Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State. It is not often that I agree with Senator Marc MacSharry, but it would have been helpful if the Minister's speech was given to us before the debate commenced.

I am a little disappointed. I made two calls to the Department yesterday seeking clarification not only on this matter but also another health Bill to be discussed after this and I find it unhelpful that I do not even know as I go into the next debate what the approach will be in dealing with the next Bill. As a result I will support the Bill on the next Stage.

This Bill amends the Nursing Homes Support Scheme Act 2009 and the Health Act 1970. The 2009 Act was brought in to set up a proper structure to provide funding for nursing homes. As far back as 2001 the Ombudsman's report had identified several deficiencies in how we were providing nursing home care. It was amazing that it took nine years before any major development took place. That followed court hearings on the matter in 2004 and 2005 and it took another three or four years to develop a proper structure. This has worked well over recent years and this Bill makes some amendments to it. We face challenges in elderly care over the next few years. There are many young people in the Visitors Gallery. By the time they reach retirement age people will be living even longer than they do now.

In 2003 there were 441,900 people over 65. By 2012 that had risen to 549,300 and by 2030 it is expected to rise to 926,000. The year 2030 may seem to some of us a long way off but it is only 17 years away and that highlights the planning that we need to do to make sure that when we provide nursing home care there is adequate funding. The figure for 2030 represents an increase of 141% on the number over 65 from 2011. That is a major challenge for the health service. One of the interesting figures emerging from research too is that there are fewer people in the older age category who have disabilities. People are far more active now. Since 2006 the number over 85 has increased by 22% which further emphasises the need for long-term planning to continue to provide the level of support that we are giving.

The budget for 2013 provided over €13.6 billion for health care which is a huge budget. It is important that we manage that and provide maximum care for all the citizens of the country and elderly care is an important part of that overall programme for the year. Maev-Ann Wren identified a need for 13,000 additional residential places by 2021 which is only eight years away. I do not think that will have to be delivered but we need to develop new programmes and try to provide more home care packages so that more people can stay at home longer when they need support. This Bill provides for increasing the asset contribution of 5% per annum for three years up to 7.5%. While the Opposition may criticise that increase we need to plan ahead.

We have not seen any figures for the recovery of money from people who signed up under the fair deal scheme over the past three or four years and unfortunately have since died. Will we get an annual report of that collection? I have not seen any evidence of the collection process in place. I know that it is a very short period in real terms but I imagine that the State is entitled to collect from people who signed up to the fair deal scheme.

This Bill provides for several changes not only in respect of elderly care and its cost but also of charges in hospital. My opposite number raised concerns and is not supporting this Bill. There is a problem in the cost of health care both in terms of the overall cost and the way the health care service has grown. It is far more comprehensive now. Over the past ten or 15 years the number of people attending outpatient appointments has gone from 2 million a year to over 3.5 million a year. While I regularly see letters in the paper criticising the health care system, a recent one even said the health care sector is in a shambles yet we have one of the best maternity care services in Europe, with one of the lowest maternal mortality rates. It is important that in providing health care we make sure that there is adequate funding to allow that develop and grow. While the Opposition is raising serious concerns about this Bill in order to continue the level of services required there must be a cost factor. This Bill is dealing with that cost factor and planning for the future.