Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

We welcome the opportunity to speak about this important issue. I congratulate and thank the Rural Independent Group for tabling the motion which is timely, given that a review is ongoing in the Department and that there is a commitment in the programme for Government to address this anomaly which is causing hardship. The Minister of State is well aware of it, as she outlined in her contribution. In addition, in the amendment to the motion tabled by the Minister there is much that is compatible with the motion. There are just a few areas of slight difference and nuance.

The way farm and small business assets are assessed under the nursing home support scheme is causing great disquiet. When one talks about the transfer of assets, by and large, one is talking about the transfer of wealth. However, in the context of small businesses and farms, one is talking about transferring a working entity or an entity to create income. Assessing the asset based on its value for the purposes of the nursing home support scheme does a great disservice. That is acknowledged in the review and the fact that the Minister of State is examining the issue. We hope and expect the required legislation to be brought forward in the context of budget 2018. Small businesses and family farms are things that tend to be inter-generational. There is a transfer pattern in place. Obviously, one would prefer to see an orderly lifetime transfer of family businesses, but that is not always possible for many reasons and also in the case of a sudden disability or illness, where there was no time for an orderly transfer during the time a person would have been compus mentis. There is a need to address that issue.

The nursing home support scheme is under huge pressure for a number of reasons. The demographics of the population are changing quite dramatically. We are living longer, with life expectancy on the right trajectory. However, that brings huge challenges for society and the State in how to fund health care and care for people who will require full-time nursing home support in the future. It will be a significant challenge for the State. It is something all of us must address and we must accept that we are not facing up to it as robustly as we should. When one looks beyond the horizon and considers issues with dementia and other illnesses that will create huge challenges, we are not putting in place the building blocks and engaging in the planning required to ensure we will have a sustainable system of funding in place, whereby everybody who will require nursing home care will be able to access quality care in a timely manner. That issue must be addressed.

The private sector plays a hugely important and integral role in the provision of nursing home care across the country. Approximately 23,000 people are availing of it and it has a budget of €960 million. A substantial number of people are residing in private residential facilities. We must accept that this is part and parcel of the system. In doing so we must ensure those providers can survive and prosper. Not only must they survive and prosper, there must also be a return for continual development. Otherwise, the full cost will fall on the State which I do not believe has the capacity in the short to medium term to address the huge challenges that will confront it in the future owing to the changing demographics and other factors that are obvious when we look towards the horizon. For that reason, it is important when carrying out reviews to examine the viability and sustainability of the private sector in the delivery of nursing home residences and beds. In that context, an issue has arisen which the Minister might take on board in the discussion on nursing homes - the re-evaluation of commercial rates across the country. That is happening and many smaller nursing homes are being put under pressure owing to the fact that commercial rates on nursing homes have been increased, but the nursing homes are tied into a National Treatment Purchase Fund contract for three years and have no capacity to absorb the unexpected hike in a top-line cost owing to the change in the rateable valuation. The Minister of State is aware of the issue, but we must be conscious of the fact that one cannot expect people to provide the best quality care and care with the best outcomes, as well as meet all of the guidelines laid down by HIQA and the inspections that are rightly carried out, while at the same time being forced to pay an increased commercial rate that was not part of the original assessment when they were dealing with the National Treatment Purchase Fund in drafting contracts. It is an issue the Minister of State should examine.

Another issue that has been raised is the centralisation of offices. I am not sure if it is the case, but we have been led to believe there will be a more centralised nursing home support scheme office system put in place. We are hearing conflicting views, but some counties are very concerned that they might be a long way from the assessment offices under the scheme. Perhaps the Minister of State might elucidate on the matter.

The motion is clear, but the amendment is equally clear. We must have the certainty the Minister of State emphasised.

The amendment calls on the Government to "bring forward the proposed changes in relation to this issue in the context of Budget 2018". That has to be done. It is part of the programme for Government. We will certainly be insisting on that. The amendment calls on the Government to "honour the commitment in the Programme for a Partnership Government to remove discrimination against small businesses and family farms". As said by the sponsors of the motion, it is very clear that there is discrimination. Let us be very honest about this. The assessment of a capital asset, a family farm, that is to be transferred intergenerationally, and in respect of which the only income derived is from farming or from the business conducted through it, is discriminatory. It would be different if it were being sold as an investment. The farms are intergenerationally transferred. This is certainly causing great concern and needs to be addressed.

The amendment calls on the Government to "publish the necessary primary legislation required to bring effect to these proposed changes to the NHSS without undue delay following the completion of the examination of this issue and decisions in the context of Budget 2018". This is critical. It has to be part of the budget arithmetic; otherwise we will be talking about this issue again next year, which would create grave concerns. I call on the Minister of State to honour the commitments in the amendment.

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