Enda Kenny (Mayo, Fine Gael) | Oireachtas source

I accept that this is a challenge. Clearly, the demographic trends are as the Deputy has pointed out. Everybody understands that not only is the number of older people in the country increasing but that people are living longer because of advances in general health and medicine. At the other end of the scale, it is true to state children being born today will in many cases live well beyond 100. However, the challenge for now is to provide a health service that gives the very best of attention to all patients. There can be no doubt that it is a challenge.

As of 28 October 2014, there were 2,135 on the placement list. The Government allocated a further €25 million in the budget for 2015 in response to the delayed discharges in acute hospitals. Deputy Martin is well aware that those affected are people that the medical profession would have cleared to leave the hospital setting but who cannot because of the lack of step-down beds or opportunities to go into appropriate homes.

There is a review of the fair deal scheme underway, as announced by the Minister. It will include consideration of the balance between community and residential services, in addition to future financing for the sustainability of the scheme. The review will be published in the coming period and work is well advanced on it. The Deputy is aware of the conditions that apply for participation in the nursing home support scheme. The review of the scheme is considering its long-term sustainability in addition to how the current model of provision balances residential care with care in the community. The question of whether this is to be changed because of what older people wish is being considered. The review will be published in the not-too-distant future.

The budget for the scheme this year is €939 million. Admittedly, this represents a reduction on the figure for the 2013 scheme. It includes €23 million that was transferred from the health service's budget to community services to deliver a greater range of care options that people require, prevent unnecessary hospital admissions, avoid undue delays in discharges from acute hospitals, and provide rehabilitation to support older people in returning home. As the Deputies are all aware, the vast majority of older people want to be in their home and community until such time as medical or other circumstances require their going into an institution.

Some €10 million of the allocation is to provide intensive home care packages, covering 250 people annually. That phase began in April of this year across eight different locations. Some €3 million was allocated for the commission of 25 intermediate or transitional care beds, to benefit 650 people. Twenty of those beds were for complex cases, to benefit 130 people with specific difficulties. Some €10 million was allocated to address funding shortfalls in the provision of public short-stay beds and to maintain the current provision of 1,860 beds.

This is a challenge and the Minister is carrying out a review of the fair deal scheme to get the balance right. The question of the number of discharged patients who can be released consequent to the allocation of €25 million this year and the longer waiting periods for approval of eligibility for the fair deal scheme that have been evident need to be addressed. One cannot expect families to fork out huge amounts of money waiting for fair deal scheme approval to come through.

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