Mattie McGrath (Tipperary, Independent) | Oireachtas source

As far back as May 2017, this House voted to accept the motion that I and my colleagues in the Rural Independent Group brought forward, outlining the reforms needed to happen as regards the nursing home support scheme called fair deal. I thank Maura Canning from the IFA for all the support she gave us at that time and since then. Since then we have had numerous commitments from the Minister of State, Deputy Jim Daly, who I accept is genuinely trying to progress the matter, that legislation to give effect to these changes is on the way.

However, other more serious matters have come to light during the intervening time. Analysis by Nursing Homes Ireland, NHI, revealed that the HSE is paying nursing homes up to seven times more than the fees being paid to private and voluntary counterparts which raises issues of competition and displacement of staff using state aid. This is totally unacceptable. This information only came to light after the HSE consistently refused to disclose and stonewalled as to the costs of care in its homes over a five-year period and would not give us answers. Now we know why. In the figures released, we see that the spend to provide care for 5,000 residents in nursing homes is approximately €366 million per annum whereas the equivalent spend to support 17,000 residents in private and voluntary nursing homes is just €600 million, which is not even double the earlier figure. There is something rotten here that has to be rooted out.

The Taoiseach must accept that such overpricing is threatening the sustainability of the entire fair deal scheme. Can the Taoiseach clarify if this is the reason for the delay in introducing the reforms? Something is holding it up. Is the HSE resisting this obvious threat to its revenue generating activities? Goodness knows the HSE is holding up enough issues and is underperforming in so many areas. It is outrageous to have rural people - farmers and business people - discriminated against in this appalling fashion and it is by no means a recent problem.

As far back as 2015, I called on the then Minister for Health, tú féin, Taoiseach, to explain to the south Tipperary participants in the fair deal scheme why they are paying, on average, €26,000 extra per year to access the scheme compared to participants in north Tipperary, all of whom are in the same county. Something is rotten in the state of Denmark. It is almost ten months since July 2018 when Minister of State, Deputy Jim Daly, announced that the Cabinet had approved a proposal to change the treatment of farms and businesses under the scheme and to extend a three-year cap to farms and businesses. The Minister of State said at the time that he was looking forward to progressing changes in the Oireachtas in the autumn session. Can the Taoiseach please confirm if we are any nearer to progressing this matter, given the considerable delays that farm families and many thousands of other families have already had to endure? The situation is totally unfair.

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