Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

It gives me great pleasure to speak to this Bill, which amends the nursing home support scheme. Like others, I compliment the Minister of State on her doggedness and determination to get this Bill before the House. It has been a difficult year for the Department of Health and great recognition and praise is due to the Minister of State that in the space of 12 months, she has managed to get this Bill to the floor of the Oireachtas.

I was president of a farm organisation when the fair deal scheme was introduced in 2009. At that time we saw the unfairness in the fair deal scheme, and unfortunately it has taken from 2009 to now to get amending legislation to take that unfairness out of the process. As Deputy Calleary has said, there are still some matters we would like to discuss to ensure there are no anomalies in this new legislation. I am nonetheless thankful this will take away the major financial hardship that farm families and small business owners have had to endure over a long period since the fair deal scheme was introduced.

I have seen farm families being brought to their knees financially in trying to meet the contribution to fund the fair deal scheme. It brought hardship on them when a farm is just an ability to make a living for farming families. The main wish of the majority of farmers is to pass that farm, intact or improved, to the next generation. Unfortunately, when ill health strikes and a person must go into a nursing homes, for example, the initial contribution is 7.5% per annum with no cap and this puts huge pressure on the family farm structure. This Bill, as a result, is most welcome and many people will breathe much easier with the introduction of this cap.

A significant contribution must still be made but that is only right. Where an asset exists, a contribution should be made, and this will be done over three years. The continuous drain with no end is being taken out by this legislation being brought forward by the Minister of State. I cannot give her enough credit for the haste with which she has brought the legislation before the Dáil. We were both elected in February 2016 and we pressed a former Minister of State, former Deputy Jim Daly, when he held the relevant position in the previous Government. There were many false dawns but it is great day for the Government that it is now on the floor of the Dáil. I praise it highly.

I will make another few points to the Minister of State when I have the opportunity to speak about care for the elderly.

As other speakers have said, people's main aspiration is to be able to stay in their own home as long as possible. With regard to home care and extending home care, I am aware it is a solid ambition of the Minister of State, Deputy Butler, to improve the home care system currently in place.

On the package that is there and the home care workers and support teams that go around to individuals to help them stay in their family residence for as long as possible, a point was made to me about the shortness of the visit being imposed. This needs to be looked at. The duration of the home care visit by the home care worker in the home must be a reasonable level. This is not just to make sure the person can get all the work done. To attract home care support workers into the scheme we also must have consideration that the person has to be able to make a reasonable income from it. To expect the support worker to come in and have half an hour or three quarters of an hour at one location and then to rush to the next location does not make sense with regard to getting the work done from the perspective of job satisfaction and from an economic and practical point of view, such as allowing people to earn a reasonable income. These workers are going to be a key part of our healthcare going forward. I am aware that the Minister of State is fully committed to home care support and that she will take these observations on board. It can really benefit a family. Everyone has a lot of commitments, we live in a rat race of a world and we have financial commitments to meet. To be able to devote the time to look after the elderly in the family can be very taxing. This support from home support teams can make the complete difference between trying to keep an elderly relative in their home or having, regrettably, to put them into a nursing home.

During Covid we saw the excellent care delivered by nursing homes and the huge pressure they came under. Unfortunately there were cases of clusters in nursing homes but the precautions and care taken by nursing homes with their patients during Covid must be commended to the highest degree.

Members have all been lobbied by private nursing homes. The contribution they get from the State per patient needs to be looked at. The public bed costs roughly 170% to 180% what a private care bed gets from the HSE. This must be examined going forward to make sure there is a level playing field and to make sure the private nursing homes, which are a key part of our health system, are able to continue and do so viably. In the days when we had pre-budget submissions and pre-budget lobbying these nursing homes had lobbied us all intensively. In my view, they made a very solid case for themselves. I ask the Minister of State to look at this to see if the contribution paid by the HSE to private nursing homes could be increased to make sure their viability is not threatened.

The roll-out of the vaccine for the elderly has been excellent. I commend the Minister of State on it. I made representations to the Minister of State about some people who were housebound and she really got her shoulder to the wheel to make sure it happened. The National Ambulance Service got involved and there was a very speedy delivery of what was a very tedious process to visit people in their homes to make sure those people, who were probably the most vulnerable in our society, got the vaccine. It was done with great speed and great efficiency. We had a few outliers for a couple of weeks, but when representations were made they were taken care of very quickly. Again, it was a job extremely well done.

Thankfully, the vaccine roll-out is going exceptionally well. We have a lot of critics in this House but not a lot of them are standing up to praise the vaccine and the way the Department of Health has handled the roll-out. It has exceeded all expectations with the level of efficiency and the amount of people per week who are getting vaccinated. Hopefully, we are over the hump with the roll-out and we are coming down now into the younger age groups. This will greatly benefit the opening up of our economy, for which we all yearn.

This Bill has taken an awful lot of pressure off a lot of families around the country. It will stand as a testament to this Government. It was in our programme for Government and we have delivered on it within a year. It is most welcome legislation. I am delighted to be able to speak to it. When the Bill was introduced I was wearing a different hat, but I saw the unfairness of the system. It is great to be part of the Government that is taking that unfairness out of the system.

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