Martin Conway (Fine Gael)
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I apologise for being late. I was in the Merrion Hotel. Secretary of State Clinton is in residence there.

I recently met a family that was taken aback after being asked to pay ¤25 a week in addition to what the Government is paying to nursing homes under the fair deal scheme. As I do not have a huge knowledge of the intricacies of the scheme, perhaps I am wrong in my understanding that the arrangement with nursing homes is that all bills relating to a person's medicine and care, etc., are discharged by the State. I understand that people declare their means and their assets, including the moneys they have in the bank, when they enter into the scheme and the figures to be paid by such people and by the State are determined on that basis. The family in this case was recently asked to pay an additional ¤100 a month. Those involved feel this is unjustified because their loved one who is in the nursing home had a small amount of disposable income, but that is now gone. The explanation they have been given is that this money is needed to cover the cost of providing additional services to their loved one.

I am sure the Minister of State, Deputy Kathleen Lynch, is in a position to provide the clarity I am looking for. Is this request for an additional payment appropriate and proper? Is it legal? If it is contrary to the ethos of the scheme, what means of recourse are open to the family to try to get this dealt with? If it is not possible to get the money paid back, the family would at least like to prevent this from happening in the future. If this request is being made in one nursing home, I am sure it is being made in many others. Perhaps some sort of audit or investigation is required. I know the Minister of State is deeply committed to the care of the elderly. I am sure she will be most anxious to ensure proper and appropriate things are being done. I look forward to hearing her response.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for raising this matter. At the end of October 2012, almost 22,200 people were receiving financial support towards the cost of long-term nursing home care. In addition to residents who receive financial support under the scheme, this figure includes people who were in public nursing homes before the scheme commenced, people in receipt of subvention and people in contract beds. A further 769 people had been approved for funding, but were not yet in payment. In addition, some 371 people were on the placement list for funding. It takes approximately three to four weeks for funding to issue. All individuals who are approved for funding under the scheme are placed on a national placement list in chronological order, based on the date of determination of their application. Funding is issued to individuals in chronological order to ensure equity nationally.

When the nursing homes support scheme commenced in October 2009, a commitment was made that it would be reviewed after three years. A public consultation process to inform the review, concluded in mid-July. The Department will publish a summary report of the submissions received and thereafter seek tenders through the public procurement process for the carrying out of the review. A considerable amount of preparatory work for the review has been completed. It will be progressed within the constraints of available staff and other priorities. It is envisaged that the review will be completed in 2013. The scheme provides financial support towards the cost of long-term residential care services. The services which fall within the scope of long-term residential care are nursing and personal care appropriate to the level of care needs of the person, bed and board, basic aids and appliances necessary to assist the person with the activities of daily living and laundry service. Incontinence wear, where required, is provided free of charge by the HSE to all nursing homes support scheme residents who possess a medical card. Individuals availing of the scheme should not be charged an additional fee over and above the contribution calculated by the HSE, unless they have chosen to obtain additional services over and above long-term residential care services.

Under the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, the registered provider must agree a contract with each resident within one month of his or her admission. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should not be charged fees which are not set out in the contract and agreed with the resident. The Health Act 2007 gives statutory responsibility to the chief inspector of social services, who is part of the Health Information and Quality Authority structure, for the independent inspection and registration of certain categories of designated centres. This includes residential care settings for older people. The chief inspector has the power to refuse to register, attach conditions to a registration or cancel the registration of a designated centre in the event of non-compliance with the care and welfare regulations or the national quality standards for residential care settings for older people in Ireland. I hope this brings some clarity to the matter.

Martin Conway (Fine Gael)
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I thank the Minister of State for her most comprehensive reply.