Martin Mansergh (Fianna Fail)

Legal doubts can be raised or expressed about practically anything. As we can see in the courts on all manner of matters, an arguable legal case can be constructed in defence of any proposition or in casting doubt thereon. It would be a brave person who could absolutely guarantee that all legislation and regulations are constitutional in every respect. The real world does not work like that. The health service is always faced with enormous financial pressures. It is understandable, but not necessarily pardonable, that people under annual pressure from the Department of Finance had no particular appetite to explore avenues that might cost a great deal of money. Having said that, we must face up to these situations. If justice requires us to spend €500 million or the best part of €1 billion, then we have to do that. We are fortunately in a financially strong position today.

Today's statement could be regarded as an interim statement, but it seemed to suggest that compensation would be given in respect of the last six years. In the case of long-stay patients such as those with mental incapacity, it would go back further. I was a little surprised and disappointed to hear the Tánaiste say that records in some of these places are very incomplete. The State should require proper record keeping in these institutions. As we have seen with institutions for children and young people, it is imperative to keep proper records in case unanticipated queries arise at some future date. A provision in this regard should be included in the Bill.

In the more numerous category of elderly people entering care, relatively few people will have a stay which lasts for many years. I accept Senator McHugh's point that families in many cases have made considerable sacrifices. We must balance payments to estates to reimburse expenditure which occurred a considerable number of years ago with the pressing needs of the health and other social services today. I appreciate that the balance which must be struck will be a matter of some debate.

Like most Members, I have some little vicarious experience of nursing homes to the extent that I have visited friends or relatives from time to time. Facilities range from the very comfortable and even superb to those with which one does not feel wholly at ease. The sector will undoubtedly grow. I spoke recently to the chairman of a hospital about the problems of accident and emergency services. He made the point that many people in nursing homes should be dealt with by primary care, which needs to be developed, while others should be in step-down facilities. It is clear that we must develop services further.