Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 44: To ask the Minister for Health and Children the action he proposes to take regarding the funding of the fair deal scheme; and if he will make a statement on the matter. [13457/11]

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Question 46: To ask the Minister for Health and Children the scope of his inquiry into spending in the Health Service Executive in relation to older persons and the fair deal scheme; and if he will make a statement on the matter. [13461/11]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Question Nos. 44 and 46 together.

As the Deputies are aware, 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. I understand these other services, which include therapies and medications, 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 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 the funding situation is under way, conducted jointly by the Department of Health and the HSE. This examination is to be completed by Friday, 3 June 2011. The Minister has 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.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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We addressed this issue in some measure earlier, so I will concentrate on just some of the different areas. The Minister indicated on 20 May that approval of applications "would resume" and said that funding would be reallocated for this purpose. We now face a situation where the entire approvals process has been suspended. Are we to wait until the end of the review, 3 June, or have any other steps been taken to identify additional funding supports for the fair deal scheme? Has everything been sent to limbo for the moment or are we proactively looking at where additional funding can be realised? Will we only start to look at this post the publication of the review?

The Minister claimed that €100 million of the funding allocated for the fair deal scheme was used for other purposes by the HSE, although the HSE would say the funding was spent legitimately on services for older people. There may be truth in both arguments. However, with regard to the Minister's position, does he accept that €100 million that was allocated for the fair deal scheme has been spent in other areas, such as drugs, therapies etc., and that this money must be restored to the fair deal scheme?

It is a pity the Minister must have a surrogate voice here to respond to questions. He has stated there are anomalies not only relating to the funding of the scheme, but also to admissions policy and assessment procedures. Will he elaborate on that? He appears to suggest that some older people have been wrongly assessed and, perhaps, wrongly admitted into nursing homes. We need clarity on his statement.

Kathleen Lynch (Cork North Central, Labour)
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I do not think the Minister made that assertion at all, but I am sure he will speak for himself later. The report on the review is due on Friday. Therefore, it is pointless to start discussing where the money will come from, whether it should be returned to the scheme or how much will be needed in the future until we see the review. This is not an issue that will disappear overnight. It is a long-term issue that will not just be about this year, but about next year and the year after. The issues need to be reviewed and we need to find out exactly what happened and what the financial and other needs are for the future.

The Minister has admitted that €100 million was spent on areas other than the subhead for which it was intended, but it was spent in nursing homes. Other subheads could have paid for those therapies and medications. This is the subject of the review, which will try to establish where the money was spent and how we will rectify the issue.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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I accept the Minister is in a difficult position. If I understand correctly, the Minister is saying that the money was spent from the wrong subhead, but it was spent in areas where it was needed and now we have the problem of trying to identify the money elsewhere, but that it may well be needed in the area from which it will be taken. This is the bind we are in. Some of the Minister's earlier comments suggest he agrees with me that even initially the fair deal scheme was not ideal, based as it was on property prices and putting liens on people's houses. Does he agree that is what makes the terrible bind in which we find ourselves? This is all happening against the background of the IMF-EU deal and the austerity programme.

I know it is not entirely up to the Minister, but should we not say that if we seek other funding, it cannot come from robbing other vital health services? It must come from elsewhere and that requires a Government willing to impose taxes on the wealthy and get money from those who can afford it in order to fund the vital health services without which ordinary people will suffer and face a continuing crisis in the health service.

Kathleen Lynch (Cork North Central, Labour)
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We all accept that this issue concerns a vulnerable group of people and we want the best possible solution. We need to find out where the money went. The review of the fair deal scheme was promised under the programme for Government and even if this problem had not arisen, the scheme would have been reviewed. The issue is accountability. If the subhead provides the money is to be spent on "X", it cannot be spent on "Y". The lack of accountability and transparency is evident and that is what the review will clarify.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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With all respect to the Minister and Minister of State, the responses they have given create a deeper crisis of confidence in the fair deal scheme for the future, because of the lack of certainty. The questions posed and responses received are hugely problematic for many people. How quickly after the receipt of the review report on Friday will the Minister be in a position to make a clear statement of intent on the future of the fair deal scheme? How quickly will he be in a position to say that we are back to processing to approval stage and that beds will be reopened and access will be provided for people who needed long-term nursing home care? Will the Minister respond as quickly as possible after Friday?

Kathleen Lynch (Cork North Central, Labour)
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It is not possible to answer the Deputy's question as none of us has a crystal ball. We will have clarity after Friday and we intend to deal with the issues early next week. We do not know what is in the review and, therefore, cannot say that we will process and approve provision next week. Above all, we reassure people in receipt of care under the fair deal scheme that there is no threat to their service. When talking about this vulnerable group of people, we must be clear, precise and honest.