Keith Swanick (Fianna Fail) | Oireachtas source

The fair deal scheme is fundamentally a good scheme and the former Tánaiste and Minister for Health, Mary Harney, deserves credit for its introduction. It was, of course, introduced at a time when there was a desperate need for a solution to the financial hardship faced by people who had to sell their homes, in some cases to pay up to €1,000 a month in fees for private nursing homes. At the time there was a stigma, whether real or not, associated with some health board facilities - that was not my view but it is a fact. Prior to the scheme being formalised, care was patchy at best and elderly people often worried what would happen to them when their money ran out. The fair deal scheme created something of a level playing field at the time and gave a level of security and comfort to those utilising it.

As I say this, however, I am acutely aware of the problems that exist within the scheme. Fianna Fáil recognises the many concerns surrounding the fair deal scheme and, in particular, those of many farming families and small businesses, as I have discussed with my colleague, Senator Paul Daly. We agree it is vitally important that the issues around residential care for older people do not generate a situation that undermines the family farm model. The programme for Government recognised the discrimination under the scheme against farm families and small businesses, and it pledged to make changes. It is critical that this commitment be honoured. Reports last week that the scheme will be changed to extend the three-year cap from the principal residence to the full family farm are welcome. We looked for the financial assessment to only apply to the assets that had been transferred prior to entering the nursing home for less than a three-year period. It is also worth noting that many farm families are opting not to avail of the scheme and are putting themselves under severe financial stress to find money to cover the costs of care in the short term. Family farms are passed down from generation to generation, as we know, and no one wants to be the generation responsible for making the farm non-viable for the next generation. The pressure is immense and this must be recognised.

There have also been quite negative aspects such as the overcharging that appears to be occurring within certain nursing homes. I was very disturbed by the reports of people being charged for services they could not possibly have participated in, or for extras such as orange juice, for example. As a medic, I find this absolutely disgusting, and it is the most blatant form of elder abuse I have seen in recent years. I echo the call made by my colleague, Deputy Billy Kelleher, that any older person, or his or her representatives, should check and double-check the small print in the contracts they have signed with nursing homes. I acknowledge they should not have to do this but, in too many circumstances, unfortunately, there are nursing homes which see older people on the fair deal scheme as opportunities to make excessive profits. We must condemn this type of behaviour at every opportunity.This evening at 8 p.m. the Minister for Health will join Brendan Courtney live on Facebook to speak about the state of the health system. It is something I plan to tune in to. Brendan Courtney and his family had to become very familiar with the fair deal scheme as a result of his Dad’s illness. Brendan’s Dad, Frank Courtney, who passed away over the summer, featured in a documentary that highlighted the lack of supports available for families trying to care for older people. What we saw was a family in turmoil trying to navigate the fair deal scheme, realising that it does not cover care in the home and learning that they will have to make hard decisions on behalf of their Dad. In my own family we were fortunate enough to be in a position to care for my mother at home in the months prior to her passing but in the case of my father unfortunately there was no facility in the locality to care for him before he passed away. He was too sick to be cared for at home. He passed away in an acute award in Roscommon hospital, something I am not proud of, but unfortunately at the time there was no suitable accommodation in the vicinity. Thanks to the sincerity and candour of the Courtney family, people were made very aware of the lack of viable options for home care or step-down facilities and the difficulties in applying for a nursing home place.

In January last year the Fianna Fáil Party introduced the Nursing Home Support Scheme (Amendment) Bill. It provides for home care packages as an alternative to long-term residential care. It will apply in circumstances where the provision of a home care package is less costly to the State compared with long-term residential care. This necessary measure not only benefits the individual concerned and his or her family but also the State because there will be fewer demands placed on long-term residential care services. We believe the funding allocated to enable older people to remain at home provides not only the best value for money but also the most humane result for older people. The HSE has estimated that some 2.2 million extra hours of home help and a further 3,500 home care packages for older people are required. We must ensure this happens as part of our commitment to ensure older people remain independent in their homes for as long as possible. It is worth remembering that in Ireland over the next 30 years, the number of people aged over 65 will double and the number aged over 85 will almost quadruple. Inevitably as we grow old we will all experience ailments and disabilities, which are part and parcel of ageing. Budget 2018 must take this reality into account.