Maria Corrigan (Fianna Fail)

I thank the Cathaoirleach for the opportunity to raise this very important issue. I welcome the Minister of State, Deputy John Moloney. The introduction of the fair deal nursing home repayment scheme has been a very welcome development. It has brought considerable peace of mind to individuals and families who are trying to plan for the future and were concerned as to how they might meet the ever-increasing costs of nursing home provision. I welcome it.

The issue I am raising appears to be somewhat of an anomaly. It relates to older people who are in need of nursing home care and who are suffering from an age-related disorder such as Alzheimer's or senile dementia and who at the time they require care or after they have been admitted to a nursing home, their disorder results in a deterioration in their condition and it is felt they need a higher degree of support in order to keep them safe. Concerns then exist as to whether the level of support they are receiving is adequate. It is then recommended that they are moved to a higher support unit.

In such instances what is occurring is that, even where such individuals have been eligible and approved for the fair deal scheme, if they are moved to a higher support unit, the nature of which, as the Minister of State may be aware, will often come under the auspices of the Mental Health Act, it may not be deemed to be an approved centre for the fair deal scheme. In those instances the financial support from the fair deal scheme ceases to exist. Families suddenly find themselves facing bills of up to €1,200 or €1,300 per week for the level of support required. This can occur in situations where the higher support unit may be in the same building and may even be on the same campus.

I am aware of an example in my constituency, the Bloomfield Nursing Care Centre, an excellent facility which has received tremendous support and funding from the Government. There are a number of nursing home residents and part of the facility is approved under the fair deal scheme. Yet, the moment a resident is required to move to a different corridor he or she is no longer eligible for the scheme and the financial support of the fair deal does not follow him or her even though he or she remains in the same building. I spoke to a constituent today who has already paid in excess of €300,000 in fees and the family savings have run out. The family is now concerned about how it can continue to meet the cost of care of their mother.

I wish to ask the Minister of State whether we can put a proposal on the table which would see us extend the fair deal to approved centres which are specifically for older people who require high support. That could take place in a nursing home or an adjacent facility. Section 3(1) of the Nursing Home Support Scheme Act 2009 contemplates that a fair deal could be extended, not alone to approved nursing homes. It states:

"long-term residential care services"—

(a) subject to paragraph (b), means—

(i) maintenance, health or personal care services, or any combination thereof, provided by or on behalf of the Executive to a person—

(I) whilst the person resides in and is maintained in a facility—

(A) that is publicly designated in writing by the Executive as a facility predominantly for the care of older people, which designation shall, subject to section 33(2), specify the health or personal care services to be provided at that facility, and

(B) in which nursing care is provided on the basis that at no time should there be less than one registered nurse present in the facility who is available to provide nursing care for the persons maintained in the facility.

Centres, such as the one to which I referred, which provide the high level of support required by people who are in the later stages of Alzheimer's would meet that designation and therefore could be designated as approved centres under the fair deal scheme, and thus alleviate a considerable source of anxiety for families. Is the Minister of State aware that under the fair deal scheme the person contributes to the scheme, whether with the value of his or her assets or property? It is a way to alleviate the concerns people have while they are alive as to how their care will be financed.