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

Táim sásta an deis a fháil le labhairt ar an rún tábhachtach seo. This motion focuses on the inadequacies of the fair deal scheme for farm families and family-owned businesses. This is an issue I have been acutely aware of for some time now. I have been lobbied and approached by families who quite rightly feel that it is unfair that they are being disproportionately penalised when accessing the nursing home support scheme, NHSS, because they had, more often than not, a small holding of farmland. The IFA has also raised this vexed matter with me.

At present, the cost of one’s care depends on one's income and assets. An individual contributes 80% of his or her assessable income and a maximum of 7.5% of the value of any assets per year towards the cost of care. The 7.5% per annum contribution applies for the duration of an individual’s stay in the nursing home, save where a three-year cap applies to the applicant’s principal residence.

There is no doubt but that this is unfair and it is those with small land holdings that are impacted the most. There are approximately 140,000 family farms in Ireland with an average size of 32.7 ha per holding. The Teagasc national farm survey shows that the average family farm income was €26,300 in 2015 and that farm family income varies considerably, with 70% of farms earning an income of less than €25,000. The motion states that the current financial assessment is not progressive, is fundamentally unfair and has a disproportionate impact on low-income farm families, and I agree. It is for that reason that we will be supporting this motion which calls for, among other things, the commitment in the Programme for a Partnership Government to remove discrimination against small businesses and family farms to be honoured.

The motion also recognises the importance of the nursing home support scheme, and I fully agree. However, it is far from perfect. There is one area that I wish to highlight. Prior to the introduction of the fair deal scheme, older people in Border communities in need of residential care could take up unhindered residence in nursing home facilities north of the Border within their own communities. The money followed the patient. The subvention went with the older person. With the advent of the fair deal, a partition descended once again in our midst, turning lifelong friends and neighbours away from each other in their final years and forcing those whose residence is located south of the Border to look to often more distant locations from their home for residential care in their own county or in neighbouring counties. This is discriminatory and grossly unfair. It also ignores the important role these facilities north of the Border have played and could play again in helping to meet the ever-growing demand of our ageing population. This is an important issue for people in my constituency of Cavan-Monaghan, particularly for those from communities that do not just run along the Border strip but straddle it, just as they have straddled the inter-county lines over many generations. This issue needs to be addressed to facilitate a right of access to the nursing home of their choice for older people in need of long-term residential care whose home address is on this side of the Border but whose nearest - I emphasise this - or preferred nursing home is situated north of the Border. I could cite several examples of that and expect the Leas-Cheann Comhairle could do too.

It is important to point to the fact that, notwithstanding the importance of the NHSS, more people than necessary are going into long-term residential care due to the lack of resources for home care packages. A great positive of the fair deal scheme is that if one qualifies for a nursing home place, the State is legally obliged to ensure one gets a bed. However, the same is not the case for those who require a home care package. There is no legal obligation on the State to ensure one gets what one requires. It all depends on the resources available. This should not be the case. The State should be legally obliged to ensure that, where safe, people should have the legal entitlement to a home care package. Investment in this area needs to be increased dramatically.

We need to urgently move to a rights-based system whereby vulnerable citizens can receive long-term care in their home and in the community when needed and thereby reduce the reliance on acute hospital beds and long-term nursing home care.

Having made those points, I have no hesitation in acknowledging the mighty service being provided to our older citizens who are in need of long-term residential care by private and voluntary nursing homes across this State. Quite frankly, we would be in desperate straits without them. It is worth noting that there is a differential of €490 between the average weekly fair deal payment and the average fee payable per resident per week in HSE care. That differential is considerably more than half the average weekly fair deal payment. These points should be noted by the Minister for Health.

With 23,590 people in residence and a staff number of 25,176, the private and voluntary nursing home sector is a significant part of the older person care regime. It is also entitled to a fair deal.

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