Dáil debates

Thursday, 20 May 2021

Nursing Home Support Scheme (Amendment) Bill 2021: Second Stage (Resumed)

 

5:30 pm

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank all the Deputies for their valuable contributions. I greatly appreciate the positive words and the cross-party support for the Bill. We have heard many contributions over the past three days. I understand that the Bill is technical and complex in nature and that there will be some further work required to refine it as it passes through the Houses. I look forward to working constructively with the House to achieve the best possible outcome for families with farms and businesses. We will work through the details of the Bill on Committee Stage and consider any amendments tabled by Deputies. As I already indicated, I will also have a small number of Government amendments. It is my sincere hope to progress this Bill through the Houses as quickly as possible in order that this long-awaited measure can begin to have a positive impact on the lives of families with farms and businesses across the country. Indeed, I am already in talks with the select committee to have Committee Stage taken next month.

This is a complex Bill, as I have said, involving many legal considerations, but its core aims are straightforward: to ensure fair treatment for farm and business-owning families without impacting negatively on the future sustainability of the scheme, thereby preserving access to care for those who need it. The Government recognises and acknowledges the real concerns that farm and business families have had for many years regarding the fair deal scheme. This legislative change will address the uncertainty faced by family successors to a farm or business as they will now be able to operate that business or farm in the knowledge that the maximum charge on the property for the person receiving care services will be 22.5% of its value, provided all of the conditions of the scheme are met. This will assist in protecting the future viability and sustainability of these productive assets for many families.

Farms are traditionally passed down by families through generations and it is important for rural communities that farms can continue to operate within the family unit and be maintained as sustainable productive assets. Small farms, in particular, play an important role in supporting rural employment and maintaining the social fabric of rural areas. This amendment will help sustain rural communities by encouraging the orderly succession of farms to family successors, encouraging young farmers to remain farming, and potentially encouraging family members who had changed occupation or emigrated to return to the family farm.

I acknowledge the important contribution of the business community, particularly small, family-run businesses, to Irish society. As someone who worked in a small family business for many years, and sold both the Irish Pressand the Irish Independent, I know how important it is that we recognise and value the investment of time and effort that business-owning families have made, and their equally strong desire to pass down their livelihoods to the next generation. The preservation of smaller family-owned businesses is a priority for the Government and has been a key focus of the supports we have provided throughout the pandemic.

I again thank all the Deputies who spoke on the Bill and raised important questions. I will address some of their points now, although there will be more time to discuss them in detail on Committee Stage. I will first address the matters that were raised in respect of the provisions of Bill.

Several Deputies asked whether retrospective payments will be considered for contributions to the cost of care already paid by nursing home residents with farm or business assets. This matter was examined in detail and, unfortunately, retrospective payments will not be possible. Retrospective application of the proposed legislative changes would create a challenging precedent, involving high legal and administrative costs and risks, in attempting to apply retrospectively a complex set of conditions. Following the contributions by Deputies Harkin and Fitzmaurice, however, I wish to make clear that the absence of retrospective payments does not prevent a person who is already in the scheme from availing of the three-year cap. The time that a person has already spent in care counts when making up the three years to quality for the cap. If, therefore, a person has spent five years in care, he or she can qualify for the relief from further contributions straight away once he or she appoints a family successor and meets the other conditions of the relief. Similarly, if a person has spent two and a half years in care, he or she can avail of the cap after he or she has paid contributions for the final six months and has met all the other relevant conditions, including the appointment of the family successor. However, the family successor must still be committed to working the farm or business for six years from the date he or she is appointed.

Deputy Pringle raised a number of issues regarding the operation of the scheme, including when the three-year cap will apply. The three-year cap will always apply after three years have been completed within fair deal, provided that the family successor has been appointed at some point in those first three years. However, applicants would be advised to appoint their family successor as soon as possible after they enter care services, so that the six-year period which the family successor must commit to can begin.

Deputy Pringle also mentioned the situation where an identified family successor who may have been working abroad returns to run a farm or business when a parent needs care services. When applying to appoint a family successor, the applicant must declare, by way of statutory declaration, that the farm or business asset had been actively worked for at least three of the five years before he or she entered care services. The family successor does not have to have worked the farm in that period as long as it was being actively worked for at least three of the five years by the person in care or his or her partner. One point to note is that the family successor does not need to provide proof of income or having worked the farm at this point.

The review process was also mentioned by Deputy Pringle. Although it is expected that most applicants will only appoint one family successor, this amendment allows a person in care to appoint multiple family successors to multiple different assets, although only one family successor can be appointed to any given asset. Once the three-year cap applies, the HSE will review each appointed family successor to ensure compliance with the conditions of the scheme. There will be an appeals process for all decisions made by the HSE.

I continue to hold the view that the scheme should not be extended to change the method of assessing income from productive assets that are subject to a lease agreement. The policy intent of this amendment is to protect family farms and businesses that will remain within the family as a source of employment and income into the future. This policy would not be advanced if income from leasing arrangements was included in the cap.

I would also like to thank Deputies for their contributions on matters that extend well beyond the scope of this amending legislation. It is heartening to hear the commitment across all parties to the improvement of older people's care in Ireland. I am particularly encouraged by Deputies' support of existing Government policy, which is to support people to live in their own homes and communities for as long as possible with the correct wraparound supports.

As Deputies are aware, the programme for Government commits to the introduction of a statutory scheme to support people to live in their own homes which will provide equitable access to high quality, regulated home care. To advance this, I am committed to establishing a statutory scheme for the financing and regulation of home support services. Work is ongoing in my Department to determine the optimal approach to the development of the new scheme within the broader context of the ongoing reform of the health and social care system, as envisaged in the Sláintecare report.

This work encompasses the development of the regulatory framework for the new scheme, the examination of the options for the financing model for the scheme and the development of a reformed model of service-delivery. Regarding the development of a regulatory framework for home support services, I am pleased to say that the Government gave approval on 27 April to draft a general scheme and heads of a Bill to establish a licensing framework for publicly funded for-profit and not-for-profit home support providers. I intend to progress this general scheme and heads of Bill as a priority with a view to bringing it through the Houses at the earliest opportunity.

In the meantime, real progress is being made that will enable us to put the scheme in place. I expect the national home support office in the HSE to be established this year and sanction has been provided for the appointment of 128 assessors to roll out the use of the standardised tool for the assessment of care needs. I have championed the single assessment tool in opposition and in government as I know it will be a vital part of improving how care is delivered for older people. I look forward to bringing this legislation to Government and anticipate strong cross-party support for it.

In the interim, 2021 saw unprecedented levels of investment in home support, with an additional 5 million hours provided to support older people to remain in their own homes for as long as possible. This means that 23 million home support hours will be available this year to support people to live well and age well at home.

Deputies also emphasised the need for broader reform of services for older people, including the development of new models of housing to support older people to age in place. Experiences over the past year have provided us with clear indications of where and how services need to be improved. The work of the Covid-19 nursing homes expert panel is a very important element of this and I am fully committed to its ongoing implementation. I also fully support the collaborative working that is ongoing under the joint policy statement, Housing Options for Our Aging Population. We must ensure that these and other strategies and plans deliver real change for the older people of Ireland.

Several Deputies highlighted the impact in communities where homes are left vacant for a period of time as a result of residents being in long-term care. It has been proposed that rental of these homes might alleviate the housing crisis. However, this brings with it real challenges and high risks of unintended consequences. There is no other exemption of rental or other business income from assessment in the scheme and care needs to be taken to ensure that incentives do not incentivise premature entry to care or create financial abuse or other safeguarding risks. It is also important to note that there would be complex legal and other impacts and responsibilities arising for residents and their families, including eligibility for reliefs and benefits they may currently be entitled to.

Throughout their contributions, Deputies emphasised the critical importance of ensuring that the fair deal is fair. Therefore, we must ensure that any incentives do not undermine the principle of fairness at the heart of the scheme or create precedents that would undermine its financial sustainability into the future. These challenges are not, however, wholly without solution and I believe that working constructively with Government colleagues on this matter will bring results. My Department is actively working with the Department of Housing, Local Government and Heritage on this issue. I am certain that we can work together to devise and bring forward policies in this area that are targeted, equitable, safeguarded and based on robust evidence.

My priority at this time is to bring forward the legislation for farmers and small business owners without delay. In the meantime, I am committed to working towards bringing forward an amendment on Committee Stage on extending the three-year cap to the proceeds of the sale of a principal private residence. This proposed amendment relating to the three-year cap, which is the subject of this Bill, is grounded in the principle of fairness that is fundamental to the fair deal scheme and seeks to remove a disincentive to those who would otherwise choose to sell their home. It is also targeted at bringing into use those homes that would otherwise be vacant for many years.

I also thank Deputies for their contributions that relate to wider questions of the financial model of the scheme and the balance between public and private provision. These are important questions that the Department is actively considering and will be an integral component of the overall reform of services for older people.

Finally, I would like to emphasise the extensive range of supports provided to all nursing homes throughout the pandemic. These have included serial testing, the provision of free PPE, infection prevention and control supports, training, financial supports, the availability of 23 Covid-19 response teams and temporary accommodation for staff. Under the temporary assistance payment scheme, up to €92 million was made available in 2020 for nursing homes, with up to €42 million available for 2021.

The last 14 months have been an incredibly challenging and difficult time for people living in nursing homes, their families and nursing home staff. However, the advanced stage of the vaccination programme across nursing homes has had a considerable impact to date with the current positivity rate at 0.11% and the number of outbreaks reduced to five. To put this in context, there are currently 571 registered nursing homes operating across the country. I would like to join with each and every one of my colleagues who have over the past three days complimented and paid tribute to the incredible work that has been done in the nursing home sector, including private, public and voluntary services, over the past 14 or 15 months. It has been an extremely difficult and challenging time for all.

To conclude, as a Minister of State from a rural constituency, and based on my own experience in family business, I am fully aware that family farms and small businesses form the backbone of our economy. They perform a vital role in providing employment and enhancing the future development of rural Ireland. I am also aware that farmers and small business owners often do not see their farm or business as an asset, but rather as something they are taking care of for the next generation. It is, therefore, essential that these farms and businesses are protected so that they remain viable and sustainable assets for families long into the future. This legislation will deliver a fair deal for these families, enhancing protections and improving the accessibility and affordability of long-term care for farm families and small business owners.

I welcome the Deputies' support for the Bill as we move to Committee Stage.

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