Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I move amendment No. 2:

In page 4, to delete lines 1 to 4 and substitute the following:"(b) In administering the Scheme the Executive shall ensure that it is user-friendly and that applicants are assisted at every stage in the making of their applications and that application procedures are as straightforward and comprehensible as possible.".".

The proposition in subsection (3)(b) did not receive any political, not to speak of public, attention prior to the publication of the Bill. I certainly did not pick up any signal that it would be included in the legislation. The paragraph reads as follows: "The Executive may enter into an arrangement with a person under which that person may perform any part of the Executive's function arising under paragraph (a) on behalf of the Executive." In simple terms, it is a mandate for the privatisation of the executive function of administering the nursing homes support scheme, otherwise known as the fair deal scheme. The insertion of this paragraph is incredible and tantamount to a vote of no confidence in the public service. I do not know for what reason it has been included but it can only have one purpose, namely, to accommodate an intent which has not been presented or explained heretofore.

The purpose of the amendment is to delete subsection (3)(b) and substitute the following paragraph: "In administering the Scheme the Executive shall ensure that it is user-friendly and that applicants are assisted at every stage in the making of their applications and that application procedures are as straightforward and comprehensible as possible." I included this series of requirements, not by reaching to the clouds but based on some not inconsiderable experience of helping people deal with what is a complex process. I seek to delete that part of section 4 which provides for the privatisation of the administration of the nursing homes support scheme. As I stated, this provision had not been signalled previously and amounts to another brick in the wall of the Government's privatisation measures, which have been especially visible in the Minister's stewardship of the health services.

The Minister of State, Deputy Kathleen Lynch, has confirmed that means testing and charges are in prospect for people requiring community-based services such as home care. This alarming prospect, which was only signalled in recent days, constitutes a further attack on older people and people with disabilities, notwithstanding the Minister's attempt in more recent commentary to row back in the latter area.

Last year, when the Minister published the so-called reform framework, Future Health, I pointed out that the types of charges to which the Minister of State alluded were in prospect. According to the Future Health document, social care services such as services for older people, people with a disability and those who need mental health services will be outside of the universal health insurance system. Under the strategy, the so-called fair deal scheme of funding nursing home care may be extended to the disability and mental health services. These were the early signals of what is currently transpiring and I strongly oppose any such proposition.

As I indicated, we have the prospect of means testing for community-based care and charges arising from the extension of the so-called fair deal scheme to incorporate these other areas of care need for older people. This has potentially serious consequences, notably in respect of demand for residential care in future.

In addition, under section 4, we now face the prospect of privatisation of the administration of the fair deal scheme. I reiterate the question I put to the Minister on Second Stage - from where has the proposal to privatise the administration of the fair deal scheme come? What is the motivation behind its incorporation in the Bill? Will the Minister provide a clear answer and indicate precisely his intention in this regard? In my view, the issue is bare-faced and, therefore, requires an open and fully frank elaboration. The Minister must share with the House any plans he may have in this regard, however far back in the pipeline they may be. What research or consultation has taken place in respect of any proposal to remove the administration of the nursing home support scheme from the public service?

The fair deal scheme is a key State scheme, which requires great care, sensitivity and scrupulous fairness in its implementation. The right of citizens who qualify under the scheme must be vindicated. I have experience of assisting people with the process of applying to the scheme and they describe it to me as complex, confusing and drawn out. In tandem with the ever deepening economic crisis of recent years, the application process has becoming increasingly complex. It has become a bureaucratic and legal nightmare and needs to be simplified, streamlined and better fitted to the needs of citizens who require the service.

The purpose of my amendment is to oppose what is, I presume, the Minister's intent in subsection (3)(b) and replace it with a firm commitment to an administration of the scheme that would be commensurate with the needs of ordinary service user applicants, specifically those who are at a stage in life where they need all the compassion and understanding our State systems can provide.

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