Liam Twomey (Fine Gael)

The Minister of State's contribution breaks down into two parts, namely, what she said about the fair deal — in respect of which I continue to have some reservations — and her comments on the standard of care available to elderly people in nursing homes.

The Minister of State indicated that it is the Government's policy to encourage people to remain living in their own homes for as long as possible. Everyone — older people, their families and the State — would prefer it if this were the case. When the Minister of State says that this is Government policy, it must be made quite clear that said policy will be followed up on. I have another job outside the House — as a general practitioner — which I do not have as much time to pursue as I would like. I am aware there are major difficulties regarding public health nurses, home care packages and access to services that allow elderly people to live at home.

There is no great commitment to allowing elderly people to remain at home, particularly when one considers the problems they encounter in trying to access services such as those provided by public health nurses. When elderly people are discharged from hospital, home care packages are often not available and, as a result, these individuals are left to their own devices. This is the first matter which must be addressed.

The fair deal involves a care needs assessment. Many people bought into the fair deal because they are of the view it involves nothing more than 80% of their incomes, plus or minus a contribution from their homes. The Minister of State indicated in soothing terms that there is nothing about which they should be concerned. It is clear, however, that all their assets will come into the equation. People may be obliged to dispose of the other assets before being considered under the fair deal. Only when they have nothing left but their incomes and family homes will these individuals be considered under the fair deal.

The care needs assessment is extremely important. The Minister of State did not indicate what such an assessment will involve or the length of time a person will be obliged to wait before one is carried out. If an individual is considered to be able to remain at home because he or she can dress, feed and wash himself or herself, regardless of whether he or she is afraid of living alone or is psychologically vulnerable, he or she will not be part of the fair deal. These people will not be able to access other residential State services and they will not be able to gain entry to public nursing homes. Once the State decides they do not qualify, they will get nothing.