Phil Prendergast (Labour)

I apologise in advance for any duplication that may arise from my remarks, as I had to take a call and was absent from the Chamber for a while. I apologise to Senator Mullen if I refer to some of the points he may already have raised. There are many inconsistencies concerning eligibility for services, even between different regions. I have been contacted by many people in the nursing sector who are involved in delivering care facilities, and I have worked in the health service myself. I also have links to the Irish Nurses Organisation which has first-hand knowledge on what is happening. In that context, my remarks are factual. Ms Marie Carey, one of the owners of a nursing home in Nenagh, contacted me recently. She is in the Nursing Homes Ireland group and referred to the criteria involved and how services differ between regions. Everyone agrees that the current system of financing long-term care fails systematically. It is inaccessible to some, while others find it fairly easy to access.

The Bill has highlighted the unfair and inequitable system which now prevails. Section 40 is a cause for concern and this has been detailed quite well. There is no provision for an arbitration process in the event that agreement cannot be reached between the Minister's designated body, which is the National Treatment Purchase Fund, and the nursing home. There is a strong feeling that there should be an appeals system where the NTPF fails or refuses to agree to include a nursing home on the approved list. That is a glaring anomaly which should be addressed. Where the Minister's designated body and the person running a nursing home business fail to reach agreement, the matter should be determined by a member of a panel of arbitrators established by the chairman of the Chartered Institute of Arbitrators. That is a reasonable proposal which should be encompassed in the Bill. It will not invalidate or worsen the conditions for anyone involved. In addition, the section, as amended by the Minister of State on Committee Stage, is at variance with statements made by the Department of Health and Children. Senator Mullen raised this issue as prices around the country were already known and the Department would have been aware of them. Would it not be obliged to reach agreement?

The contributor to this part of the debate stated that if the National Treatment Purchase Fund had formed the reasonable view that if the price at which long-term residential care services were provided by a particular nursing home was in excess of that at which such services were provided by other comparable nursing homes, the Bill should provide that the National Treatment Purchase Fund should request the nursing home to provide the board with a written explanation of how the price was calculated. If the National Treatment Purchase Fund is not satisfied with the written explanation received, it should have the power to examine the records and accounts of any such nursing home and report the findings of such an examination to the Minister and the nursing home in question. This would provide for the inspection of records, to be preceded by a request that the nursing home in question submit the rationale for the proposed prices. This is a critical issue for members of Nursing Homes Ireland and addressing it in the legislation would remove the anomalies. I would like to hear the Minister of State's comments on this issue.

I thank Mr. Gary Downey and Ms Maria Carey from Silverstream Healthcare because they went to a lot of bother to make sure issues that had been raised and discussed in the Dáil Chamber were followed up here. The fair deal nursing homes scheme has been on the cards for a long time and is very complex. The needs assessment is subject to such scrutiny that sometimes we can miss the small but obvious things that can have cost implications. We are talking about equity and fairness. I will listen with great interest to the response of the Minister of State.