Mary Harney (Dublin Mid West, Progressive Democrats)

There seems to be some misunderstanding. Deputy Reilly's example could not happen. If one does not own the property there is no question of the HSE being in a position to make a charge against that property. If, for example, the property is 80% mortgaged that is a priority. At the time of registration the priorities are dealt with. At any time if somebody's financial circumstances change or the property values change that can be reassessed. For example, where dividends from bank shares form part of one's income and banks do not pay out dividends, as they have not done here recently, that would greatly affect one's income stream but that can be reassessed at any stage.

The Irish Farmers Association has genuinely and warmly welcomed the changes we have made. I met it recently and what applies to farms applies equally to other businesses. It is not exclusive to farms but the case was initially put forward because of concerns in the farming community and among its representatives.

In respect of the National Treatment Purchase Fund, we are going over the main provisions of the Bill. I am happy to do so. The National Treatment Purchase Fund was given the remit because it is independent of the HSE. An organisation independent of the organisation charged with supporting and providing public health services would be responsible for procuring from the private nursing home sector. It is generally acknowledged that it has a good track record in this regard.

To be able to participate in the scheme, which is voluntary, the nursing home must be approved from the financial cost point of view by the National Treatment Purchase Fund. The taxpayer will fund 70% to 80% of the cost of this care throughout the country and the purpose of these provisions is to ensure that we get high quality and reasonable value for money. The new regulations come into effect next week. The new independent inspectorate starts on July 1, which is next Wednesday, and from here on public and private nursing homes will be inspected on the same basis.

With regard to Deputy O'Sullivan's query on capacity, this year 790 new long-term beds and 317 replacement beds will come on stream. Much of the investment over the past two years has been to upgrade current facilities and, in many cases, substantially reduce the number of beds because as Deputies are aware, many of our long-stay facilities are 120 years old. They are former workhouses and totally unsuitable to the standards we are entitled to expect in 2009. A huge amount of the investment is in replacement, which often leads to a substantial reduction in the number of beds. That is important for the quality of life of the residents and so that we meet the standards that are now the law. Existing facilities have a number of years to meet those standards.

If it was not for the participation of the private nursing home sector and the provisions introduced by Deputy O'Sullivan's party colleague and former Minister for Health, Deputy Brendan Howlin, in 1993, when nursing home subvention for the private sector first came into operation here, we would have been in a very difficult situation because the vast majority of older people in long-term care - I believe the figure is 13,000 or 14,000 - are in facilities funded by private providers.

The concern of the State has to be the financial supports that we give and at present 90% of the care costs in the public sector is paid by the Exchequer or those for whom a bed has been procured in the private sector. Those who had to procure their own beds must pay on average 50%, 60% or 70% of the cost and that is grossly unfair and inequitable. The purpose of the fair deal is to bring equity to those situations.

I accept that some Deputies would prefer all of the care to be paid for, there are very few countries if any where long-term care is treated on the same basis as acute care. I know those who represent older people and some geriatricians have concerns about the fact that we will put a charge against the home of the older person where they have ownership or part ownership of the home. However, unless we do so we will not be able to introduce this equitable scheme and, as I stated, very few countries treat long-term care the same as acute care and if people live at home they have care costs.

Resources are capped and, as I stated on many occasions in this House and regardless of who is or has been in this position, there was never unlimited resources and there never will be. No country in the world has unlimited resources. The resources are capped but we believe the Estimates we have made to begin the operation of the scheme in the autumn of this year are realistic to cover the demand.

The people who speak to me must be different to those who speak to Deputy Reilly; we get more calls on this issue from family members of older people in care than on any other issue. This morning we received calls from people wondering when it will happen and when will it be passed.

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