This deals with cash and property values. Members of the public will not be long in telling the Government if they are not satisfied with the scheme. I am surprised by the number of occasions we have to revisit legislation. This process started in December 2006 and we need to get this legislation right. We do not want to have to amend it in the future. We must thrash it out in the House and ensure everybody is satisfied.

In regard to the foreign property aspect of the legislation, tens of thousands of people in the State own foreign properties. Is such property assessed as a cash or a relevant asset? The opinion to defer payment against foreign property assets, as is the case with the principal private residence, is not available. Therefore, money charged against a foreign asset must be raised each year. People could find themselves in difficult circumstances with falling asset values in terms of foreign property.

See this speech in context