David Norris (Independent)

I thank the Minister of State and understand her argument, particularly as regards the internal contradictions which we do not want. However, I should like to place before the Houses the reasons for proposing the amendment. The Minister of State is quite right in saying it derives from the brief of Age Action Ireland. The Bill, as it exists, proposes to inform people of long-term care needs and to place their needs into a care group and detail the costs of different aspects of care. It also promises to provide care services, defined as maintenance, health or personal care services. However, individuals will sign up to this deal on the basis of self-sufficiency. They will be partially responsible for the provision of their own care needs should therapy services be an additional, unforeseen expenditure for the Exchequer, and by this fact not affordable to the fair deal. It should have been explained to the public from the start. This funding mechanism does not allow for the capacity of individuals to make personal contributions towards services defined as additional that are very basic to their ability to participate in activities of daily living, such as talking.

I find that quite interesting and I accept what the Minister of State says about internal contradictions. She is right that despite the fairly general wording, "identified in the care needs assessment as necessary", it principally refers to services such as therapy. Could the Minister of State clarify a point for me? From Age Action's argument, which I have just read, it seems there is an implication that should a patient under the fair deal scheme or his or her advisers identify certain therapeutic treatments as necessary or beneficial, they will not be able to add them into the scheme even by paying for them. If that is the case it would be regrettable.

It is regrettable that there should be a two-tier system, but it is even worse if a person has an identified problem that can be met by a professional remedy and can afford to pay for it but cannot add that in. There is a strong argument in terms of the welfare of the patient that they should be permitted to do so. I do not approve at all of two-tier systems. We have a two-tier health system and I deplore that. However, within that two-tier system it is additionally unfair, if my interpretation is correct, that without this amendment a patient with private means would be inhibited in accessing beneficial treatments. I hope I am wrong in that. The Minister of State will have an opportunity to demonstrate whether I am wrong. If I am right, there is still a serious problem in the Bill.