Fergal Browne (Fine Gael)

The one political issue about which I have changed my mind is the need to plan ahead. Care for the elderly is an integral part of that concept. When I worked as a teacher, I took for granted the fact that I would have a nice pension on retirement. Many older people find themselves in nursing homes and, consequently, under severe financial hardship. The Bill is designed to place the current regulations in a legislative framework. Fine Gael's concern, however, is that it will make it more difficult to obtain basic or enhanced subventions. The Minister of State spoke of standardising subvention rates throughout the country but it remains to be seen how that will work in practice. The current system is far from perfect but at least there is some scope for appealing and making representations on individual cases. Will that scope be removed in the standardised approach? Will it be a black and white situation with someone being either under or over the limit?

I am puzzled by the provision whereby 5% of the value of a person's home is taken into account when calculating subvention rates. We will all die some day but we never know when and therein lies the difficulty. An elderly person could spend three weeks, six months or ten years in a nursing home. Due to advances in medicine, patients are now living longer. I am sure Members of the House have made representations to their local geriatric hospitals to get people admitted, but the answer is always that all the beds are occupied and there is no regular turnover of patients. That is a particular problem in the case of women in nursing homes who tend to live there for two to three years on average. The lifespan of patients in nursing homes has increased, which has put great pressure on those involved. People seeking to have their elderly relatives accommodated in nursing homes must often seek places in private nursing homes.

The 5% rule is unfair in some cases. I was approached by a couple whose relative was in a nursing home. The man was single and in calculating the equation they were going to take into account 5% of the value of his house. He would not sign over the house at the time, however, so the couple were left in an impossible situation. Some days he was for signing over the house, while on other occasions he was against doing it.

There is an onus on everyone to plan ahead. Has the Minister of State considered the idea of encouraging people to set aside money in case they have to go into a nursing home? Could he discuss with the VHI a possible expansion of its scheme to give people that option? If they wished to pay extra money into the VHI, it might cover them for future nursing home charges. We should examine this matter and encourage people to plan ahead. None of us knows whether we will end up in a nursing home. My own grandfather had a peaceful death in his 80s. He got up one morning, did not feel well and so lay back in his own bed and died a few minutes later. It is a lovely way to go but others who are unwell may spend years in a nursing home. I am thinking of patients with Alzheimer's disease in particular. They are physically well but unfortunately their minds are not.

The Minister of State should negotiate with the health insurance companies or establish a scheme, similar to the SSIAs, whereby people could set aside money to cover the cost of nursing homes in later life. The population is living longer and the number of 65 year olds is set to treble in the coming years. That statistic represents a timebomb waiting to explode.

The Government's record on the elderly is not good and the Minister of State knows that. It took the Fine Gael Party to highlight the issue of medical cards and overcharging for nursing home care. As we have seen, the repayments are not coming on line as quickly as they should be. In addition, nursing home patients are still being charged for clothing and social outings. Recently, I received representations from a lady whose brother was in an institution for people with mental disability. She claims that he is being charged for clothing and social outings, including a trip to Lourdes. She is concerned about the interpretation of the regulations. Perhaps the Minister of State could re-examine whether it is appropriate to charge for such facilities?

Last year, the Minister for Health and Children, Deputy Harney, promised a better home-care package, yet there is great ambiguity over the increased number of home-care hours. In his speech, the Minister of State referred to additional hours. In the Dáil, Deputy Twomey said that home-care hours had been cut, a claim never conclusively refuted by the Minister.