Billy Kelleher (Cork North Central, Fianna Fail)

I welcome the opportunity to speak on this issue. The difficulty last year was that funding for the fair deal nursing home scheme ran out. It was suspended last June or July creating uncertainties. Admittedly, a further €50 million was put into the scheme by the Exchequer to ensure it would not run out of funding. A review is currently under way but reviews by extension lead to uncertainty. I am concerned this review could drag on for a long period and, therefore, I want to get clarity on what the review will entail. Is it just a value for money review or is it an overall review of the scheme? Is it an overall review of how we fund care for the elderly in our communities and society generally.

As a practising politician, the Minister of State knows the anxiety and concern among people about how they will fund long-term residential care for their elderly loved ones. Filling out application forms for such subventions years ago put huge stress and strain on families while eating into their savings. In some cases, their basic ability to function as a family was undermined by funding long-term residential care for relatives.

While there has been some criticism of it, the fair deal scheme has been transformative in removing uncertainty. People now know a place will be available for their loved ones when they need long-term residential care. I am concerned, however, that this review will undermine the good work that was done in the context of establishing the nursing home support scheme and all that stemmed from it.

While this is not a criticism of the Minister of State or her ministerial colleague, Deputy Kathleen Lynch, is there an ideological issue concerning private nursing homes? Such homes can make a contribution in delivering health care and long-term residential places. The reduction of 630 private nursing home beds will have a huge impact because there has been no increase in home support schemes or home care packages. People will not be able to move from the acute hospital sector to an intermediary step-down facility and perhaps on to long-term care, if required.

A large capacity is being taken out of long-term stay beds, but there is no indication from the Department or from the HSE about how they will find long-term residential accommodation for those who require it. The demographic increase in our elderly population means that in the short to medium term this issue must be addressed once and for all. Is the fair deal nursing home review fundamentally a value-for-money review or is there a broader remit to the review group in terms of how we fund such facilities and how we will care for the elderly in future? Ultimately, the fair deal nursing home support legislation is primary legislation which will have to return to the Dáil for discussion if any amendments are made to it. The legislation must be effective, quick and we must ensure it does not undermine people's confidence or increase anxiety among those considering long-term residential care or nursing home care.

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