Áine Brady (Kildare North, Fianna Fail)

The Bill currently defines long-term residential care services as "maintenance, health and personal care services" and further stipulates that the precise goods and services which constitute maintenance, health and personal care services shall be laid before the Houses of the Oireachtas by the Minister for Health and Children - sections 3(1) and 33(2).

The Senators' amendment would introduce a contradiction into the legislation whereby on the one hand, the definition would be based on the comprehensive and complete list of goods and services laid before the House, while on the other, it would comprise any matter or service identified in any individual's care needs assessment. Thus, the definition would suffer from internal contradiction. The proposal would reconfigure the definition, making it both completely open-ended and constantly changing, depending on each individual care needs assessment. This undermines the Minister's ability to fulfil her commitment under section 33(2) and would therefore be unworkable from a legal perspective.

Furthermore, the definition of long-term residential care services, including the list of goods and services laid before the Houses, forms the basis for the published cost of a public bed and the agreed price of a private bed. The State will not be able to publish and stand over the cost of a public bed if the basis for the costing is a moveable feast contingent upon a future care recipient's care needs assessment. Similarly, the NTPF and the private nursing homes will simply not be able to negotiate effectively if the services that are provided are not clearly specified and agreed.

In addition, I understand from the Age Action Ireland policy document, from which this amendment stems, that the underlying purpose of the amendment is to include therapy services implicitly within the definition of long-term residential care services. However, as I stated on Committee Stage, the provision of and access to therapies is a matter which extends well beyond nursing home settings. As such, it must be addressed comprehensively by the forthcoming eligibility legislation. The Department of Health and Children is currently working on eligibility legislation. There is considerable confusion about what people are eligible to receive. In the context of therapy services, whether physiotherapy, occupational therapy, speech therapy, community based services or primary care, we need to bring greater clarity to the range of services available and to the issue of eligibility. The eligibility legislation is the appropriate place to deal comprehensively with this matter.

I trust the Senator will accept my very strong reasons for not being in a position to accept amendment No. 1.