Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State for being in the House to take this very important Commencement debate on the fair deal scheme, which is a good scheme when it works but for farm families and the families of small business owners the system is anything but fair. I welcome the support the Minister of State has given on ensuring that elderly people can stay at home and access extra home care hours. It is very important to do everything we can to avoid older people having to go into nursing homes. Some people will still need to have extra care that cannot be provided at home. It is very traumatic for any family when someone has to go into a nursing home to receive that level of care. It is made even worse when the family runs the risk of losing a family farm or business to pay for necessary care. We can imagine the anxiety it causes to older people and their families.

While fair deal is a lifeline for many, farmers and small business owners have been treated very harshly under the current conditions of the scheme. As we know, under the scheme an annual levy of 7.5% on farmland applies to all elderly farmers for every year they avail of long-term nursing care. For most people, this 7.5% per annum levy is limited to the first three years of the nursing home care but farmers and business owners face indefinite contributions on their assets, which in some cases threatens the very viability of their farm or business. This clearly discriminates against the agricultural community and causes terrible hardship for young farmers who hope to inherit farmland. It renders non-viable many farm holdings in rural Ireland. This needs to be addressed as a matter of urgency. A review was done in 2015 but the previous Government did not do anything in response to it. The matter is now under the watch of the Minister of State and I hope she will be able to do something about it.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senators for raising this important issue and giving me the opportunity to update the House on the proposed reform of the nursing home support scheme, commonly known as the fair deal scheme. As they will know from working with me over recent years, this matter is close to my heart.

The House will be aware that the fair deal scheme is a system of financial support for those in need of long-term nursing home care. It aims to ensure that such care is accessible to and affordable by everyone and that people are cared for in the most appropriate settings. The scheme was introduced in 2009 and is built on the premise of fairness and equity, but there are always some unintended consequences. Unfortunately, those have affected farmers and small business owners whose loved ones have been in nursing homes for in excess of three years.

Participants in the scheme contribute to the cost of their care according to their means while the State pays the balance of the cost. The less one has, the less one pays and the more one has, the more one pays. That is fair. Under the scheme, the capital value of an individual's principal private residence is only included in the financial assessment for the first three years of his or her time in care. During my work on the legislation, it was interesting to note that, as of November 2020, the average length of stay was 3.3 years but that 37% of all persons in the scheme left it within six months of entry. That said, we want to make the scheme as fair as possible for those who are in nursing homes in excess of three years so that they can afford to stay there.

It is recognised that the scheme in its current form does not place caps on the financial assessment of family-owned and operated farms or businesses when calculating the means to pay for nursing home care. Under existing provisions, caps only apply in cases of sudden illness or disability. I well appreciate that this may place a potentially onerous burden on family successors and could challenge the future viability of these productive assets. The imminent legislative amendment to the scheme seeks to address this issue by introducing additional safeguards in the scheme to protect further the viability and sustainability of family farms and businesses that will be passed down to the next generation of the family.

The change to the scheme proposed by the Department of Health is to cap financial contributions based on farm and business assets at three years where a family successor commits to working the productive asset. This change was approved by the Government and underwent pre-legislative scrutiny in the previous Dáil. Unfortunately, progress on the development of the Bill was negatively impacted by the dissolution of that Dáil and the Covid-19 pandemic. The response to the pandemic has been and continues to be a national and public health priority. When I was appointed last July, though, this matter was one of the priorities that I wanted to progress as quickly as possible. I thank the Attorney General for all his support in that regard. A team was put in place in my office last November or December to work on this issue. We have finally come to a conclusion, which is welcome. Officials in my Department and draftspersons in the Office of the Attorney General have been working intensively.I am pleased to say a finalised draft of the Bill has now been signed by the Attorney General. I am sure Senators will appreciate several steps must be completed before the Bill is laid before the House, including its approval by the Government. I expect to bring the Bill to the Cabinet in the next two weeks. It has now been circulated to the Departments and it must be with them for ten working days. It was circulated last Thursday. I intend to have it before the Cabinet in two weeks and I hope it will be approved. It will then come before the Houses very quickly. I have spoken to the Government Chief Whip to ensure it can be facilitated and I would like to hope and encourage everybody to support it. I believe there will be great cross-party support and it is very badly needed.

Fiona O'Loughlin (Fianna Fail)
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It is a great start to the week to hear that really welcome news. Senator Chambers and I can attest to the work and focus the Minister of State put into this when she was part of the Opposition. I am really delighted to see she has prioritised it. It is really important that this is imminent. It will make the scheme fair and equitable for everybody, which is all we want. It is much appreciated.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senators for their words of encouragement. This is quite a technical Bill, although people might think it is not. There are 26 sections in it. The Attorney General went back to the drafters in the Department of Health seeking 136 clarifications, so there is quite a bit of work on the question of a successor, who is working a farm and all the details that have to be put in place. That is also the case with small businesses. In some cases there are operations that function with small businesses and farmers. There was quite a bit of technical work.

Strategic reform of the model of delivery of care for older people is currently under way in pursuit of the policy goal of supporting older people to remain living independently in their own homes and communities for as long as possible, as I have always sought, with the correct wrap-around supports. This will involve a demonstrable shift in the provision of care from hospitals to community settings and significant investment has been made in intermediate care and home supports in 2021 to advance this goal. Nevertheless, long-term residential care is part of an overall continuum of care and will, at a certain point, be a necessary option for many older people in order to meet their healthcare needs.

The Covid-19 pandemic has brought into sharp focus the vulnerabilities of many older people, especially those living in long-term residential care. It is therefore absolutely critical that public investment in long-term services is maintained and such care remains accessible and affordable, including for those with farm or business assets. I am very pleased to inform the House today that the Bill has been finalised, pending approval by the Government. It will be presented to the Houses for discussion and debate in the next few weeks.

Mark Wall (Labour)
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Well done. We all look forward to seeing the Bill. I thank both Senators for bringing up the matter today. I welcome the Minister of State at the Department of Education, Deputy Josepha Madigan, to the House.