Paddy Burke (Fine Gael)
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I welcome the Minister of State at the Department of Jobs, Enterprise and Innovation, Deputy Damien English, to the House.

Thomas Byrne (Fianna Fail)
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Gabhaim buíoch leis an Aire as ucht teacht isteach sa Seanad inniu chun an t-ábhar tábhachtach seo a phlé. I and my colleague, Councillor Damien O'Reilly, have been contacted by constituents in Dunboyne, County Meath, who have a family member who regularly avails of respite services. This gives the family respite from their duties of constant care and attention. The family recently received a letter from the Health Service Executive prescribing charges of €25 per day for the respite service in certain circumstances. This is the first the family has heard of this charge. While I understand a system of charges has been in place for some time, I wonder if it is being enforced. The only people who will be affected by the charge are families who are in a difficult position and must carry a significant burden because a family member is badly in need of respite services. This burden is also one of love. While they love their family member, the duty of care they have clearly make it difficult for them at times. It appears such families will be required to pay a significant amount of money that many of them do not have for a respite service. Will the Minister of State outline the position regarding charges for respite services?

Damien English (Meath West, Fine Gael)
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I thank Senator Byrne for raising this matter. I apologise on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who could not come to the House as she is in the Dáil. I understand she is not aware of the details of the case raised by the Senator. Perhaps he will furnish her with a copy of the letter to which he referred to enable the matter to be explored.

I propose to clarify the position in response to the Senator's request that the Minister discuss and justify the proposal to charge medical card holders for respite care. The provision of respite care is vital in meeting the needs of individual service users. It also helps reduce the pressures elsewhere on the wider health service, such as acute hospitals and long-term residential care. Respite care is provided in a number of different ways and settings to provide support for carers of persons with care needs in the home.

No new proposals to charge medical card holders for respite care have been brought forward by my Department during the lifetime of this Government, nor are any such proposals currently under consideration. However, charges for the maintenance element of long-stay inpatient services, which may include respite inpatient services and which apply to adults with full or limited eligibility, were provided for under the Health (Amendment) Act 2005. These charges came into effect on 15 July 2005 under the Health (Charges for In-Patient Services) Regulations 2005.

Under the Act, long-stay charges for inpatient services only apply to the further provision of inpatient services to adults who have already received at least 30 days of inpatient services during the immediately preceding 12-month period. Accordingly, many respite episodes would not attract any charge. Those receiving ongoing acute care and those being supported under the nursing homes support scheme are excluded from these charges.

The regulations provide for two different classes of income-based charges in respect of the maintenance element of the inpatient services provided. Class 1 relates to charges for those receiving inpatient services on premises where 24-hour nursing care is provided, subject to a current maximum of €175 per week for a person whose income is €208 or more. Class 2 charges apply where 24-hour nursing care is not provided, subject to a current maximum of €130 per week for a person whose income is €194 or more.

Affordability and the avoidance of financial hardship are built in features of the charging provisions under the 2005 Act and regulation. First, the Act caps the amount which may be charged at 80% of the non-contributory State pension weekly rate. This currently means an upper limit of €175.20 per week. Second, the charges are structured to ensure that those paying them retain a reasonable income for personal use, namely, at least €33 per week for those paying class 1 rates and at least €64 per week for those paying class 2 rates. Third, the Act provides that the HSE may reduce or waive a charge imposed on a person if necessary to avoid undue financial hardship.

To assist in the fair application of the provisions of the 2005 Act and regulations, the HSE has developed national guidelines for the determination of long-stay charges for inpatient services. These include the need to have regard to the individual circumstances of each service user and his or her dependants. The guidelines ensure that the applicable charge is determined taking account of each person's income and necessary outgoings while receiving care, including reasonable regular financial commitments. This avoids any unfair burden on the service user or his or her dependants. Perhaps the Senator will furnish us with the letter in order that the case can be investigated as it appears some confusion has arisen.

Thomas Byrne (Fianna Fail)
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The position is clear.