Mary Harney (Dublin Mid West, Independent)

No. All officeholders must live by the Constitution. We all have clearly defined powers. Section 5 of the Ombudsman Act states that the Ombudsman may investigate a matter but if the person affected by the action has initiated any court civil legal proceedings and the proceedings have not been dismissed for failure to disclose a cause the Ombudsman is precluded from investigating the case. In spite of that, the case of Mrs. B, who is the centrepiece of the investigation, is currently before the High Court. That was made very clear to the Ombudsman. In a letter of 29 August the Ombudsman said she would not deal with litigation yet that case is the centrepiece of her report. She mentioned many other cases that she would not investigate but she would presume she could rely on the complaints. If we got complaints and did not investigate them nobody would take us seriously. The issue is one of law. The Ombudsman's role is clear in the law. On the advice of the Attorney General to me, my Department and to the Government, the Ombudsman went way outside her authority on the investigation.

I wish to deal now with the substance of the report. The Ombudsman said we failed to bring legal clarity on the eligibility of older people to care. The nursing home support scheme could not be clearer. It has now supported 12,200 people in long-term care. Two hundred individuals have been refused care. Relatively speaking, that is a very small number. One of the officials involved in the nursing home scheme was speaking today at an OECD meeting because of the interest expressed in the scheme. The British Government has asked for a copy of the scheme and Norwegians have come to this country to ask about it also. Many countries see our long-term support scheme as not only sustainable and fair but one they would like to mirror in their own countries. In Britain 60 old people a day sell their homes to pay for long-term care.

The reason we introduced the nursing homes support scheme is that the system we had was grossly unfair. There is no doubt about that. I said that when I brought the legislation through this House. To be fair to parties opposite, with the exception of Sinn Féin, the nursing homes support scheme was broadly supported. I accept Deputies had issues with it but it was broadly supported as it was seen to be a reasonable attempt to introduce a system of support for older people and their families that was fair to families. Heretofore, if one were in a public nursing home 90% of the cost of care was paid regardless of one's means. If one were in a private nursing home 40% of the cost of care was paid. Now we have a nursing homes support scheme that treats everyone equally.

Everyone is entitled to an assessment of his or her need. That assessment of need is done on the same basis for every single individual. In the case of the 200 applications which were refused, some decisions were made on the basis that applicants were not regarded as people who were in need of or suitable for long-term care. Everyone has a financial assessment, again, based on his or her means. Everyone gets support on that basis. Nobody pays more than 80% of his or her disposable income, whatever that is. Everyone is entitled to keep 20% of his or her income.

I visited three nursing homes in the past week. Some of the correspondence we receive from families show considerable support, especially from those who were supporting parents or loved ones in nursing homes for many years. Nursing home care was completely unaffordable for many people, some of whom had to sell homes, remortgage or take out big loans. In the current financial circumstances I cannot imagine what that would have been like.

In 1993 the then Minister, now Leas-Cheann Comhairle, Deputy Howlin, introduced the nursing home subvention scheme as an honest attempt to support people in private nursing home care. The allocation for the scheme was £5 million in 1993. It rose to €350 million in its final year of operation. The subvention is still being paid to some people, on the basis that no one was going to be adversely affected, but nobody new can avail of it. This year, between the subvention and the nursing homes support scheme we are spending just under €1 billion.

The Department's estimate of support required for the rest of this year is sufficient to meet the demand. Notwithstanding the financial pressures we are under, that money is being ring-fenced for next year. We are providing sufficient money. On the issue of eligibility and entitlement, in every country in the world entitlement is subject to a cap on resources. Nobody has infinite resources for health. Whether it is in the United States or in Europe a finite amount of money is available to fund health. Therefore, eligibility must be governed by the resource cap that is available in any year. This has been the policy of successive Governments, although it means waiting lists for services in many areas. The Ombudsman seems to take the view that it is never acceptable to have a waiting list. Nowhere in the world is there not a waiting list. It is not realistic in the context of a finite amount of resources. For the foreseeable future, however, we will be able to provide the resources required to meet demand.

Not only can older people get supports on the basis of their means and a single assessment of need, but nursing homes are all quality assured. Two nursing homes have already been closed down by the Health Information and Quality Authority, HIQA. Nursing homes are inspected against rigorous environmental and, more important, care standards. Everyone must have an individual care plan, which must be implemented. We are receiving considerable praise from nursing home residents and their families for our new standards of care. Last week, I attended the first inaugural awards for private nursing homes, presided over by Uachtarán na hÉireann. It was great to see people being enthused about the even-handed approach to inspection in the public and private sectors.

In the Ombudsman's report, she was critical of a number of factors, including what she calls marketing and spin. On page 129, the report unfairly refers to public servants being involved in political marketing and spin.

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