Seán Haughey (Dublin North Central, Fianna Fail)

I will reply to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Breen for raising the issue, which provides me with an opportunity to update the House on recent and proposed policy developments in services for older people.

The Government is committed to supporting people in living in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the health service supports access to quality long-term residential care and we continue to develop and improve health services in all regions of the country and ensure quality and patient safety.

The year 2009 was a time of fundamental change and reform within the nursing home sector. In addition to the new quality standards, care and welfare regulations and a system of independent inspection for all nursing homes, the Minister for Health and Children also introduced a new scheme of financial support for long-term nursing home care, a fair deal. The fair deal scheme was introduced to address the fundamental inequity in the treatment of public and private long-term nursing home residents and to alleviate the financial hardship being experienced by long-term residents in private nursing homes.

Prior to the introduction of the scheme, many people in long-term nursing home care experienced unaffordable care costs over many years. The result was that many people had to sell or remortgage their houses or turn to family and friends in order to find the money to meet their care costs. A fundamental purpose of the new scheme was to offer assurance to one of the most vulnerable groups in society, those in need of long-term nursing home care. Such care was to be affordable and remain affordable for as long as required.

The Government also recognises that many people need short-term care in nursing homes from time to time. The HSE provides significant short-term care, including over 750 designated respite care beds benefiting an estimated 19,000 people. It also provides in excess of 1,000 dedicated rehabilitative, convalescence and assessment beds within its own facilities. In addition, the HSE is currently working to reconfigure services within its facilities to ensure that the best possible use is made of public resources in the provision of both long-term and short-term residential care services.

The Department of Social and Family Affairs provides a respite care grant which may be used to purchase short-term care in private nursing homes. With regard to the extension of the fair deal scheme to short-term care patients, it must be noted that the scheme involves long-term co-payment arrangements between applicants and the HSE, including the possibility of entering into a loan agreement secured by a mortgage. The feasibility of extending these arrangements to short-term patients would have to be carefully considered.

The Government is committed to developing a financially sustainable funding model to support all long-term care services, both in community and residential care services. It is envisaged that this work would also encompass short-term residential care such as respite and convalescence care. This commitment by Government was made in the social partnership agreement, Towards 2016, and preliminary work has commenced within the Department of Health and Children on the analysis of funding models.

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