Billy Kelleher (Cork North Central, Fianna Fail)
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Question 38: To ask the Minister for Health and Children if he will provide further clarity regarding funding for the nursing home support scheme; the reasons behind the review of the scheme; when he was informed that funding had run out for the scheme; when he called for the review to take place; the reason the public was not informed of this review sooner; when he expects the review to be completed; the number of persons waiting for funding to be approved; and if he will explain the effect that this will have on these persons and on hospital waiting lists. [13617/11]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 39: To ask the Minister for Health and Children the action he will take to ensure the immediate resumption of approval of applications under the fair deal scheme; and if he will make a statement on the matter. [13516/11]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 38 and 39 together. The Minister for Health and Children has recently been made aware of a serious shortfall in the fair deal budget for this year. The budget is coming under pressure from, among other things, increases in overall costs and increases in net demand for long-term care. Furthermore, the HSE has advised that the long-term residential care subhead is also funding services other than those covered by the nursing homes support scheme. These other services, which include therapies and medication, are being provided to people in nursing homes.

The decision to suspend approvals under the nursing homes support scheme was made by the HSE on Friday, 13 May 2011 and a letter was issued to each regional director of operations for further distribution to all hospitals in their areas. A copy of this letter was sent to the Department of Health and Children on Tuesday, 17 May. The Minister for Health and Children was advised that day and a meeting with the HSE took place that evening.

A full examination of funding is under way, conducted jointly by the Department of Health and Children and the HSE. This examination is to be completed by Friday, 3 June 2011.

The Minister sought further information about the level of funding provided for and the cost drivers impacting on the long-term residential care subhead. The main priority at this stage is to establish what steps might be taken to allow more people to benefit from the scheme. In the meantime, applications for financial support under the scheme will continue to be accepted and processed. However, decisions to grant approval will be subject to the availability of funding.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister of State for the reply but it leaves me more confused than I was before. I do not mean that disrespectfully. Last week in The Irish Times, the Minister for Health and Children said "I believe it is only proper that money be brought back from the ancillary services and put back in to the Fair Deal scheme which will allow for the continued processing and approval of people". When this issue was raised in the Dáil several days ago, the Taoiseach said quite clearly that there would be processing and approval of applications. At the same time we find there is no approval. Does the Minister of State agree that this was badly handled in the context of notification to the public? It happened in a drip-drip manner and there was concern, fear and anxiety generated among people dependent on nursing home care or who had applied for nursing home care. We had fanfare at the announcement of the sacking of the board of the HSE, where cameras and media were tripping over each other. This took place in a drip-drip feed to the public and there was no clarity brought to the issue. There is still no clarity because one Minister is saying approvals are being allowed and today's statement says we must wait until 3 June for a review to be completed.

Kathleen Lynch (Cork North Central, Labour)
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Everyone is very concerned about this but the days of spinning a message are long gone. We must be honest and open with people and there is a substantial shortfall in the necessary funding to provide long-term care for elderly and not-so-elderly people. There is no disagreement between myself and the Minister and we are looking at how to best provide for the long-term care of the people for whom we are responsible into the future.

Applications are being accepted and processed. When funding becomes available, approvals will be forthcoming; as of now there is a shortfall in the budget. Items were paid for out of the subhead which should not have been paid for in that way. We are not saying anybody made off with the money, as it was spent in nursing homes on people who needed the services. They should have been paid for out of a different subhead. That position is clear to most people and we must be clear with people from here on. There must be honesty and openness rather than a notion that there can be a spin on bad news.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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This is the first time we have had the opportunity to put questions directly to the Minister since news of this issue broke on 18 May and yet it appears, very strangely, that we will not hear answers from him. I have the height of respect for the junior Minister in the Department answering, as she has, although the answers are most disturbing. It would be doubly disturbing for the Minister to sit silent through all of this.

Does the Minister or Minister of State acknowledge that over the period since 18 May - the issue dates from 16 May - many older people and their families have been and still are very concerned about the future of the fair deal scheme? We cannot lay enough emphasis on that. I presume we are all cognisant of all that was exposed in the "Prime Time Investigates" programme last evening, which is a backdrop to this afternoon's exchange. How many older people are currently awaiting approval and in acute hospital beds? That number was speculated yesterday to be 477; that is almost 500 older people awaiting approval and access to nursing home beds across this State. They are currently in inappropriate acute hospital beds in hospital sites the length and breadth of the State. How many others are at home under the loving care of families or home care packages? What is the total number of people awaiting approval? When will approvals recommence?

Kathleen Lynch (Cork North Central, Labour)
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I agree with the Deputy as people are very concerned. It should be made crystal clear that those people in receipt of long-term care face no threat to the service. That is not what we are talking about. I cannot tell the Deputy how many people are at home who may have aspirations involving long-term care or how many people are in beds in hospitals with aspirations of long-term care. I can only deal with the facts as presented.

As of end of March 2011, the level of applications processed is at 78%. The figure sought by the Deputy of figures in process is 4,604. The number of people in receipt of long-term care is approximately 22,000. We are not talking about small numbers or in a vacuum as we have facts. We know that of the 22,000 in receipt of long-term care, there is absolutely no threat to the service. When we get the money in order to grant approval to those who deserve it, we will issue grants of approval.

Billy Kelleher (Cork North Central, Fianna Fail)
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In the programme for Government it is stated quite clearly that there will be an increase in funding every year in the provision of nursing home care. We now find money is being taken from ancillary services in order to fund the fair deal nursing home scheme. Does the Minister of State agree that at this stage it is clear there are insufficient funds for the continuation of new approvals? Is it now time to admit that the programme for Government is dysfunctional and what is required is a Supplementary Estimate?

This is about choices. A couple of weeks ago the Government potentially raised €2 billion with a pension levy but none of that money went to the health system. It is about choice.

Róisín Shortall (Dublin North West, Labour)
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It is about choices made by Fianna Fáil.

Billy Kelleher (Cork North Central, Fianna Fail)
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People have suggested this could go away but it will not; we must confront the problem. Nobody is talking about spinning the matter. We are talking about clarity and truthfulness as there are not sufficient funds for the programme. Funds must be found.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I am not privy to how the figure was compiled but I assume some assistance was given through the HSE but I again point out that almost 500 older people are in acute hospital beds awaiting approval for access to nursing home beds at this time. In other words, there is a serious hold-up in the freeing up of very important acute hospital beds because of this debacle. What steps are being taken by the Department in order to ensure that those people gain access to nursing home beds under the fair deal scheme and that those beds are freed up to cater to the many others who need them?

Will the Minister of State clarify the figure of 4,604 referred to as in processing? Was that of 31 March? Will the Minister of State clarify the detail of the response and would the Minister of State agree that the figure is staggering? If the €100 million is to be redeployed from another source, it will not be adequate to cater for the remainder of 2011. What further funding is being sought now for the fair deal scheme?

Kathleen Lynch (Cork North Central, Labour)
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There is a clear shortfall in the funding. Maybe the 500 people in acute beds make up part of the 4,604 but that is not clear. All we know is that a certain number are waiting for final approval. Some will not gain final approval because of other circumstances such as not being in need of long-term care and various other issues.

We do not have the money to provide final approval for the applications; it is as simple as that. There is turnover in long-term care and that will always be an issue. People will come out of the system, which is an issue that can be considered. The final examination of where the money went and how we will manage this scheme for the rest of the year will come to us on 3 June.

The figures I provided were for the end of March. We can stand here all day playing games but the issue is way too serious for that. People are very worried about the long-term care of elderly parents, spouses or siblings and the problem is too serious for political games. We are working very hard to ensure the matter is resolved.

Billy Kelleher (Cork North Central, Fianna Fail)
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We need leadership.

Kathleen Lynch (Cork North Central, Labour)
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This is clearly a legacy issue.