Mary White (Fianna Fail)

It is my pleasure to welcome the Minister of State, Deputy Kathleen Lynch, to the House. Having participated with her on the former Committee on Health and Children, I know she will efficiently address the issues that need to be resolved. I also know how passionate and genuine she is in dealing with people in need, including those who may have been forgotten.

The new fair deal scheme was welcomed by many people, including me. As my party's spokesperson for children and older people in the last Seanad, I praised the then Minister for Health and Children, Ms Mary Harney. I felt it was one of the former Minister's greatest achievements, but on current evidence it is anything but. There are many failings in the scheme, which is disappointing. The main factor was that we were to have equitable and consistent pricing around the country for people in private nursing homes. In addition, no elderly person or their families would have to worry about raising the money themselves because it would be levied after the resident's passing.

However, from my experience of talking to those dealing with older people in residential care, it is apparent that it is complicated for the elderly to apply for such care. If they own their own home there are issues concerning personal capacity and an older person may need to apply for ancillary State support. The nursing home support scheme clearly states that no solicitor is required for ancillary State support, but as two medical capacity reports from two medical practitioners are required, some doctors are asking for a solicitor's request prior to issuing the reports.

This ancillary support also means that a proposed care representative has to attend a hearing in the Circuit Court, which is daunting for older persons and their relations. In addition, there is a cost involved with the solicitor and the court, plus the cost of valuing property from an estate agent. These costs are significant for old age pensioners.

Another serious issue is the lack of nursing home beds. Public nursing homes have vacant beds which cannot be filled due to a lack of staffing. One public nursing home - Brú Chaoimhín in Cork Street - was recently closed as it was not able to meet HIQA's requirements. As a result, the residents had to be accommodated in other public nursing homes and therefore overall bed numbers have been further reduced.

Private nursing homes in the Dublin area - and most acutely in Dublin south-central, south-west and west - have literally no vacancies. Patients are thus being strongly encouraged to accept placements in Kildare, Wicklow or Meath. Once the nursing home support scheme is approved, the HSE states in its approval letter that a patient has ten working days to transfer to a nursing home. Due to the lack of beds, however, this is impossible.

Most private nursing homes are issuing a weekly charge to older people on top of their nursing home support scheme contribution of €150 per week. They went in knowing that they would be able to support themselves financially, but because of the wide range of items not covered by the scheme, a further €150 per week is being added. This was decided by nursing homes in agreement with the HSE.

In some Dublin teaching hospitals, the number of patients currently waiting for a bed in a nursing home is 50. Acutely unwell patients cannot go home, as they would be unsafe, but cannot be transferred to nursing homes either as their applications have not yet been approved. Or when the applications are approved, there are no vacancies. This is not only having a negative impact on patients' health, as they do not receive the stimulation they need, but they are also exposed to infections. In addition, they are preventing patients in emergency departments from being admitted.

I am optimistic that the Minister for Health, Deputy Reilly, will be a good Minister. However, despite his statement on 9 June announcing that the support scheme would resume on 13 June, as of yesterday, HSE offices had not received clearance for this. Even patients approved for the nursing home support scheme are not being admitted to nursing homes as there is no guarantee that payments will be met.

There is concern that the scheme was budget-capped and that, at some point, the money will run out. Our main concern is that there does not seem to be a wait-listing system, or some alternative, while funds become available.

I was excited by the fair deal scheme when it was announced, but I am disappointed by how it has turned out. It is clear to me that the fault lies with the Department of Health because the scheme has not been adequately thought out. The Minister has a major job on his hands to bring the Department of Health - like many other Departments - up to 21st century standards in conducting its business.