Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank Deputies Brendan Ryan and Emmet Stagg for raising this issue which is very pertinent at this time, given that we are in prolonged discussions with various Departments and desperately trying to do what they are asking for. As they rightly pointed out, the nursing homes support scheme provides financial support for those who require long-term nursing home care, with residents contributing a portion of the cost in accordance with their means, which is essential. It is a scheme which relieves families of potentially very onerous expense and even protects the greater part of the value of a participant's main residence. However, it is also expensive. The amount allocated to the scheme in 2015 is €948.8 million. Again, demographic trends mean that the scheme is under pressure because of the increasing numbers of older people in the population. The number of the population over 65 years is growing by approximately 20,000 each year and the population over 80 years which has the greatest need in terms of utilisation of health services is growing by some 4% per annum.

The scheme is demand-led but, as Deputy emmet Stagg rightly pointed out, resource-capped. In the Nursing Homes Support Scheme Act 2009 a provision was included in order to ring-fence the funding for the scheme and ensure it was used for the provision of financial support under the scheme. To manage the available funds through the year, the HSE operates a national placement list in order of when applications are approved, which is very important, and funding is released in strict chronological order as it becomes available. As of 16 January, there are 1,313 people on the placement list, with an average waiting time of 11 weeks, down in some cases from 17 and 18 weeks. The budget for the scheme in 2015 is €948.8 million, an increase of €10 million on the figure for 2014. Some €10 million allocated to the scheme related to the delayed discharges initiative.

I will forward this reply in full to both Deputies, but I believe we need to talk about some other issues concerning the fair deal scheme. For example, the review of the scheme which I expect to receive in the next few weeks will tell us that it is unsustainable in its current financial make-up, given the demands on it. What it should tell us and what I would like it to tell us is that people will be able to access the fair deal scheme in the community, rather than having to avail of long-stay nursing home care, if that is their preference.

It is about preference and choice. I would hate to think that because I had reached a certain age and despite the fact I was capable of making these choices myself, my choices would be limited. We also need to look seriously at the issue of capacity. Even if we could provide a fair deal scheme place for everybody in hospital who needed one, there are certain areas of the country where we do not have the capacity to move patients from hospitals.

I am a great believer in identifying difficulties and finding solutions. If the fair deal scheme was resource and demand-led, it would provide comfort for both the public and private sectors and deliver more of the beds we so desperately need. The fair deal scheme must be a combination of the two options. It must be about choices in the community and ensuring that if people are offered a bed, it is in an the area close to where they live and those who might wish to visit them. For example, if the patient is in Naas or Kildare, the bed offered should not be in some place that is inaccessible to him or her such as in Waterford. We need a full and wider debate on this issue. We understand the difficulties, but we need to come up with perhaps different solutions.

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