Seanad debates

Thursday, 1 February 2007

Health (Nursing Homes) (Amendment) Bill 2006: Committee Stage

 

Sections 1 and 2 agreed to.

SECTION 3.

1:00 pm

Rory Kiely (Fianna Fail)
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Amendments Nos. 1, 11, 15 and 19 are related and will be discussed together. Is that agreed? Agreed.

Fergal Browne (Fine Gael)
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I move amendment No. 1:

In page 5, between lines 24 and 25, to insert the following:

"(5) (a) A person applying for a subvention, or a person acting on his or her behalf, may appeal, to an appeals officer designated by the Minister, on the grounds of——

(i) his or her means and circumstances, or

(ii) any abatement of the rate of subvention to that person of the maximum rate appropriate to that person's level of dependency, against a decision of the Executive—

(I) not to pay a subvention, to pay a lower amount of subvention than the maximum rate,

(II) to withdraw a subvention, or

(III) to reduce a subvention, within 28 days of the date on which the Executive notified the person of its decision and the grounds for its decision.

(b) The designated appeals officer shall consider an appeal under paragraph (a) and shall inform the person making the appeal of his or her decision within 28 days of the receipt of the appeal.

(c) For the purpose of deciding the appeal, the designated appeals officer may request information from the Executive and from the person to whom the appeal refers or a person acting on his or her behalf.

(d) A decision of an appeals officer shall be final and conclusive.

(e) Where the Executive has determined that a person does not qualify for a subvention, or qualifies for less than the maximum rate of subvention, it shall inform the applicant of his or her right to appeal the decision under this subsection.".

Amendment No. 1 relates to prescribed subvention and the appeals mechanism. I understand there is currently no appeals mechanism to query the issue of subvention not being awarded. We feel it is important this provision is made in the Bill.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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These amendments were raised on Committee and Report Stages in the Dáil and none was accepted because the Bill provides for a single appeals process. It is not considered necessary to include a separate appeals provision under each section of the Bill.

The appeals provision at section 7E of the Bill provides for a more robust and transparent appeals procedure in accordance with legal advices received and in compliance with Article 6 of the European Convention on Human Rights. The appeals process provides that a person can appeal any decision made by the HSE on subvention, under sections 7A (3), 7C (1) and (4) and 7D (2). Under the appeals section 7E, the person appointed by the HSE to consider the appeal must comply with the HSE's guidelines in respect of procedure.

The HSE has advised that a new appeals process and associated guidelines will be in place before the Bill has been enacted. There is not likely to be a significant change in the current appeals process on foot of this Bill. The HSE has advised that current appeals officers will continue to consider appeals under the new system. It has also advised that a single appeals process will be in place throughout the country, which was not previously the case. This will bring clarity and transparency to the process.

Individuals now have 60 days to make an appeal, as opposed to 28 under the current system. A person's right to make an appeal to the Supreme Court on a specified question of law is also now enshrined in legislation. It is considered that the provisions currently contained in the Bill provide for a fair, transparent and robust national appeals system. Therefore, it is not considered necessary to make any amendment to them and I do not propose to accept these amendments.

Amendment put and declared lost.

Rory Kiely (Fianna Fail)
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Amendment No. 2 is a Government amendment. Amendments Nos. 2, 3, 16, 17 and 18 are related. Amendments Nos. 17 and 18 are consequential on amendment No. 16. These amendments will be discussed together. Is that agreed? Agreed.

Government amendment No. 2:

In page 5, lines 36 and 37, to delete "degree of dependency of the applicant" and substitute the following:

"need for the applicant to be maintained in a nursing home".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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These amendments relate to a change introduced on 1 January 2007, which replaced the three levels of dependency previously used, namely, medium, high and maximum, and their corresponding subvention rates with a single maximum rate of €300. Levels of dependency no longer exist. A person now is deemed to be either dependent or not dependent. In simple terms, a person either does or does not need to be maintained in a nursing home.

Amendment No. 16 provides that a review of a person's dependency may still be carried out. However, whereas previously such a review would have been to see whether a person's level of dependency had changed, the amendment provides that the purpose of such a review will be to ascertain whether the person still needs to be maintained in a nursing home. This flows from the fact that there are no longer three distinct levels of dependency. The abolition of the three levels of dependency and the creation of a single maximum rate of dependency were part of a number of measures that took effect on 1 January 2007 as provided for in the Nursing Homes Subvention (Amendment) Regulations 2006. The provisions of these regulations are now being included in the primary legislation and the regulations will fall on the enactment of the Bill.

Before Christmas, the Minister for Health and Children announced a new nursing home care support scheme, which will be introduced on 1 January 2008. The purpose of the changes being introduced for 2007 is to pave the way for the new scheme and render an increased number of people eligible for subvention in the short term. Some €85 million has been provided to fund these measures for 2007 and it is expected that some 2,000 people will benefit from the changes.

Amendment agreed to.

Government amendment No. 3:

In page 5, lines 49 and 50, to delete "degree of dependency" and substitute "need to be maintained in a nursing home".

Amendment agreed to.

Rory Kiely (Fianna Fail)
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Amendment No. 4 is a Government amendment. Amendments Nos. 4, 6, 8, and 9 are consequential on amendment No. 10. Amendments Nos. 4, 6, 8, 9, and 10 will be discussed together. Is that agreed? Agreed.

Government amendment No. 4:

In page 7, line 20, before "the" where it firstly occurs to insert "subject to subparagraph (vi),".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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These amendments provide that where 5% of an individual's property is taken into account as part of the financial assessment for subvention, it will be taken into account only for the first three years the person is paid subvention. These amendments are intended to benefit many of those in private nursing homes in the immediate term. On foot of the amendments, the HSE will assess applicants for subvention and will ensure that if income has been imputed from the principal private residence for three or more years, no further income will be imputed under the financial means assessment process. It is consistent with the new nursing home support scheme, A Fair Deal, whereby the maximum rate of depletion of the principal private residence is capped at 15%, or three years. This limit of three years is being provided for in the Bill as part of the range of measures being introduced in 2007 in advance of the new scheme taking effect next year. As already mentioned, these measures have been provided for by way of regulations made before Christmas. Therefore, the measure is already in force and is now being transposed into primary legislation.

Amendment agreed to.

Rory Kiely (Fianna Fail)
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Amendments Nos. 5 and 7 are related and will therefore be taken together. Is that agreed? Agreed.

Government amendment No. 5:

In page 7, to delete lines 29 to 39 and substitute the following:

"(IV) a relative of the applicant in receipt of—

(A) disability or similar allowance,

(B) blind person's pension,

(C) illness benefit,

(D) invalidity pension,

(E) state pension (contributory) in any case where, before 28 September 2006, the relative would have been entitled to invalidity pension,

(F) state pension (non-contributory),

(G) any successor to an allowance, pension or benefit referred to in this subclause in any case where that allowance, pension or benefit, as the case may be, ceases to be provided, or

(H) any European Union equivalent to an allowance, pension or benefit, or any successor thereto, referred to in this subclause,

(V) a relative of the applicant in receipt of—

(A) state pension (contributory),

(B) any successor to a pension referred to in this subclause in any case where that pension ceases to be provided, or

(C) any European Union equivalent to a pension, or any successor thereto, referred to in this subclause, which is the relative's sole income,".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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These amendments are largely technical and the main reason for them is to update the names of certain social welfare benefits and pensions referred to in the legislation. Some of those names changed recently owing to the Social Welfare Law Reform and Pensions Act 2006.

The amendments also do two other related things. First, they provide that if the names of any of the social welfare payments or benefits referred to in the Bill change in future, they will continue to be covered by the appropriate provisions without our having to make any further legislative amendments. Second, they specifically provide that persons receiving EU benefits equivalent to the domestic benefits outlined in the Bill will also be covered by the appropriate provisions. That is in line with EU Regulation 1408/71, to which Ireland is bound. The purpose of the regulation is to ensure that European Economic Area nationals who move around the EEA have their social security entitlements protected as if they had remained in one EEA state throughout the course of their working lives.

Amendment agreed to.

Government amendment No. 6:

In page 7, line 40, to delete "subparagraph (v)" and substitute "subparagraphs (v) and (vi)".

Amendment agreed to.

Government amendment No. 7:

In page 8, to delete lines 1 to 5 and substitute the following:

"(iii) one-fifth of the weekly rate of—

(I) subject to clause (II), state pension (non-contributory),

(II) any successor to that pension in any case where that pension ceases to be provided, and whether or not the applicant is in receipt of that pension or any successor thereto,".

Amendment agreed to.

Government amendment No. 8:

In page 8, line 8, to delete "and".

Amendment agreed to.

Government amendment No. 9:

In page 8, line 20, to delete "made." and substitute "made, and".

Amendment agreed to.

Government amendment No. 10:

In page 8, between lines 20 and 21, to insert the following:

"(vi) without prejudice to the generality of subparagraph (i), the principal residence of the applicant in any case where the applicant has been paid in accordance with this Act a relevant subvention for not less than 3 consecutive years at any time following the commencement of this subsection.".

Amendment agreed to.

Fergal Browne (Fine Gael)
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I move amendment No. 11:

In page 9, between lines 1 and 2, to insert the following:

"(8)(a) A person whose degree of dependency or means are assessed by a person, or a person acting on behalf of that dependent person, may appeal, to an appeals officer designated by the Minister on the grounds that he or she is not satisfied that his or her means and circumstances were adequately, properly or correctly assessed.

(b) The designated appeals officer shall consider an appeal under paragraph (a) and shall inform the person making the appeal of his or her decision within 28 days of the receipt of the appeal.

(c) For the purpose of deciding the appeal, the designated appeals officer may request information from the Executive and from the person to whom the appeal refers or a person acting on his or her behalf.

(d) A decision of an appeals officer shall be final and conclusive.

(e) Where a report is produced as to the means or degree of dependency of a person, and such report is provided to the Executive, the Executive shall inform the applicant of his or her right to appeal the contents of that report under this subsection.".

Amendment put and declared lost.

Rory Kiely (Fianna Fail)
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Amendment No. 12 is a Government amendment. Amendments Nos. 23 and 24 are related, and amendment No. 23 is consequential to amendment No. 24. We will therefore take amendments Nos. 12, 23 and 24 together. Is that agreed? Agreed.

Government amendment No. 12:

In page 9, line 2, after "subsection (4)" to insert "and section 7K".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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Amendment No. 24 adds a provision to the Bill whereby the Health Service Executive, HSE, may refuse to pay a subvention where the nursing home in question is not tax compliant. Under normal circumstances, the HSE will seek a tax clearance certificate from companies to which more than €6,500 of public money has been given in payment over a 12-month period. That is to ensure that the tax affairs of such companies are in order.

However, although a tax clearance certificate may be sought in respect of a home when an official agreement is being signed, such certificates are generally not subsequently sought in the case of nursing homes in receipt of subvention payments. That is because such tax clearance has not been provided for in primary legislation to date.

There is some concern regarding the issue given that the level of funding being provided to such homes, most of which were registered many years ago on an annual basis, can be very high. This amendment provides specifically that the HSE may now refuse to make subvention payments in respect of a home where a tax clearance certificate is not in force. Amendments Nos. 12 and 23 are technical amendments consequential to amendment No. 24.

Fergal Browne (Fine Gael)
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I accept the idea behind the amendment but how do we safeguard patients who might otherwise be caught in the crossfire? If they are in a nursing home, their first choice may well be a public bed, but the reality is that they would be hard-pressed even to get a private one. If they are in such a private nursing home and apply for a subvention, it is difficult to do so successfully and now they may be caught in the middle of a row with the HSE and the tax authorities regarding clearance certificates.

Have we thought through how we ensure the patient does not get caught in the crossfire? I can envisage this becoming problematic. Although the patients pay money to a private nursing home, the nursing home management might blame the tax authorities and say that they have requested a tax clearance certificate but not been given one. The Minister is aware that there can be difficulties with accountancy. It may not be a question for today, but I would hate to see a scenario where patients in a nursing home, despite their paying, do not receive a subvention because of a row over a tax clearance certificate. I appreciate that, in an ideal world, the nursing home should have a tax clearance certificate, and everything should be fine, but I am also aware that the world is not ideal.

Photo of Brendan RyanBrendan Ryan (Labour)
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Are we discussing amendmentNo. 12 and two others?

Rory Kiely (Fianna Fail)
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Yes.

Photo of Brendan RyanBrendan Ryan (Labour)
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I am not trying to be troublesome; it is too late on a Thursday for that.

Rory Kiely (Fianna Fail)
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The Senator is never troublesome.

Photo of Brendan RyanBrendan Ryan (Labour)
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I thank the Cathaoirleach, although I am sure he would not allow me to be so, even if I wished.

I am not trying to be smart, but amendment No. 23 effectively states that we should delete "website" and insert the same word. I am obviously missing something, but I cannot work out what. In my version of the Bill, line 52 contains the single word "website", with what looks to me like an erroneous set of inverted commas behind it. Is the proposal to replace it with "website" with inverted commas beside it?

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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It is a simple punctuation change.

Photo of Brendan RyanBrendan Ryan (Labour)
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It is exactly the same as what is there. That is what intrigued me.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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I take Senator Browne's point, but we are living in changed times, and if one is doing business with the Government in any shape or form, it is expected that one be tax compliant and that a tax clearance certificate be capable of being provided if requested. The homes will very much be in line with every other industry doing business with the Government. One may rest assured that the HSE will address this in a very pragmatic manner and deal with individual situations as they arise.

From 2008, we will be in a completely different situation. We will ensure that patients are not put at any disadvantage as a result of our introducing this measure, but it is important that we do so. It should have happened some time ago and we are now rectifying matters.

Fergal Browne (Fine Gael)
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I see a potential difficulty in the case of nursing homes changing hands. The patient might be there during the tenures of both owners and be caught in the crossfire. Perhaps the HSE might give special consideration to that scenario. In the case of a nursing home being taken over, there might be a delay in eliciting a tax clearance certificate from the new owners. The bottom line is that patients should not be caught in the crossfire. I envisage a problem since businesses changing hands can be quite traumatic and cumbersome.

Rory Kiely (Fianna Fail)
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I am advised that the purpose of amendment No. 23 is to remove the inverted commas. I do not think that it interferes with the website.

Photo of Brendan RyanBrendan Ryan (Labour)
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It was my pedantry. That is all.

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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I would like to address Senator Browne's point regarding tax compliance. I can understand his standpoint and perhaps the new rule might be formulated to avoid that problem. When one sells a home, one must ensure that all local authority charges are paid before one closes the sale. In the case of a nursing home, a tax clearance certificate could be required before the sale is complete.

Amendment agreed to.

Rory Kiely (Fianna Fail)
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Amendments Nos. 13 and 14 are related and may be discussed together by agreement.

Government amendment No. 13:

In page 10, line 15, to delete "€300,000" and substitute "€365,000".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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From 1 January the basic rate of subvention was increased to €300 per week. The increase in the basic rate necessitates an increase in the property threshold for areas outside Dublin from €300,000 to €365,000 where a person has an average annual income greater than €10,400, increased from €9,000. Under the terms of the financial means assessment, a person with income equivalent to the State non-contributory pension and a house worth €364,000 and no other income or assets would qualify for basic subvention at the increased rate. The amendment to the threshold acknowledges this fact and renders the provision compatible with the increased rate of subvention.

Fergal Browne (Fine Gael)
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The greatest difficulty with the Bill is plotting the Dublin area against non-Dublin areas. The Minister of State is from County Kildare and does not need a lecture from me. Carlow belongs more in the greater Dublin area than in the south east. Our colleagues in Waterford could not give a damn about us except when it suits them to include us in the south east. Otherwise we are completely ignored.

I am not sure what the solution is but people could live in a house worth €1 million while living in poverty. Does the Minister of State recommend people sell their houses to raise cash? People can find themselves asset rich but cash poor. In every county property prices are higher in urban areas than rural areas. Perhaps it is foolish to refer to a fixed amount. Why not insert an index-linked figure? Although €365,000 may seem a large amount today, by 2010 it could be obsolete. An index-linked figure keeps pace with reality rather than going out of date. Will the Minister of State be forced to return, making new regulations annually? Is the €10,400 linked to the annual amount of the State pension?

Photo of Brendan RyanBrendan Ryan (Labour)
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There is eternal optimism in Government circles that house price inflation will decline but there is no market evidence that it will do so. The sum of €365,000 will diminish relative to the value of a house within five years. This is a way to reduce the number of people who will have access to the services. The Minister of State will deny any such intent. There is no logical reason to separate south Dublin and north Wicklow, one of the most desirable areas in the country. It is illogical to suggest that because one lives in Enniskerry, County Wicklow, rather than Dalkey, County Dublin, the house price to be considered will vary by a factor of 25%. This measure was inserted in a hurry because people realised that house prices are higher in Dublin. In fact, Dublin is the cause of house price inflation in circles reaching as far as Carlow. What is the logic in choosing Dublin? There may be logic for banding house prices depending on the region. There is no simple solution because the only way one can establish the price of a house is through the market, the amount a willing seller is prepared to accept from a willing buyer where both are acting freely. The current solution is attractive as a bureaucratic solution but makes no logical sense.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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It may not make sense to some people but this tool has also been used by the Department of the Environment, Heritage and Local Government for some time. One cannot deny that a major difference exists in regard to house prices in Dublin and the rest of the country. The further one goes, the greater the difference. If Wicklow and Kildare were included in the Dublin region, Laois could argue for inclusion. The line must be drawn somewhere. The 5% imputation in the means assessment is what really counts. Where there is a limit to the money provided for a scheme, one must establish qualifying criteria. An extra 2,000 people will benefit as a result of this measure during 2007.

Fergal Browne (Fine Gael)
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What about index-linking the payments?

Photo of Brendan RyanBrendan Ryan (Labour)
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I do not care if Dick Roche has decided to undertake the same measure. That confirms my view that it is illogical.

Rory Kiely (Fianna Fail)
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Is Senator Ryan referring to the Minister for the Environment, Heritage and Local Government?

Photo of Brendan RyanBrendan Ryan (Labour)
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Yes, I apologise. That another Department has done it proves that it is a bureaucratic simplicity rather than a sensible measure. Something was needed in a hurry and people thought that prices in Dublin were higher. The Dublin region is where house prices are higher, not Dublin. Perhaps there is a plan to extend boundaries of Dublin to include north Kildare, north Wicklow, south Louth and east Meath. For planning reasons this may be a good idea but there is no reason two houses next door to each other should be evaluated for eligibility differently. If it is not logical, it will not work. We will be back with this Government or another remedying an anomaly that went unnoticed in the Health (Nursing Homes) (Amendment) Bill. There will be an implication that it slipped through unnoticed, although it did not. It is a profound mistake.

All these means tests are appalling, but that is a separate issue. If such tests are operated, the first requirement is that it should be simple and transparent, but this stipulation is neither. Senator Browne has already mentioned the reason, the lack of index-linking. As a result of this we will require amending legislation every year or the number of eligible people will be affected. This issue revolves around simplicity and a calculation of what level it should be pitched at to have an appropriate number of eligible people.

Fergal Browne (Fine Gael)
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I wish to return to the issue of index-linking, which puzzles me. If a pensioner lives in Dublin in a house worth more than €500,000, or outside Dublin in a house worth €366,000, is the Government indicating that there is no entitlement to subvention? What is such a person meant to do instead?

Photo of Brendan RyanBrendan Ryan (Labour)
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Sell the house.

Fergal Browne (Fine Gael)
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A person may have lived in an area all their life and there could be some family relations in the vicinity. Is that person meant to sell the house and move to a different part of the country which may be affordable but has no family or friend support? What if the person is in their 80s or 90s? It is a difficulty and I am puzzled by it.

The €10,400 figure is equal to the State pension. Am I correct in thinking the Minister for Social and Family Affairs recently announced that people were entitled to earn a certain amount of money per week in addition to the State pension without affecting it?

Photo of Mary WhiteMary White (Fianna Fail)
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It is €100.

Fergal Browne (Fine Gael)
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Has that amount been taken into account? If, for example, a person in receipt of a State pension did some work during the week, he or she might have almost €300 per week between the pension and the extra income. Such a person would then be outside the subvention rate if the person were in a nursing home because the income would breach the €10,400 limit. This figure should be increased immediately to take into account the €100 per week, approximately €5,000 over the year, to leave a figure of approximately €16,000.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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When the subvention scheme was introduced in 1993, the intention was to assist people with the cost of care. At that stage the property threshold was £75,000, which remained unchanged for a good few years. We have made some changes but a system will never be brought in that will satisfy everybody. The Senator would have to acknowledge there is a serious difference in house prices once one leaves Dublin.

Photo of Brendan RyanBrendan Ryan (Labour)
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I would not.

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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Of course there is a difference.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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I have admitted on a number of occasions that the subvention scheme in place is far from ideal, and if we started from scratch we would never arrive at the current position. This has been acknowledged. As today is 1 February, we will have a completely new scheme in operation in 11 months' time which will be much more equitable and which I am sure Senator Ryan and Senator Browne will find favourable.

Photo of Brendan RyanBrendan Ryan (Labour)
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I might not be a Member of this House.

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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Is that a wish?

Photo of Camillus GlynnCamillus Glynn (Fianna Fail)
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The Senator is not throwing in the towel already.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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I clearly have more confidence in the Senator than he has himself.

Fergal Browne (Fine Gael)
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I wish to ask the Minister of State to reply on the €16,000 figure. Is it the case that people who receive the State pension and earn a few euro extra per week, as they are allowed to and are encouraged by the State to do, will find themselves outside the loop? That is a serious mistake if it is the case.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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There is a difference between the income and value of property. I made the point that a person could be in receipt of a pension, have a house valued at €364,000 and still qualify for subvention.

Fergal Browne (Fine Gael)
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I am still confused. A pensioner may earn €100 per week along with their State pension, which is allowed, leaving a total sum of approximately €15,000 per year. We are discussing an amendment stipulating that a person cannot have an income of more than €10,400, but the income of some pensioners will be above this. The State will on one hand indicate that such people can work away, and although €100 will not make a major difference, it will have a significant impact if such people cannot obtain subvention for a nursing home during the year.

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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I take the point made by the Senator. I believe the people allowed to earn up to €100 per week are people younger than those in receipt of the State pension. These people would be in receipt of a widow's or widowers' pension, although these have new names. I did not believe it applied to people in receipt of the State pension. Perhaps the difference is that if they are earning €100 per week, they are unlikely to find themselves looking for subvention for nursing homes.

Fergal Browne (Fine Gael)
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My understanding is pensioners can earn €100 but perhaps I am wrong.

Amendment agreed to.

Government amendment No. 14:

In page 10, line 22, to delete "€9,000" and substitute "€10,400".

Amendment agreed to.

Fergal Browne (Fine Gael)
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I move amendment No. 15:

In page 10, between lines 35 and 36, to insert the following:

"(6) (a) A person applying for a subvention, or a person acting on his or her behalf, may appeal, to an appeals officer designated by the Minister, on the grounds of—

(i) his or her means and circumstances, or

(ii) any abatement of the proposed rate of subvention to that person from the maximum rate appropriate to that person's level of dependency, against a decision of the Executive—

(I) not to pay a subvention, to pay a lower amount of subvention than the maximum rate,

(II) to withdraw a subvention, or

(III) to reduce a subvention, within 28 days of the date on which the Executive notified the person of its decision and the grounds for its decision.

(b) The designated appeals officer shall consider an appeal under paragraph (a) and shall inform the person making the appeal of his or her decision within 28 days of the receipt of the appeal.

(c) For the purpose of deciding the appeal, the designated appeals officer may request information from the Executive and from the person to whom the appeal refers or a person acting on his or her behalf.

(d) A decision of an appeals officer shall be final and conclusive.

(e) Where the Executive has determined that a person does not qualify for a subvention, or qualifies for less than the maximum rate of subvention, it shall inform the applicant of his or her right to appeal the decision under this subsection.".

Amendment put and declared lost.

Government amendment No. 16:

In page 10, to delete lines 43 to 48 and substitute the following:

"(i) of—

(I) the need for a dependent person to whom a relevant subvention is paid to continue to be maintained in a nursing home, or

(II) the means of the dependent person,

on the same bases as are specified in section 7B(2) and (3).".

Amendment agreed to.

Government amendment No. 17:

In page 11, to delete line 2 and substitute the following:

"(I) where subparagraph (i)(I) is applicable, a".

Amendment agreed to.

Government amendment No. 18:

In page 11, to delete line 8 and substitute the following:

"(II) where subparagraph (i)(II) is applicable, an".

Amendment agreed to.

Fergal Browne (Fine Gael)
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I move amendment No. 19:

In page 12, between lines 8 and 9, to insert the following:

"(5) (a) A person who is in receipt of a subvention and who is deemed by the Executive under subsection (2) either to be no longer qualified for the payment of a relevant subvention, or qualifies for the payment of a different relevant subvention than that currently being paid to the person, or a person acting on his or her behalf, may appeal, to an appeals officer designated by the Minister, on the grounds—

(i) of his or her means and circumstances,

(ii) that the review conducted under subsection (1) was inadequate, improper or incorrect, or

(iii) of any abatement of the maximum rate appropriate to that person's level of dependency,

against the decision of the Executive under subsection (2).

(b) The designated appeals officer shall consider an appeal under paragraph (a) and shall inform the person making the appeal of his or her decision within 28 days of the receipt of the appeal.

(c) For the purpose of deciding the appeal, the designated appeals officer may request information from the Executive and from the person to whom the appeal refers or a person acting on his or her behalf.

(d) A decision of an appeals officer shall be final and conclusive.

(e) Where the Executive makes a determination under subsection (2), it shall inform the dependent person to whom a relevant subvention is paid, of his or her right to appeal the decision under this subsection.".

Amendment put and declared lost.

Rory Kiely (Fianna Fail)
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Amendments Nos. 20 and 22 are consequential to amendment No. 21. The amendments will be discussed together by agreement. Is that agreed? Agreed.

Government amendment No. 20:

In page 14, to delete line 28 and substitute "(4).".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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Amendment No. 21 replaces the three previous rates of subvention, namely, €114.30, €152.40 and €190.50 per week for medium, high and maximum dependency, respectively, with one single rate of €300. This measure is one of those already introduced from 1 January this year by way of the Nursing Homes (Subvention)(Amendment) Regulations 2006. This is now simply being transposed into primary legislation.

The second part of amendment No. 21 is technical and serves purely to reflect the fact that there is now a single rate of subvention, as well as the change of name from old age non-contributory pension to State pension (non-contributory). Amendments Nos. 20 and 22 are technical amendments necessary on foot of amendment No. 21.

Amendment agreed to.

Government amendment No. 21:

In page 14, between lines 38 and 39, to insert the following:

"(4) Subject to subsection (5), the amount of subvention which may be paid under section 7C(1)(a) is a weekly maximum rate of €300 or the prescribed amount, whichever is the greater.

(5) Without prejudice to the generality of section 7C(1)(b) or 7D, the amount of the prescribed subvention that is applicable to a dependent person shall, by virtue of this section, be reduced by the amount by which such person's means, as determined in the assessment referred to in section 7B(3) or review under section 7D, as the case requires, made in respect of such person, exceeds the weekly rate of—

(a) subject to paragraph (b), state pension (non-contributory),

(b) any successor to that pension in any case where that pension ceases to be provided,

payable at the time of assessment.".

Amendment agreed to.

Government amendment No. 22:

In page 14, to delete lines 39 to 48, to delete page 15 and in page 16 to delete lines 1 to 7.

Amendment agreed to.

Government amendment No. 23:

In page 16, to delete line 52 and substitute "website.".

Photo of Brendan RyanBrendan Ryan (Labour)
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I am tempted to oppose this but I will not.

Amendment agreed to.

Government amendment No. 24:

In page 16, after line 52, to insert the following:

"7K.—(1) In this section, 'tax clearance certificate' means a certificate under section 1095 (as substituted by section 127(b) of the Finance Act 2002) of the Taxes Consolidation Act 1997.

(2) The Executive may refuse to effect the payment of a relevant subvention in any case where the Executive is satisfied that a tax clearance certificate is not in force in respect of the proprietor of the nursing home in which the dependent person concerned is or intends to be maintained.".".

Amendment agreed to.

Question proposed: "That section 3, as amended, stand part of the Bill."

Photo of Brendan RyanBrendan Ryan (Labour)
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I am well aware that some of what is contained in section 3 was introduced when my party was in Government because that is the usual defence, but I believe it to be the wrong way to go. We are showing a level of defensiveness that will create the equivalent of a moral panic over the population gradually and gently getting older. I invite someone to explain why this rigmarole must be introduced. Does it mean if we have a sudden explosion in the birthrate we will charge people for the use of maternity hospitals? The fundamental issue is universalism. Effectively, this states most of our old people must pay for their nursing homes and the Government intends they should. It may have been necessary in days of hardship. However, this decision is based on an unwillingness and not an inability to resource.

I will not call a vote on this but I want to put on the record it is ungenerous to a degree which Irish society will come to regret. It imposes a complicated process on people at the latter end of their lives who, by definition, need support. It is a complicated bureaucratic process full of pitfalls. It assumes people on the margins of requiring nursing home care will be able to fill in forms. It is not worthy of a country as well-off as ours. I am not particularly concerned about who originated it or from where it came. It is unworthy of us.

Question put and agreed to.

Sections 4 to 10, inclusive, agreed to.

NEW SECTION.

Rory Kiely (Fianna Fail)
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Amendments Nos. 26 and 27 are consequential on amendment No. 25 and will be taken together. Is that agreed? Agreed.

Government amendment No. 25:

In page 17, before section 11, to insert the following new section:

"11.—The Health Act 1970 is amended by inserting the following immediately after section 61:

"61A.—(1) A home care provider shall give notice in writing to the Health Service Executive, as soon as it is practicable for the provider to do so, of—

(a) the name and address of the provider,

(b) the name and address of each person to whom the provider provides home care services,

(c) the nature of such services so provided, and

(d) particulars of any change to information previously given by the provider to the Executive under any paragraph (including this paragraph) of this subsection.

(2) The Health Service Executive may, for statistical purposes, retain and process information given to it under subsection (1) provided that such information is not publicly disclosed except in the form of a summary so compiled as to prevent particulars relating to the identity of any home care provider, or of any person for whom any home care provider provides home care services, being ascertained from it.

(3) In this section—

'home care provider' means a natural or legal person who, whether or not pursuant to arrangements referred to in section 61 (1), provides, at a charge, home care services;

'home care service' means a service made available in a private dwelling for a person who, by reason of illness, frailty or disability, is unable to provide the service for himself or herself without assistance;

'private dwelling', in relation to a person referred to in the definition of 'home care service', means a permanent dwelling that is not open to the general public to visit unless invited and where that person habitually resides.".".

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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The effect of amendment No. 25 will be to facilitate the VAT exemption on privately provided home care. Under the current system, home care services provided by health boards or voluntary bodies do not generally come within the scope of VAT. However, services provided by private home care providers, whether through the HSE or directly to the client, are subject to VAT. This amendment has been tabled due to the focus on encouraging measures to allow older people to remain in their homes and communities for as long as possible.

Irish VAT law must comply with requirements of EU VAT law under which such services cannot be zero rated. To allow for the VAT exemption the home care sector must become one which can be regulated by a Minister, which this amendment effectively does. This year's Finance Act will contain a provision referring to this new section on exempting private home care providers from VAT.

This amendment means private home care providers must supply certain information to the HSE on their services, namely, the name and address of the provider, the nature of the services being provided and the names and addresses of all persons to whom such services are provided. The amendment allows for a clearer picture to be built up of privately provided home care services as it also allows for the retention of such information by the HSE.

The amendment also defines "home care service", "home care provider" and "private dwelling". The definition of "home care service" is not limited to people over the age of 65. Rather, it focuses on persons who cannot provide the particular service in question for themselves because of illness, frailty or disability.

Although this Bill has a general commencement order, amendment No. 26 will give legal effect to the new section 11 immediately following its enactment. This will allow the VAT exemption for home care providers to come in to force as soon as the Finance Bill 2007 is enacted. Amendment No. 27 is a technical amendment which inserts the name of the Health Act 1970 into the title of the Bill.

Photo of Brendan RyanBrendan Ryan (Labour)
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Why should the name and address of a commercial home care provider be regarded as confidential? I understand fully why the name and address of the service recipient should be confidential. Why should the public not know who the HSE contracts to provide home care services? How will we conduct checks on the probity, reliability and truthfulness of home care providers if we do not know who they are?

This will not involve private addresses as these will not be individuals. They will be commercial organisations. The amendment states, "'home care provider' means a natural or legal person who, whether or not pursuant to arrangements referred to in section 61(1), provides, at a charge, home care services". Home care providers could be companies. However, we will not know who they are or the location of their offices or accounts. Why?

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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Senator Ryan has read too much into it. Nothing will prevent one from obtaining the information which he states the HSE will hide.

Photo of Brendan RyanBrendan Ryan (Labour)
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The new subsection (2) will state:

The Health Service Executive may, for statistical purposes, retain and process information given to it under subsection (1) provided that such information is not publicly disclosed except in the form of a summary so compiled as to prevent particulars relating to the identity of any home care provider, or of any person for whom any home care provider provides home care services, being ascertained from it.

Subsection (1) referred to states:

A home care provider shall give notice in writing to the Health Service Executive, as soon as it is practicable for the provider to do so, of—

(a) the name and address of the provider,

(b) the name and address of each person to whom the provider provides home care services,

(c) the nature of such services so provided, and

(d) particulars of any change to information previously given by the provider to the Executive under any paragraph (including this paragraph) of this subsection.

Either the information can be easily found elsewhere, in which case this provision is meaningless, or the provision means the public will not know who are the companies providing home care services. I believe it slipped in by accident. I have considerable experience of finding accidental errors in legislation. It is a fact of life and is not a comment on anybody. It is the way life is.

Why should the public not know who the HSE contracts to provide this intimate service? These companies will provide services in people's homes on a one-to-one basis. People should know who are the service providers.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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At present, the HSE supplies a list of providers in particular areas and this will not change.

Photo of Brendan RyanBrendan Ryan (Labour)
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This discussion should not take two minutes. All the Minister of State should do is remove the provision, particularly if it means nothing, and keep this cranky fellow here happy. No reason exists for a prohibition. Is this is a classic act of making something secret and seeing whether the public will find out about it? It should be dropped. What was intended was that the names of those receiving services would not be revealed nor would the nature of the service received. That is quite right and we all support it. The Freedom of Information Act covers this because it would be regarded as an intrusion on personal privacy.

The Minister of State has not given an explanation for this amendment. He stated the information is published. However, if it is published this amendment is meaningless. Once this Bill is formalised one will no longer be able to publish the information. A major corporation which wants to keep information quieter than it otherwise would be will insist it be kept private which is wrong.

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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This is not intended to hide or protect the names of care providers. It is the practice of the HSE to publish the information and to provide it when requested because naturally enough people seek the names of care providers on a regular basis and that practice will continue.

Photo of Brendan RyanBrendan Ryan (Labour)
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I apologise for holding up the House and I do not want to keep us here all day. The legislation states, "provided that such information is not publicly disclosed except in the form of a summary so compiled as to prevent particulars relating to the identity of any home care provider, or of any person for whom any home care provider provides home care services, being ascertained from it.". Therefore, we are preventing the publication of particulars relating to the identity of any home care provider. This is what the Bill provides. What is the purpose of this? Somewhere in the future, some judge will ask how the Oireachtas could have passed this legislation. The Bill is going back to the Dáil so there is no problem here. If this is as innocuous as the Minister of State says it is, the simplest thing to do is remove it.

I am now in situation where I must introduce an amendment on Report Stage because I cannot see what purpose this serves. I thought I was just picking up something and that there was a deliberate policy. The Minister of State says there is no such policy, but the Government is including a prohibition on it happening even though there is no such policy. I am not confused, but I am sufficiently annoyed to notify the House that I must introduce an amendment on this matter on Report Stage.

Photo of Mary WhiteMary White (Fianna Fail)
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It is important that there be no ambiguity in the public arena in respect of owners of individual nursing homes. It is important that the matter be clarified. Members of this House believe that amendments from whatever side of the House should get recognition and that we play a role. It is not clear from the amendment's language what is meant. I know it is not intended that the public would not know who are the providers because we know those providing services. The language seems to be unnecessarily complicated.

Amendment agreed to.

SECTION 11.

Government amendment No. 26:

In page 17, subsection (3), line 33, to delete "section 10" and substitute "sections 10 and 11".

Amendment agreed to.

Section 11 agreed to.

Government amendment No. 27:

In page 3, lines 11 to 13, to delete all words from and including "AND" in line 11 down to and including "2006" in line 13 and substitute the following:

", AMEND SECTION 2 OF THE HEALTH (REPAYMENT SCHEME) ACT 2006 AND AMEND THE HEALTH ACT 1970".

Amendment agreed to.

Title, as amended, agreed to.

Bill reported with amendments.

Rory Kiely (Fianna Fail)
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When is it proposed to take Report Stage?

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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Now.

Photo of Brendan RyanBrendan Ryan (Labour)
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I was quite happy to agree to take Report Stage today, but the Minister of State was most unhelpful and I want time to introduce an amendment on Report Stage.

Rory Kiely (Fianna Fail)
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Is it agreed to take Report Stage now?

Fergal Browne (Fine Gael)
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I had no difficulty with taking Report Stage today, but I am unhappy with the explanation I received about the figure of €10,400. Is it possible for us to adjourn for 30 minutes to seek clarification on that point and return? I am not sure what is the view of the House on this.

Rory Kiely (Fianna Fail)
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Committee Stage has concluded.

Fergal Browne (Fine Gael)
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Can we reconvene in 30 minutes to get clarification on the points raised by Senator Ryan and I? We could then proceed to Report Stage.

Rory Kiely (Fianna Fail)
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I am in the hands of the House, but I wish to point out that on the Order of Business it was only agreed to take Committee Stage today so I do not think we can take Report Stage today. When is it proposed to take Report Stage?

Photo of Geraldine FeeneyGeraldine Feeney (Fianna Fail)
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Next Tuesday.

Report Stage ordered for Tuesday, 6th February, 2007.

Rory Kiely (Fianna Fail)
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When is it proposed to sit again?

Photo of Camillus GlynnCamillus Glynn (Fianna Fail)
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At 2.30 p.m. on Tuesday 6 February 2007.