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

Sadly and despite all his protestations, which I cited in respect of amendment No. 2, one did not expect the Minister to do so. Talk about performing a volte-face. The position he holds now is a complete reversal of that which he held when he was on the Opposition benches. Essentially, he is a cheerleader for all he opposed when he was an Opposition spokesperson on health. His position is no longer recognisable. The only thing which is recognisable is his face. What is happening here is extremely sad because it will feed into the loss of confidence among so many people in the political process. Citizens cannot believe in or depend on voices in this House because what those voices are saying changes to suit the moment. There must be a restoration of confidence in order that people can believe that a position taken while in opposition is one which will be followed through on in government.

The proposal to increase the contribution from 5% to 7.5% will act as a deterrent. I am concerned about the impact it will have on families engaging in a consideration of the needs of their loved ones and alternatives to residential care. The latter is not the first choice or option for families in the context of loved ones who are in their later years. The normal and natural inclination is to do everything possible to allow loved ones to remain in their homes, where they are happiest and in familiar surroundings. If they are able to offer an opinion - some cannot do so as a result of a deterioration in their circumstances - I am of the view that the overwhelming majority will indicate that they want to remain at home. Sadly, however, there comes a time when residential care becomes a real option. In some instances, it is not an option at all but is rather a requirement. It is a sad point in the life of any family when a parent, elderly sibling or whoever must have recourse to residential care.

I am concerned on a number of levels. I am of the view that a distinction should not be made between the provision of care to people with dementia, Alzheimer's and a range of other degenerative and life-impacting conditions and other areas of care in respect of which asset charges do not apply. Such charges have, however, applied in this area since the introduction of the scheme in 2008. We should consider the health care of all citizens equally and provide universally on the basis of need alone rather than on the basis of ability to pay or geographic location. Those are principles.

My amendments do not do what I would like them to do. However, they acknowledge the situation which obtains and seek that there will not be a two-tier system whereby those already in the scheme will only pay a contribution of 5% while those whom enter the scheme subsequent to the passing of the Bill will be obliged to pay 7.5% in respect of the net asset value of their estates. It is important we should treat everyone equally and that we should not create two-tier approaches in this or any other area relating to meeting the health care needs of and providing supports for citizens. All people should be treated equally and respectfully.

I again urge the Minister to retain the current contribution of 5%. He made an excuse to the effect that as a result of the reduction in the value of property, there is no alternative to imposing the increase in order that the level of intake will subsequently increase. The Bill does not provide for the Minister to revisit and reduce the asset contribution at some point in the future when matters might come full circle. Damn right he will not revisit and reduce it if there is an upturn in fortunes - as we hope there will be - in the short to medium term. Sadly, the position is that, once imposed, the increase will be here to stay. For all of the reasons I have outlined, I believe amendments Nos. 3 to 6, inclusive, should be accepted.

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