Maurice Hayes (Independent)

I will be brief as the Minister of State has already heard most of the arguments and comments. Senator Mooney was somewhat kind to the subsidiary legislation by suggesting its flaw was minor when in fact it was ultra vires. It attempted to change the intent of the main legislation, not to bring it into effect. This is an elementary point and legal advice would have been clear and consistent on this over the years. However, we have a chance to discuss the issue tomorrow.

I have sympathy with two points made by Senator Mansergh. The first is that it is rather much to take up to 80% from an old age pensioner. It is all very well to say he or she would spend the money outside, but one is taking choice from them. A pensioner might decide to have another cigarette instead of another loaf of bread.

The second point concerned the need for flexibility. It is important to remember that what was done under the flawed legislation was neither irrational nor shameful. It is not an unreasonable principle to expect people to pay towards the costs of maintenance and ordinary expenses, particularly when the result of them not doing so is simply to increase the patrimony of their heirs. Whatever is done regarding the correcting of the retrospectivity of the charges, I see no grounds for paying the heirs and successors of people who were charged.

I would like to raise an issue regarding the health economics of the issue. I had some experience of this in another jurisdiction and some of the difficulties that have arisen in terms of definition and practice are the result of the blurring of the division between residential care and nursing care. That comes from the fact that people are living longer and frailer people are being maintained in these homes. There might be an argument for greater flexibility in determining what it is. Doctors were under tremendous pressure in the North, where there was a charging regime for residential homes, to certify people and keep them in hospitals, where they did not have to pay. There was huge resistance to the transfer of a patient from an acute hospital bed, which he or she was blocking up, to a residential home where he or she would be better looked after. There is a need to avoid those kinds of hiccups. There is much to be said for a comprehensive look at the system in general to see if providing more support to keep people in their homes might not allay much of this problem.

It has been stated that the full cost of granting everyone free care might be €300 million per year. I am not suggesting that this should happen. Even if it did happen, €300 million against a health budget of €10 billion is not an enormous sum if it produces savings and frees up acute hospital beds elsewhere. The Minister might ask some of his officials to examine what has happened in Scotland in the last year or so because the Scottish Parliament made the decision to grant nursing and other care to older people, a decision that was not replicated in England and Northern Ireland. It would be interesting to see the difference that decision has made. I would like to reinforce the plea made by Senator Mansergh for flexibility. A maximum amount that might be charged could be proscribed but after that, professionals should be allowed to deal with the individual case in a way that maximises the benefit to the individual and reduces generally the burden on the health services.