Trevor Ó Clochartaigh (Sinn Fein) | Oireachtas source

This is a complicated section dealing with several aspects of the residential support services scheme. Section 19 provides for the insertion in the Health Act 1970 of a series of new sections which change how the scheme is administered. It introduces a definition for residential support services as services other than outpatient, acute, inpatient or long-term residential care services provided by or on behalf of the HSE to a person residing in a hospital, convalescent home, nursing home or residential accommodation for persons with physical, sensory, mental health or intellectual disabilities and where that person's accommodation is provided by or on behalf of the HSE.

This scheme is essentially to supplement the fair deal scheme for certain categories of persons who do not, or, more correctly, will not qualify for the scheme. We are concerned about this scheme. The services that are to be provided under the residential support services scheme are in no way comprehensive enough to deal with the considerable demands for high-quality residential care and, in reality, it is rather unclear how this will work in practice. We are also of the view that this complex section could operate to the disadvantage of some who are seeking to avail of residential support services.

One of the new sections inserted by section 19, section 67C, provides that the HSE shall collect a contribution towards the cost of maintenance and accommodation from a person who is receiving residential support services if the person has previously received specified services on at least 30 days within the 12-month period ending on the day in question. It also provides that the Minister for Health, with the consent of the Minister for Public Expenditure and Reform, may make regulations specifying the amounts of the contributions required from persons or classes of persons within certain limits. This means the contributions could rise and it is not clear what the contributions would amount to. As I understand it, the section was not originally meant to form part of the Bill. Why has the Minister sought fit to insert the section now and why are there not more details on the operation of this?

We are seeing a reorganisation with regard to this area, with this scheme supplementing the fair deal scheme. However, there has been insufficient discussion on this. The Bill is separating out things that had previously been together meaning that people who were not charged will now be charged for residential support services. It is hard to understand why medical cardholders will also need to pay. This section disadvantages certain categories of people who wish to avail of residential support and will affect some of the most vulnerable in our society. The Bill heaps further pressure on people who are elderly, disabled or unwell and their families at a time when they can least afford it and therefore we oppose it.