Michael Finucane (Fine Gael)

I hoped the Minister of State's speech would include some changes in nursing home subvention rates, although I understand he will table amendments later in order to revise those rates. I remind the Minister of State that those subvention rates have been in place since 2001, despite the changes that have occurred since then, including the increased cost of private nursing home care. In the past, when one applied for private nursing home care, family members were taken into consideration in factoring whether or not one was entitled to subvention. Even though that provision was removed subsequently, it happened in a surreptitious way. If one takes the maximum subvention level of €192 and the new pension rate of €200, that makes a total of €392. That means that a person attending a nursing home must find an extra €300 or more to cover the required costs. That is what is causing these problems.

While the provision involving family members may have been dropped from the application form, the same thing is now happening by stealth. In many cases, when an elderly person faces financial difficulty in paying nursing home costs, his or her family members will make up the differential. The Government should recognise what is happening and increase the subvention rates so they will be compatible with current costs. Over the years, the Administration has gradually, by stealth, reduced the number of beds in public nursing homes. By definition, all incentives are going towards private nursing homes. Private nursing homes operate to make profit, which is one of the main reasons some of the inherent difficulties encountered in Leas Cross and other nursing homes occurred. In my constituency public nursing home beds are not available to many of those aged 70 years and over who hold a medical card and are, therefore, entitled to one. The case assessment unit will assess people for public beds but finding a place for them is as difficult as getting a camel through the eye of a needle.

I take issue with the practice of imputing a value of 5% of a person's house. The house of an elderly person living in a rural location was recently valued at €95,000. While this may not seem a great deal of money, is it fair that the 5% imputation, which amounts to almost €5,000 in this case, will reduce the low level of subvention available to the gentleman in question by as much as €90?

The Government has received many plaudits for increasing pensions above the €200 figure. I remind Senators of the much vaunted fact that Ireland is one of the wealthiest countries in the world. The new pension rate is equivalent to 40% of the average weekly income. This is in sharp contrast to the figures in many European countries, specifically the Nordic countries where pensions are 70% of average weekly income. Let us not get carried away with the increase in pensions.

I am annoyed by the layers of bureaucracy attached to dealing with elderly people. It is understandable that the adjudication process for determining eligibility for home care requires an assessment to be carried out by a home help organiser. However, the process also requires that a financial evaluation of eligibility be carried out and a determination made of the number of home help hours the person will receive. If a person is unable to look after himself or herself and moves to a private nursing home, another layer of bureaucracy applies. A further means test, financial determination and an assessment of medical capacity are carried out to determine the level of subvention. Given that the home help organiser will be familiar with the person in question, it must be possible to short circuit much of this work and remove many layers of bureaucracy and administration.

What do officials in the Department of Health and Children do? Every time Members query a decision taken in any area of the health service we are told to refer to the Health Service Executive. The HSE has created layers of administration and tiers of management all over the place. The greatest cause of frustration is the inability to find out who in the HSE is responsible for what areas. I am aware the Government is trying to address this matter by establishing a parliamentary affairs division in the HSE.

Elderly people have major concerns. I hope the package to which the Minister of State referred, including an additional 780,000 home help hours per annum, materialises because most elderly people like to live at home. My mother is 90 years of age and lives at home, thank God. I hope her good health prevails and she will be able to continue to do so. This is not an option for many elderly people who do not have someone to look after them.

The Minister of State, in his 30 minute speech, referred to a series of new regulations which will tighten up matters. I share Senator Browne's concern that the new regulations will give administrators even more power to tighten up rather than relax criteria. It is extremely difficult to receive enhanced nursing home subvention from the Health Service Executive.

If a person is deemed eligible for subvention, by definition he or she will be entitled to a home care package if he or she chooses to remain at home. Is the value of the home care package equal to the maximum amount of nursing home subvention? For example, if the nursing home subvention is €192, will fairness dictate that the person will receive the maximum number of hours of home care? I am concerned that this is not the case and that a person who has been determined eligible to receive the maximum level of nursing home subvention will not receive home care hours of an equivalent value. I ask the Minister of State to investigate this matter. His officials should examine whether equity and fairness apply when a person decides to remain at home. I care about this subject because, like all public representatives, I encounter it on the ground.

A fortune has been spent on an extensive advertising campaign encouraging victims of abuse in long-term residential institutions to claim compensation. How many compensation claims have been paid out? Will there be a sudden rush in April or May next year to pay compensation with a view to impressing people before they go out to vote? The same incentive was used last year when child benefit payments were deliberately delayed and paid in one instalment the week before elections were held. This was done to ensure people voted for Fianna Fáil. I hope the Government is not deliberately withholding compensation payments to people who spent time in residential institutions. Shame on it if that is the case.