Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank the Senator for raising this issue. Before I give the official response, I wish to outline that the balance is delicate because we are dealing with vulnerable people. Because of the approach taken to long-term residential care for older people we must strike the balance well. We do not want regulation and bureaucracy to interfere with the care people receive, but, on the other hand, we must be extremely careful that the type of light-touch regulation we have seen in the past is not applied to a sector which must be regulated and in which we must ensure people receive the best of care.

As the Senator is well aware, Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible and to ensure only the most highly dependent people are in long-term nursing home care. We are dealing with a vulnerable cohort of people and must be careful about how the care is delivered. There is and will always be a cohort of older people who require the long-term residential care option. Residential care for older people is provided in a range of public, private and voluntary facilities throughout the country. In recent years there have been two significant developments in the nursing home sector, both of which were the subject of regulatory impact analyses, RIAs. The introduction of the nursing homes support scheme in 2009 put in place a system of financial support that ensured nursing home care was affordable to all. It is a very generous scheme of assistance under which the State bears the larger part of nursing home costs. Contributions from individuals who choose their own nursing home from an approved list are related to their ability to pay. More than €970 million is allocated to the scheme this year to support more than 22,700 people. Under the Health Act 2007, statutory responsibility for registering and inspecting nursing home settings against national quality standards was given to the Health Information and Quality Authority. Access to appropriate quality long-term residential care is now underpinned by both a strong regulatory regime and an excellent system of financial support.

A regulatory impact analysis was completed in advance of the introduction of both the nursing homes support scheme and the nursing homes standards drawn up by HIQA. The Department of Health prepared information leaflets, A Guide to the Fair Deal and a frequently asked questions document. In addition to dealing with queries and representations from interest groups, public representatives and members of the public, the Department also met interested parties. The factors arising from the RIA were taken into account in implementing the scheme. For the RIA on the national quality for residential care settings for older people in Ireland theDepartment commissioned an independent consultancy to carry out an assessment of costs on the impact of the standards. In addition, a consultation session was hosted in Dublin Castle. The Department has also recently carried out a regulatory impact analysis arising from two changes to the nursing homes support scheme announced in budget 2013. One of the changes was related to the contribution. All three RIAs are published on the Department's website. The Senator will be aware that a review of the nursing homes support scheme is under way and will include a broad analysis of how future overall provision for older people can be made sustainable and best meet people's needs. The review is being carried out by the Department, in collaboration with the HSE. Work will continue on the review in the coming months with a view to completion in early 2014.

I accept the Senator’s point on bureaucracy and form filling, but one must bear in mind that the sector deals with vulnerable people and that it is only the most vulnerable who receive such long-term residential care.

We must be extraordinarily careful that one does not impact on the other and at the end of the day, the care is really what is important.