Colm Burke (Fine Gael)
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I welcome the Minister of State, Deputy Kathleen Lynch, and thank her for the work she has done on the fair deal scheme. Last year, in particular, when there was a substantial backlog associated with the discharging of people from hospitals, she and the Minister got involved and came up with additional funding. As a result, the waiting time for admittance to nursing homes has been reduced from 16 weeks to less than four. That is a very welcome development.

The issue I am raising, with which the Minister of State is very familiar, is especially related to people in the farming community. I am dealing with a number of cases in this regard, one of which concerns a widow who developed Parkinson's disease and who is now in full-time care. Her family is paying over €2,500 per month to the nursing home. The farm is not generating sufficient income for someone to make a living from it. The land now has to be rented, rather than farmed by the family.The three-year rule is the one that particularly affects them, and this will continue ad infinitum. There are costs associated with the fair deal scheme. Almost €1 billion per annum is being provided, which is a substantial sum out of the health budget. However, people in the farming community in particular feel they are being penalised, and I hope we can work towards changing it. I would welcome the Minister's comments.

Kathleen Lynch (Cork North Central, Labour)
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I understand the Senator's concerns well, and we considered them as part of the review. The woman credited with creating the fair deal scheme, Geraldine Fitzpatrick, was buried last Saturday week. I always feel at some stage I will read into the record of the House her last note to me, in which she urged me to continue the way we are going and ensure that the care of the elderly never falls entirely into private hands. Even when she was unwell, she was still concerned about how we treat older people. She was a remarkable woman and will be greatly missed.

I thank Senator Colm Burke for raising this matter. The nursing homes support scheme provides financial support towards the cost of long-term residential care services in nursing homes and ensures long-term nursing home care is accessible to everyone assessed as needing it. By the end of 2015, the scheme will have supported approximately 23,600 people this year. I am pleased to say the Government increased the budget allocation for the scheme for 2016 by €66 million - from €873.8 million in 2015 to €940 million, almost €1 billion - as the Senator said. Under the scheme, an applicant will contribute up to 80% of his or her assessable income and a maximum of 7.5% of the value of any assets per annum. The State will then pay the balance of the cost of care.

It is important to note that an applicant's principal private residence will only be included in the financial assessment for the first three years of his or her time in care. This is known as the three-year cap. The scheme ensures nobody will pay more than the actual cost of care and contains a number of important safeguards. Where an applicant's assets include land and property held in the State, the contribution based on such assets may be deferred and collected from his or her estate. This is the optional loan element of the scheme, which very few take up. A commitment was made in 2009 that the scheme would be reviewed after three years. I am pleased to say that the report of the review was published this year. One of the many issues considered is the treatment of business and farm assets for the purposes of the financial assessment. It is important to note that the scheme already contains some provisions which qualify the treatment of income generating assets.

The three-year cap will apply to a person's farm or relevant business under certain circumstances: where the person has suffered a sudden illness or disability which causes him or her to need long-term nursing home care; where the person or his or her partner was actively engaged in the daily management of the farm up until the time of the sudden illness or disability; and where a family successor certifies that he or she will continue the management of the farm. The Senator will be aware of these conditions. The review of the scheme acknowledges that farms or family businesses could face an annual diminution of a capital asset that they depend on for as long as nursing home care is required, and that this can cause real difficulties. Accordingly, the review recommends that the treatment of such assets be reviewed, and arrangements for this are already in train.

An interdepartmental and agency working group is being established to progress many of the recommendations contained in the review of the scheme. As part of this, consideration will be given as to whether a cap should be applied to the charge for nursing home care based on non-residential productive assets which are passed on to a direct family member after, or in the five years prior to, the death of a fair deal scheme participant, and where the new owner carries on the farm or other business as his or her principal livelihood. This working group will be chaired by my Department and will comprise officials from other relevant Government Departments. The group is due to report to the Cabinet committee on health in June 2016. The Department of Agriculture, Food and the Marine would also be relevant, given its wider scope and greater knowledge on this issue.

Colm Burke (Fine Gael)
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I thank the Minister of State for her very comprehensive reply. I am delighted that a review is going ahead. As the Minister of State said, the issue is that the three-year cap applies in the case of sudden illness but not in the case of a gradual illness such as Parkinson's disease. I welcome the Minister of State's response and I am delighted that progress is being made. I hope to keep in touch with the Minister of State about it.

Kathleen Lynch (Cork North Central, Labour)
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In cases in which a farm is a working farm, as in the case the Senator raised, it is unreasonable to expect people to pay ad infinitumor impose an attachment to the asset forever. We must treat these cases differently. We must put safeguards in place and there will be issues regarding land that is not income-generating. I hope the review will come to a conclusion as soon as possible.