Áine Brady (Kildare North, Fianna Fail)

I understand the intent of amendment No. 25 is to provide for situations where a person is in nursing home care but could return to his or her community if sufficient community-based supports and services were in place. It stipulates that the HSE would offer to undertake a review of care needs every six months and no later than every 12 months to ascertain whether the person could move back to a community-based setting. A person may seek such a review under section 30 at any time. As such, this amendment is unnecessary and I do not propose to accept it. I hope my clarification addresses the Senators' underlying concern.

Amendment No. 26 proposes that all reviews be undertaken by people who have not been involved in a previous assessment. While I appreciate the good intention of this amendment, the review mechanism is different in purpose from the appeal mechanism. The initiation of a review does not indicate confrontation or disagreement with a decision. Rather, it is a mechanism by which changes in a person's circumstances or issues which were perhaps overlooked in an initial assessment may be brought to attention and taken into account.

Under the subvention scheme, subvention recipients generally undergo an annual review of their financial circumstances. In many cases recipients will have depleted their assets or may have reached the three-year cap in respect of their principal private residence and these factors can be taken into account in determining the future level of subvention payable. A review of care needs will be undertaken by health care professionals on the same basis as the original care needs assessment.

Given that some individuals may require assessment by particular dedicated specialists and that these specialists are limited in number, it would be wholly imprudent to stipulate that a review of care needs could not be undertaken by an individual who was a member of the original multidisciplinary team. In many cases it would be highly beneficial for the same practitioners to re-assess a person periodically. It would ensure a continuity of care whereby the practitioners will be known to the individual and will have a solid knowledge of the person's previous health status and circumstances. For these reasons I do not propose to accept amendment No. 26.