Seán Ó Fearghaíl (Kildare South, Fianna Fail) | Oireachtas source

I apologise on behalf of Deputy Kelleher, who is unable to be here. Fianna Fáil will not be opposing the amendments, which appear to address certain lacunas in existing legislation. With regard to the changes proposed to the Nursing Homes Support Scheme Act, how much additional revenue does the Minister of State anticipate will accrue from them? It is a pity, however, that the Government is not amending other measures relating to the Fair Deal or nursing homes support scheme in 2014. As the Minister of State will be aware, great concern was expressed about the impact that changes to the scheme in the HSE's service plan for 2014 would have on the sickest and most vulnerable of older people. The 2014 service plan acknowledges the reality that waiting times for a nursing home bed under the Fair Deal scheme would increase in 2014. The 2014 service plan stated that 700 fewer beds - 22,061 beds - would be funded under the scheme in 2014 compared to the target for 2013. In reality, the 2014 target is 1,702 beds fewer than the 23,700-plus nursing home beds funded under the scheme at the end of October last year. In addition to these 23,000-plus people, a further 394 were on the waiting list in October for a nursing home bed. Now, according to figures given by the Minister, Deputy Reilly, to my colleague Deputy Barry Cowen, 1,265 are on the placement list awaiting funding.

Under the 2014 plan, the HSE is to allocate €23 million from the Fair Deal budget and earmark it for community care and home-based care initiatives, such as intensive home care packages, which will benefit 250 people; intermediate or transition beds, which will benefit 650 people; and beds for more complex cases, which will benefit about 130 people. However, as Age Action pointed out, there is a considerable gap between those who will benefit from these initiatives and those left waiting for a nursing home bed as a result of the changes. This will unavoidably lead to an increase in the number of older persons presenting at our already stretched and overcrowded acute hospitals. With inpatient and day-case waiting lists above 50,000 mark now, it is likely that the Fair Deal changes are having an impact.

Last year the Government also amended the nursing home support scheme through legislation. The Fair Deal scheme, as introduced, saw individuals contributing 80% of their incomes and 5% of their assets per year, fixed at a maximum of three years or 15%, and that included their principal private residence and, in some circumstances, farms or businesses. Last year the Government increased the maximum proportion payable from 5% to 7.5% per annum, with a cap at three years or 22.5% in the case of a principal private residence. Savings of €3 million for a half year were anticipated as a result of those changes to the contributions. I expect that at this point the Minister of State will be in a position to indicate whether those savings have been achieved.

Last year's Bill also abolished the requirement to backdate State support to the date of the scheme's commencement for those who were in nursing home care prior to that date. I would like the Minister of State to address an issue that also falls within his remit in primary care. Last week the Government announced that the HSE is to restore more than 12,000 discretionary medical cards that have been lost since 2011. However, last October, when Fianna Fáil tabled a Dáil motion on discretionary medical cards, the Minister of State, Deputy White, who was present, basically told the Dáil that just 1,000 discretionary cards had been lost between the start of 2011 and the middle of 2013. That does not even bring us into the discussion on whether a discretionary medical card even exists. The Government amendment to a Fianna Fáil motion on the issue stated: "[O]f the 24,000 reduction in discretionary medical cards from the start of 2011 to July 2013 almost 23,000 of these persons have been awarded medical cards on the basis of their financial means". In other words, just 1,000 people lost a medical card completely, as the other 23,000 were now qualifying for medical cards under the standard financial criteria instead of on a discretionary basis. The Minister, Deputy Reilly, agreed with the Minister of State, Deputy White, when he said:

The number of discretionary medical cards has fallen. As the Minister of State demonstrated clearly, this is because almost 23,000 people who would have had discretionary medical cards now hold full medical cards.

If that is the case, why is the Minister, Deputy Reilly, now pledging to restore more than 12,000 discretionary medical cards? Even if we add in the additional 6,000 or so discretionary cards lost after July 2013, only 7,000 cards would need to be restored if what the Minister of State, Deputy White, told the Dáil last autumn was accurate. The question is whether the Dáil was misled in this particular matter, even inadvertently, by the Minister. According to this morning's edition of the Irish Examiner, the Department of Health explained last night that the response to the Private Members' motion was "prepared by the HSE at short notice" and based on "preliminary analysis". The question that arises is whether the Minister of State was aware that this analysis, which was the cornerstone of his rebuttal last October, was just preliminary and that it had been produced at short notice. Most of us are required from time to time to produce information at short notice, but this does not remove from us the absolute requirement to be accurate in the information that we produce. Did the Dáil vote for a Government amendment which was factually inaccurate? Did the Department subsequently advise the Minister that the preliminary analysis given to him was inaccurate? Does the Minister of State now accept that he, on the basis of the information that he had, inadvertently misled the Dail? I know we have a short time for discussing these particular matters, as the Minister of State has been engaged in other activity - we wish him well in that endeavour - but the questions we have posed are none the less relevant and I hope he will be in a position to respond.

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