Imelda Munster (Louth, Sinn Fein) | Oireachtas source

I welcome the Bill. It aims to limit the period for including the value of family farms or businesses to three years for financial assessment under the fair deal scheme, where the family successor continues to operate the farm or business for six years and takes over the running of the farm or business within three years. It is, indeed, a welcome reform.

However, it is a real shame that the Bill does not address some of the other issues with the scheme that I and others have been highlighting for several years. For a number of years, I have sought to find a way to stop the double charging of residents of private nursing homes for items and services to which they are entitled as medical card holders. This practice goes on in many nursing homes where elderly residents or their families have to pay for items as basic as wound dressings, certain medications, sanitary products and services such as physiotherapy and occupational therapy. If these residents were living in the community, these would be provided free of charge under the medical card scheme. The legislation states that this should not happen, but in practice, residents have to sign contracts that include clauses allowing nursing homes to charge them for these items and services. These residents need the nursing home care; they have no choice but to sign the contract. I have highlighted this matter repeatedly to the Government, but it has failed to address it or even to acknowledge that it is a serious problem for some people who have to pay enormous bills for items that should be provided free of charge.

That is only one issue that needs to be addressed. As a member of the Committee of Public Accounts, I know only too well that there are significant shortcomings in how the fair deal scheme is run. Last October. we raised the fact that the National Treatment Purchase Fund, which decides what price nursing homes will charge patients in private and voluntary nursing homes, had ad hocand inconsistent record keeping, which meant that the process was not transparent in some cases. We know that the maximum price decided upon for a patient's care is always the actual price. That is not acceptable.

We also know that when some assessments are done, the process of checking when properties and other assets were signed over to family members is not thorough, meaning that people who hastily sign over assets a year or two before they join the scheme often do not pay the correct amount as the scheme is unaware of the actual value of assets they owned.

We also know that some private nursing homes will not accept certain high-dependency residents, particularly those who are very unwell, or have significant impairments. The public nursing homes often look after these residents, which places an unfair burden on them.

We have been told that some of these are being addressed and the committee will continue to work on these issues. However, I have seen no evidence that any of these issues have been addressed.

I hope that this Bill is only a first step in addressing some of the problems with the fair deal scheme, as a huge number of people rely on it. It has to be fair and work for as many people as possible.

I take issue, in particular, with the charging of residents who are in possession of a medical card for items and services. If they were living in the community, they would be entitled to those products, medicines and therapies free of charge. However, because they are in private nursing homes and have signed contracts, they are being charged. If the residents cannot afford to pay, their families must pay. I came across a family facing a bill of almost €1,500 for a one-year period. That is unfair. The resident in question was entitled to all of the items for which the family was being charged under the medical card scheme. If there is one issue that I ask the Minister of State to tackle from today onwards, it is that. It is wrong.

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