Pat Breen (Clare, Fine Gael)
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I thank the Acting Chairman who always brings a breath of fresh air to the Chair and is very efficient.

Finian McGrath (Dublin North Central, Independent)
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Hear, hear.

Pat Breen (Clare, Fine Gael)
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I welcome the opportunity to raise this important issue on the Adjournment debate and I thank the Ceann Comhairle for it.

The fair deal nursing home scheme which came into effect on 27 October 2009 was described by the Minister for Health and Children, Deputy Harney, at the time as a groundbreaking change within the nursing home sector. It was to give peace of mind to people who required nursing home care for the future by providing a single comprehensive scheme covering private, public and voluntary nursing homes. Its aim is to give patients equal access to care and end the two-tier system that had applied.

My constituency office has been inundated with queries from anxious patients and their families about the scheme. I organised a public meeting on the issue in Kilrush recently at which there were more than 150 people. They are concerned and do not know what is happening. My intention was to try to provide some clarity to people as to how the scheme operates and who qualifies for it. I thank the HSE for giving me information and supplying personnel to the meeting.

I draw the Minister's attention to some of the difficulties which have been experienced by families following the introduction of the fair deal, especially the fact that no provision was made for patients who would require short-term stay in nursing homes. Furthermore, since the scheme was introduced last October the HSE received more than 5,200 applications by the end of December. As a result it is taking a considerable number of weeks for these applications to be processed. Some applications take up to five months. Although there is a provision for financial support to be backdated to the date of admission of the person into a nursing home the reality is that in the meantime patients and their families are coming under enormous pressure and suffering anxiety regarding paying for the care of their loved ones in a nursing home.

The nursing homes, too, reported to me that like any other business they cannot afford to wait five months for payments. They have operating costs, wages, electricity, etc. Applications for the fair deal scheme for County Clare are being dealt with by the HSE nursing home support section in Limerick. I have heard very positive stories from both families and nursing homes following their interactions with this office. The staff there are doing their best but are overloaded with cases.

I appeal to the Minister of State present, Deputy Seán Haughey, to put extra resources into the office to help it clear the backlog of applications. It is traumatic for any family when an elderly person has to go into a nursing home. If people are to have confidence in the scheme it is essential that applications are dealt with quickly.

I understand the Department of Health and Children has begun work on analysing future funding requirements for long-term care which would include the role of short-term care such as step-down or respite care within nursing homes. I urge the Minister not to allow this backlog situation to continue and I hope the Minister of State will convey this information to Deputy Harney. She must introduce measures to bridge the gap for those people who need short-term stays.

Only this week I met a constituent who was in tears as she told me of her experience. She lives in Dublin; her uncle, who broke his hip some weeks ago, lives in County Clare. He is an old age pensioner living alone so after his hip surgery he had to go into a nursing home where he might have to stay for up to two months. His niece is out of her mind with worry and the bill for his care is already over €5,000. She is out of work but people from the nursing home are on to her every week looking for money. There are similar cases all over County Clare and we can all give such examples.

I met with other families with similar experiences, whose members require nursing home care for convalescence after hospital treatment or short-term nursing home care in emergency cases. The Minister claims the availability of the respite care grant can be used to cover the cost of short-term care in a nursing home. However, the winter initiative now only allows for a person to have one week of free respite care in a nursing home to convalesce. Once the winter passes, there is nothing in any event. One week is completely inadequate.

The scheme should be extended and the number of qualifying weeks increased to bridge the gap that currently exists. This would help to alleviate the worry and stress families are currently enduring. I appeal to the Minister of State this evening to introduce interim measures to handle the anomalies which have arisen since the introduction of the fair deal scheme. A nursing home scheme to address the requirement for short-term stays in nursing homes should be implemented; otherwise, nursing home care for some people and their families will be anything other than a fair deal.

Seán Haughey (Dublin North Central, Fianna Fail)
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I will reply to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Breen for raising the issue, which provides me with an opportunity to update the House on recent and proposed policy developments in services for older people.

The Government is committed to supporting people in living in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the health service supports access to quality long-term residential care and we continue to develop and improve health services in all regions of the country and ensure quality and patient safety.

The year 2009 was a time of fundamental change and reform within the nursing home sector. In addition to the new quality standards, care and welfare regulations and a system of independent inspection for all nursing homes, the Minister for Health and Children also introduced a new scheme of financial support for long-term nursing home care, a fair deal. The fair deal scheme was introduced to address the fundamental inequity in the treatment of public and private long-term nursing home residents and to alleviate the financial hardship being experienced by long-term residents in private nursing homes.

Prior to the introduction of the scheme, many people in long-term nursing home care experienced unaffordable care costs over many years. The result was that many people had to sell or remortgage their houses or turn to family and friends in order to find the money to meet their care costs. A fundamental purpose of the new scheme was to offer assurance to one of the most vulnerable groups in society, those in need of long-term nursing home care. Such care was to be affordable and remain affordable for as long as required.

The Government also recognises that many people need short-term care in nursing homes from time to time. The HSE provides significant short-term care, including over 750 designated respite care beds benefiting an estimated 19,000 people. It also provides in excess of 1,000 dedicated rehabilitative, convalescence and assessment beds within its own facilities. In addition, the HSE is currently working to reconfigure services within its facilities to ensure that the best possible use is made of public resources in the provision of both long-term and short-term residential care services.

The Department of Social and Family Affairs provides a respite care grant which may be used to purchase short-term care in private nursing homes. With regard to the extension of the fair deal scheme to short-term care patients, it must be noted that the scheme involves long-term co-payment arrangements between applicants and the HSE, including the possibility of entering into a loan agreement secured by a mortgage. The feasibility of extending these arrangements to short-term patients would have to be carefully considered.

The Government is committed to developing a financially sustainable funding model to support all long-term care services, both in community and residential care services. It is envisaged that this work would also encompass short-term residential care such as respite and convalescence care. This commitment by Government was made in the social partnership agreement, Towards 2016, and preliminary work has commenced within the Department of Health and Children on the analysis of funding models.