Seanad debates

Thursday, 15 July 2021

Nursing Homes Support Scheme (Amendment) Bill 2021: Second Stage

 

Question proposed: "That the Bill be now read a Second Time."

9:30 am

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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I am pleased to introduce this Bill to the Seanad. Since I was appointed as Minister of State with responsibility for mental health and older people last July, updating the fair deal legislation to enhance protections for family farms and business owners has been a priority for me. I thank Senators for the opportunity to present the provisions of the Bill in the House today.

The nursing homes support scheme, also known as the fair deal scheme, is a system of financial support for those requiring long-term nursing home care.Participants contribute to the cost of their care according to their means while the State pays the rest. The scheme has a gross budget of approximately €1.4 billion in 2021 to support up to 22,500 people.

Although there is broad agreement that the fair deal scheme operates well, concerns have been raised about the impact of the annual financial contributions assessed under the scheme on the sustainability of family-owned farms or businesses. This amendment seeks to cap contributions based on farm and business assets at three years where a family successor commits to working the productive asset. The intention is to ensure that the viability of the family farm or business is protected when its income is relied upon as a principal livelihood and it is being handed down to the next generation.

I have also introduced an amendment to the Bill that effectively extends the existing three-year cap on contributions from a principal residence to the proceeds from the sale of that residence. As well as introducing further fairness by treating the home and its proceeds in a similar way, in the context of the housing crisis it removes a disincentive to selling a vacant home when someone moves to long-term care.

Other amendments were introduced in the Dáil to resolve technical issues with the Bill or to address concerns raised on Committee stage. This is a long and technical Bill, which comes to 60 pages in total. I will take the House through it section by section to clarify its provisions, including the amendments made on Report stage in the Dáil last night.

Section 1 is a standard provision to clarify the principal Act to which the amendment applies. Section 2 amends section 3 of the principal Act to provide definitions for certain key terms used.

Section 3 provides for the appointment of a family successor to a farm or business asset which the person in care, or his or her partner, owns or previously owned. Section 4 provides for the creation of a charge against a farm or business asset. This charge acts as security for relief advanced in case a recoupment has to take place.

Section 5 provides for the duties of the HSE when determining whether the three-year cap will apply in respect of farm or business assets. Section 6 mandates the HSE to calculate the revised state support that will be payable following a determination that the three-year cap applies. Section 7 provides for the review process for all appointed family successors.

Sections 8 to 10, inclusive, provide for certain circumstances that may occur with regard to the family successor, for example, if the family successor passes away before completing the six-year period during which he or she is required to work the asset.

Sections 11 and 12 provide for repayment events. This may occur where the family successor does not comply with his or her obligations.

Sections 13 to 15, inclusive, provide for certain situations that may arise in the case of a second partner entering care.

Section 16 makes it an offence for any relevant person to knowingly or recklessly give the HSE information that is false or misleading. Section 17 amends section 21 of the principal Act to extend the powers of a care representative if a person in care does not have full capacity to make decisions regarding an application to the scheme. Section 18 amends section 24 of the principal Act to require the appointed family successor to provide written notice of any material change in circumstances of the person in care to the HSE.

Section 19 mandates the person in care, his or her partner and the family successor to inform the HSE of any material change in circumstances of any family successor. Section 20 amends section 27 of the principal Act to allow the HSE to request that the assets of an estate are retained to repay any moneys owed as a result of a repayment event. Section 21 sets out the administrative process relating to the discharge or release of the charge made against an asset. Section 22 refers to a charge or charges to be made under section 14B against farm or business assets which are under joint ownership.

Section 23 amends section 32 of the principal Act to extend the circumstances under which appeals against certain decisions of the HSE can be made. Section 24 allows the Minister, by regulation, in respect of any difficulty which arises during the period of three years from the commencement of the Act to take any necessary action to bring the amendments to the principal Act into operation. Section 25 expands the HSE's duties with regard to the storage, retention and disposal of applications and notifications made under this Bill.

Section 26 requires the HSE to produce an annual report for the Minister for Health detailing the effects of the new provisions of the scheme. Section 27 provides for the Minister to carry out a review of the operation of the amendments to the principal Act not later than five years after the Act comes into operation. Section 28 amends section 47 of the principal Act to clarify that, in the context of the key provisions under this Bill, only a care representative can officially act on behalf of a person in care. Section 29 creates a right for any person, when attending an interview under the scheme, to be accompanied by another person over 18 years of age. This reflects the concerns of Deputies raised on Committee Stage.

Section 30 provides for the proceeds of sale deductible amount, as set out in section 31, to be accounted for in determining a person's contributions to care. Section 31 amends Schedule 1 to the principal Act to repeal the availability of the three-year cap on productive assets as a result of sudden illness or disability. This section introduces additional provisions that allow for the three-year cap to apply to farm and business assets following a positive determination under this Bill. This section also extends the three-year cap on the principal residence to the proceeds of its sale. Section 32 provides for transitional arrangements and amends certain paragraphs in Part 3 of Schedule 1 to the principal Act. Section 33 is a standard provision dealing with the Short Title and commencement arrangements. It also provides that the Act will come into operation 90 days after enactment, a measure which I agreed with Dáil colleagues.

I thank Senators for considering this Bill. I understand that it is complex with several highly technical provisions. I hope I have set these out with sufficient clarity and I look forward to hearing the contributions.

Photo of Lorraine Clifford-LeeLorraine Clifford-Lee (Fianna Fail)
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I welcome the Minister of State to the Seanad to outline the Bill. She has done so in a comprehensive manner and I thank her for that. I pay tribute to her because I know how committed she is to this issue. She has brought this Bill, which should be wrapped up shortly, to the House a little over one year after coming to office and this is to be commended. It shows a great focus and commitment to the issue and a commitment to the job. It is remarkable that she has brought forward this Bill and we commend her on her work, especially given the unprecedented year we have had in the Department of Health. All her colleagues and officials in the Department are to be commended.

This overhaul of the fair deal scheme has been long awaited. It is delivering upon a commitment in the programme for Government and it shows that the Minister of State and the Government mean business.

The pandemic has brought the issue of care into sharp focus. We will need a radical overhaul of the care system, especially in respect of care for our youngest, vulnerable people and older people in society as well as in respect of how we pay for that care and how we pay the people who deliver that care. These are all important issues and I am sure the Minister of State will address them during her tenure.

I am happy to see the measures aimed at protecting the family farm. This is an important measure for rural Ireland and for the communities that make up rural Ireland. It is also important for those of us who live in urban Ireland because the viability of the rural agricultural sector benefits all of us. These days we are all talking about sustainability and food security. It is vital that the farms in rural Ireland, which make a significant contribution to the economy and the well-being of our rural communities, remain intact. We must allow them to be passed down to other generations to care for these lands. I know plenty of farmers and farming families who say they are merely custodians of the land. They are there to protect it for future generations and to work it and deliver for their communities. That is what this Bill does.

I am happy to see the disincentive relating to vacant homes being removed. When people have gone into nursing care there has been a disincentive in respect of a vacant home and this has been removed. When knocking on doors throughout north County Dublin, I often come across vacant homes. We hear that so-and-so is in a nursing home and that is why a certain house is vacant. When we go back to the same area over the course of a couple of years we see the same houses lying vacant.I am sure this will have a significant impact on the available housing stock in Ireland. I wish the Minister of State the very best of luck with this Bill for the duration of its time in the Seanad. We in the Fianna Fáil group in the Seanad will certainly be giving it great support. I hope that we will get cross-party support in both Houses because this is progressive legislation from a progressive Minister of State.

Photo of Martin ConwayMartin Conway (Fine Gael)
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The Minister of State, Deputy Butler, is very welcome to the House. Every time she comes here, she engages with us fully. Over the last 12 months, I have been most impressed with her openness, her dedication to her role in the Government and the progress she has made. It has not been easy. The last 12 months have seen the worst pandemic in living memory and yet upgraded legislation on the fair deal scheme comes before us today. The fair deal scheme has been a great success in giving people the opportunity to get nursing home care and, while they must make a financial contribution, that contribution is in no way punitive. The scheme has been designed in such a way that it provides access to proper care for older people. The upgraded fair deal legislation that is before us today represents a natural progression in improving this scheme, which has run successfully for a number of years. I commend the Minister of State for bringing this legislation before us.

We have a long way to go in terms of providing the standard of care we all want for our older family members and which we will want for ourselves when we get old. There is significant work to be done. There will be a significant increase in the number of older people in our society. We should be thankful that we will be living longer lives. The age to which people can expect to live has increased dramatically. Someone aged 80 is not old now whereas, a number of years ago, 80 was considered a significant age. People now have a legitimate expectation to live to 90 or beyond. That means that the State has a responsibility to provide high-quality care for people reaching the twilight of their lives.

We all want to see older people looked after in the best possible way our society and our communities can provide. The most ideal way in which to look after old people is in their own homes. Unfortunately, that may not be possible when people reach a certain age and, unfortunately, they may have to get care. The State provides significant support through local authorities, such as housing aid for older people and housing adaptation grants. We would all like to see more money provided for those schemes because they upgrade homes to allow people to continue living in them by, for example, making bathrooms and bedrooms accessible. That is what we want to see. However, when people can no longer live at home, the fair deal scheme can kick in. The few unintended consequences of the scheme are largely addressed in this legislation, which is very welcome. We all know that old people can suffer from anxiety, worry and stress when they reach a stage at which they require residential nursing home support. It is incumbent on us to streamline the system, to make it easy to understand and to give older people reassurance that the scheme will not destroy an asset that has been built up over a lifetime. This legislation goes a long way towards addressing that.

As time goes on, as the Minister of State evolves into her brief, as the population of older people in the country continues to increase and as the commitment of the Minister of State and her Department continues, it is possible that she will be back in the Seanad with further upgrades to the legislation. It is an evolving process and there will be further amendments and further legislation in this area. That is welcome because, as we go forward, we are going to have to continuously upgrade and invest in services for older people. I wish the Minister of State every success in the work she is doing. The last 12 months have seen major steps forward with regard to supports for older people. I have no doubt that will continue.

Photo of Shane CassellsShane Cassells (Fianna Fail)
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The next person listed to speak is Senator Boylan.

Photo of Lynn BoylanLynn Boylan (Sinn Fein)
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I am not usually up so quickly.

Photo of Shane CassellsShane Cassells (Fianna Fail)
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We have other speakers listed.

Photo of Lynn BoylanLynn Boylan (Sinn Fein)
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It is no problem. I thank the Cathaoirleach Gníomhach. Cuirim fáilte roimh an Aire Stáit. I welcome this Bill and its introduction of a three-year cap on the assessment of transferred assets to protect the viability of family farms and businesses. I also welcome the fact that a successor will be appointed to assets and that rigorous safeguards will be put in place to ensure this is done for the purposes of running a family farm or business. Section 5 sets out how the HSE will determine eligibility for the cap to apply. This only happens after someone has been in care for three years, which may put in doubt some of the certainty which is being looked for and which would allow people to plan ahead. Section 14 allows for a care representative to make decisions in the event of the incapacity of the person in care. However, it is important this is overseen appropriately and carefully to ensure there is no abuse of these powers.

We welcome the amendments the Minister of State brought forward in the Dáil, especially the ones that arose out of concerns some Members had with regard to dealing with second partners and issues around family successors. The Minister of State spoke about the provisions in the amendments that will allow the Minister to make regulations in the future and my colleague in the Dáil, Deputy Cullinane, outlined his concerns and the importance of giving us more detail on the type of regulations that can be brought in by the Minister in that regard. We accept these amendments are being tabled in good faith. However, on a more general point, when we are being asked to support amendments that will give powers to the Minister to make regulations, it is important that we are given a better and clearer sense of what those regulations might be.

I will take this opportunity to address the wider issue of nursing home neglect and deaths during the pandemic. Sinn Féin introduced a motion on this topic in the Dáil this week. It is a scandal that needs a full public inquiry. This is a crucial issue which has devastated many families. At the very beginning of the pandemic, fatal flaws were exposed in our health and social care services. We must take the necessary steps now to identify these problems and ensure they do not arise again. I commend the many nursing home staff who worked so hard under considerable pressure and stress during the pandemic to do their best to look after those in their care. However, it is clear the sector as a whole was unable to cope effectively due to chronic understaffing, weak governance arrangements, poor safeguarding provision and a lack of investment. Many nursing homes were unprepared for any infectious disease outbreak and, as we know, the consequences were devastating for the families who together have lost more than 2,000 relatives in these institutions alone.

One important change we feel is needed is that an independent safeguarding authority must be established within an appropriate State agency. Adult safeguarding legislation must also be expedited. Mandatory reporting of suspected neglect or abuse must be the norm across the sector and workers who come forward should be supported and protected. Accountability at an organisational level, with appropriate penalties including criminal sanctions, must be put in place where a failure to govern safely results in harm or death for residents. Along with a public inquiry, this is the only way to deliver truth and justice for relatives and friends of those who have died or who have been neglected by care homes during the pandemic.

Families and social workers need to be at the centre of this reform. Sinn Féin is committed to standing with families and supporting their calls for truth. Residents of nursing homes deserve to get the best possible care and to know they are safe. The mistakes of the pandemic must be learned from to ensure that they are not repeated. We must deliver a high-standard and fully public model of care for older people. The statutory home care scheme needs to be expedited. It was reported at the end of last year that the scheme had been pushed to 2022 because the IT system and a new assessment process had yet to be developed.Once again, IT systems are a problem. It is not a result of cybersecurity in this instance but of the fact, which we have seen throughout the pandemic, that our health system does not have a modern IT infrastructure. This impacts on the State's ability to respond to new systems, policies and processes when needs be.

Sinn Féin supports the Bill, insofar as it goes. The three-year cap on assessments of transferred assets to protect the viability of family farms and businesses is welcome. I commend the Minister of State on introducing the Bill.

Photo of Mark WallMark Wall (Labour)
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I welcome the Minister of State to the House. The Labour Party will support the Bill. I am sure like many Members, not a week goes by when I do not deal with families and their applications for the nursing home support scheme. These meetings are often difficult as the families have done so much to keep their loved ones at home but, given the medical need of their father, mother, brother or sister, they are left with no option but to avail of the scheme. The need to help with the scheme has extended to relatives and friends. These are difficult times and decisions for all families but, thankfully, there is a scheme, which I hope we will see extended today.

It might not generate headlines in the same way as other, more emotive topics that we deal with, but passing this Bill will have a massive impact on the lives of families across the country. It is important we get it right, particularly because we know the demographic reality coming down the line. According to EUROSTAT, Ireland has one of the lowest proportions of people over 65 in the European Union, at 14.4% compared to an EU average of 20%. It is as high as 23% in Italy. However, we all know and it has been flagged by NGOs working in the area that we will not be immune to the pressures of an ageing population in the near future, as the Central Statistics Office, CSO, estimates that the number of over-65s in Ireland will rise by more than two and a half times to 1.6 million people by 2051. Given the huge rise in numbers who will need residential care and may not otherwise be able to afford it, it is important we act now. We need only look at Britain and the endless frustrations that campaigners in that country have come up against in trying to reform social care to see the dangers of getting it wrong. Ireland can be proud of instituting the fair deal when it did.

This Bill will have many benefits for farming families, in particular, and we as a party welcome those changes. We know many farmers are not far from poverty. They usually have low debt but, unfortunately, with low incomes. In this context, the costs of nursing home care can be onerous and this is filling families with fear and apprehension. According to Teagasc’s 2019 national farm survey, released last December, the average age of Irish farm holders is over 55 years and this rises almost to 60 years among cattle and other farmers. Given how close to retirement so many farmers are, this Bill will be of great importance to a large number of farming families. Some 23% of full-time farms have farm family income below €20,000.

We must remind ourselves of the damage caused by institutional approaches to care in this country. We saw it with mother and baby homes, Magdalen laundries and industrial schools; we see it today with direct provision. If we can implement policy that allows older people to live independently with the dignity they deserve for as long as possible, we should always take that chance. Nevertheless, we need to provide just, equitable and affordable access to nursing home care to all who need it. There is a time in everyone’s life when it becomes the best option but just as important, in providing a system that allows older people to live independently and with dignity for as long as possible we must look at other forms of independent living.

While speaking on independent living, I will take the opportunity to raise the need for reform of the housing adaption and housing aid grants administered by the local authorities. I and Labour Party colleagues have raised this with the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, who informs me that there is a review under way but we need this to happen urgently. I bring this up because I am continually coming across cases where families cannot afford the rising building costs of adapting their house for their loved one, given the level of grant funding available. I find myself chasing down community welfare officers to try to obtain the balance. In one case, the cheapest quote was €30,000 above that offered by the grant. If we do not reform those grants, we will see a lot more applications for the scheme we are discussing here this evening.

Yesterday saw the launch of the healthy age friendly homes programme under Sláintecare. It aims to provide 4,500 homes for older people to live independently with the appropriate supports as an alternative to nursing home or hospital care. We need to move faster with the roll-out of this kind of model, which can allow so many to continue living in their communities without families searching for the nearest nursing home or hospital in order that they may remain close.

We should bear in mind our climate commitments as they pertain to agriculture. We should emphasise a model of small-scale, sustainable farm holdings, rather than allowing our agriculture to be swamped by unsustainable practices and corporate agribusiness. In order to allow family farms to remain in the family, we should support farming families more and not force them to be driven down by the costs of care.

The Labour Party welcomes the changes, thanks the Minister of State for her work on the Bill and looks forward to supporting it.

Photo of Frances BlackFrances Black (Independent)
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The Minister of State is welcome to the House. It is great to see her. She is doing a great job in her role. I thank her for her recent support in helping with a young woman who had an eating disorder. The family is grateful to the Minister of State for her intervention.

I support this Bill's aim to address a long-standing issue affecting business owners and farming families under the fair deal scheme. It is an issue that has been long recognised as needing to be addressed. However, I have some concerns. We have this legislation on the fair deal scheme but there are a number of pressing issues related to nursing homes that it fails to address. There are many broader issues it ignores and we need to look at those issues, including the issue of adult safeguarding. Before I delve into the importance of tackling the urgent human rights violations that occur all over our country at every hour of every day, I will mention a number of issues I have with this Bill specifically.

The Bill fails to tackle the over-reliance on private nursing home care and the tendency to see nursing home care as an investment opportunity and a business, rather than a critical element of the social care system in the country. The over-reliance on the private sector has clearly failed adults at risk in more ways than one. It has led to a situation where nursing homes are largely unregulated and nursing home care has been seen as an opportunity for profit and investment.

The Bill fails to make any attempt to reorientate the social care system towards the community. We agreed through Sláintecare to orient people away from institutional care to services in their community. This is a noteworthy absence.

We have learned many vital lessons during the pandemic. One is that concentrated care of our older people is far from ideal. The reality is not good. The number of deaths is deplorable. By May 2020, nearly 1,000 nursing home residents had passed away from Covid-19, accounting for more than half of all virus-related deaths at the time. When the third wave of Covid-19 peaked in Ireland in January, outbreaks claimed the lives of over 2,000 people in nursing homes. That is more than two thirds of all deaths in nursing homes linked to outbreaks of Covid.

Adults across Ireland are being abused or neglected or both every day. In 2019 alone, the HSE safeguarding and protection teams received more than 12,000 allegations of abuse and neglect. The vast majority of these allegations related to abuse, be it physical, psychological or financial, at 40%, 33% 10%, respectively. The stories are many and all too familiar. They include the harrowing Grace case, concerning a woman with an intellectual disability who was left in a foster home for 20 years despite allegations that she was being sexually abused. Social workers, civil society organisations and academics all agree that legislation is urgently needed to address the gaps in our safeguarding framework and ensure that such tragic events are never repeated. More can and should be done as a matter of urgency.

The "RTÉ Investigates" programme, which aired two weeks ago revealed some shocking evidence of neglect and ill treatment in nursing homes. They spoke to a whistleblower who was sent into Cahercalla nursing home as replacement staff. We heard heartbreaking stories of awful, horrendous neglect. It is inhuman and deeply concerning. We cannot stand back as it continues to occur.Since then, I have progressed my new Adult Safeguarding Bill, which will build on the incredible work and research that Senator Colette Kelleher carried out with dedication during her time in the Seanad. I will bring forward this new Bill with the Civil Engagement Group in the next few months. The Bill will aim to provide for robust and effective measures to prevent abuse and neglect, to support people to protect themselves when harm occurs and to put human rights at the core of our safeguarding framework. Throughout this process, I will listen carefully to the views and unique perspectives of individuals with lived experiences, and their families, front-line social workers and civil society.

I have been in consultation with members of many non-governmental organisations, NGOs, social workers, academics and experts who said that the RTÉ documentary barely scratched the surface of the inhumane treatment of some of the adults at risk in care settings in Ireland, which extends beyond nursing home settings. There are no two ways about it, this is an urgent human rights matter that needs the involvement of everyone in every part of society. The whole of society and the whole of government must come together on this issue to be the voice of the voiceless.

I hope the Minister of State will support this legislation. I apologise that I have to leave the Chamber. I cannot stay as I have another commitment to the RISE Foundation. As I am sure the Minister of State is aware, I facilitate some group work for families whose loved ones are in addiction.

Photo of Róisín GarveyRóisín Garvey (Green Party)
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I congratulate the Minister of State. It is a very proud day. I am proud of her so I hope she is proud of herself. This legislation has been worked on for more than five years but she was the woman to get it over the line with great help from her civil servants, some of whom are in the Chamber. It is a great day for rural Ireland too. We often get accused, as a Government, of being very Dublin-centric, which is obviously not the case. When the Minister of State got into the House, this legislation was a priority for her from day one. It is always important to celebrate wins because there are so many negative stories, problems and issues in Irish society, especially since the Covid pandemic. It is very important that we acknowledge and celebrate wins when we get them. To put it simply, this legislation is an amendment to the fair deal scheme but it really helps the family farm, which is very important. The scheme will enhance and protect family farms and small businesses. The proposed amendments to the scheme extend the principle of the three-year cap to contributions based on family owned and family operated farms and businesses. I thank the Minister of State for that.

The lack of appropriate home care help for elderly people is another issue. This is the beginning of the Minister of State solving all the problems and she has a lot of work ahead of her. Home care help is the issue I have got most phone calls about since I became a Senator. So many old people have rung me who wanted home help in their houses but could not get it because they were not eligible or could not afford to go into a home care centre they felt comfortable with. Older people have many fears about going into home care centres. We have a lot of work to do on this issue.

Originally, back in the day, older people were seen as our elders and the wise people of our communities. They were the centre of communities and everything revolved around them. They passed on their wisdom to us because with age comes wisdom. We listened to our elders and that is how communities and societies then decided what was best. Unfortunately, we have moved away from elders being the centre of society. However, this is a very good day for elderly people living on the family farm in rural Ireland. We need a proper assessment of the housing needs of older people in Ireland. It is probably the next matter we will have to look at because older people do not always put their hands up to say they have a problem with where they live and that they need to move into a home, village or town because they are too rurally isolated.

One major thing I have learned in the past year is that if an older person does not have any medical ailments, as such, it is very hard to get home help. Many old people have rung me purely out of loneliness. They just wanted someone to come to visit them. Families are getting smaller and the days when one had a cluster of siblings all around the place are gone. There were seven children in my family and I have one son. That is a big difference in one generation. That is the way we are going now, so who will take care of old people when siblings are not there? As a society, people are busier and do not have time to mind old people so everything has changed.

I now realise that if one wants home help on mental health grounds, it seems one has to have a major mental health issue before it will be given. Prevention is better than cure and if people ring me who just want home help, even for an hour twice a week because they are devastatingly lonely, I need to be able to say, "I can do this for you, you deserve this, you have lived on the planet eight decades, you have given a whole life to this planet and it is time to give back to you." I have listed major challenges the Minister of State has but, overall, this is a very positive day and a very good day for farming families. I thank her profoundly for that.

Photo of Fiona O'LoughlinFiona O'Loughlin (Fianna Fail)
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I welcome the Minister of State and this legislation. The Minister of State will recall that Senator Chambers and I brought a Commencement matter to the Seanad in April regarding this much-needed legislation on the fair deal scheme. At that point, she made a very firm commitment to honouring farming families and I sincerely thank her for that. This update of the fair deal legislation to enhance protections for farmers and business owners has been a priority for her since she took office just over 12 months ago. I sincerely hope that this Bill receives cross-party support so that these hugely important changes can be delivered without delay.

The increase in home care hours and supports that encourage older people to live at home as opposed to going into nursing homes is most welcome. Again, that is something on which the Minister of State has worked very hard and is fully committed to. Nursing home care, however, is crucial for many older people and their families. The peace of mind in knowing that their loved one is being take care of and is receiving the help and care they need is a huge weight off many families' shoulders. It is vitally important that the State supports that in cases where it is needed.

One would think because of the name that the fair deal scheme is fair but, currently, it is not. It is not fair to small business owners and farming families who currently risk losing a family farm or their small family business should a loved one need to access the scheme. The current 7% annual levy is a major disincentive to these families and is preventing those who may need nursing home care from accessing it. This is why it is so crucial that we have the changes the Minister of State is putting forward in this Bill. The change to the scheme proposed by the Minister of State, which is to cap financial contributions based on farm and business assets at three years where a family successor commits to working the asset, is a massive step in the right direction. This will provide a huge sense of relief for many farming families and business owners.

We all want to see our loved ones receiving the highest quality of care that they can. We want to see them enjoying the highest quality of life possible for as long as possible. This Bill absolutely supports that. Nursing homes are not the right setting for everyone. Many people want to stay in their own homes for as long as they can and if they are physically and mentally capable of doing so we should support them in that. However, when, or if, the time comes that people require nursing home care, they need to be able to access care quickly and in a cost-effective manner. This Bill will allow many people to do that.

Fianna Fáil warmly welcomes this Bill for which there was a firm commitment in our manifesto. When the Minister of State spoke as an Opposition Deputy she was a very strong advocate of bringing this legislation forward so it is really terrific to see her acting on it once she was in a position to do so. Not alone is this change important for those who need to access nursing home care, it is essential to the viability and sustainability of family farms as it allows them to be passed down to the next generation. Again, it ensures that the fair deal scheme is fairer, more accessible and more affordable. This is a very emotive issue for farm families in communities throughout the country. I want to raise two other issues. I thank the Minister of State for the work she has been doing with the Alzheimer Society of Ireland. It is great to see day care centres starting to reopen, but it is very difficult for the centres dealing specifically with patients with Alzheimer's disease to do so. Could a fund be put in place to accommodate them? I appreciate that only a certain percentage of facilities are dedicated purely to the care of people with dementia and Alzheimer's disease. Nevertheless, a fund needs to be established to ensure they can reopen as quickly as possible.

The housing adaptation grant scheme needs to be streamlined and made reflective of current building costs. There must be an effort to reduce the large amount of red tape for people who need to access the grants to stay in their homes.

Photo of Malcolm ByrneMalcolm Byrne (Fianna Fail)
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I thank the Minister of State, Deputy Butler, for coming to the House. I join other speakers in welcoming the progress of this legislation. There has been campaigning for these provisions for a number of years. The Minister of State ran with the issue and has delivered on it inside a year. That is what a good politician does.

I have a number of questions on the provisions contained in the Bill. Assuming the legislation is passed in the Seanad by tomorrow and goes on to receive the presidential signature, on what date is it expected to be enacted? For somebody who is already in a nursing home and who appoints a successor, will the time that person has spent in care be taken into account? For example, if a person in that situation has been in a nursing home for two years, will that time count in the calculations? I am conscious there are particular criteria around eligibility and there is a plan for a five-year review. It may be the case that when the scheme is up and running, issues will arise. Is there the possibility of having a review sooner than in five years' time?

It is important we have a debate at some stage on the broader question of care for elderly people. Our elderly care model needs to support more opportunities for people to be able to live independently. The discussion needs to go beyond the traditional nursing home model to look at ways in which older people can live within the community. We also must accept we are an ageing society and we need to adapt everything we do because of that. The facilities and resources must be in place to accommodate that. A statistic that struck me in recent times was that one in five teenagers today will live to the age of 100 and one in three babies born this year will live to that age. We must start thinking about a society in which people are living for much longer and in which more people are elderly.

These are big challenges but I have no doubt, given what the Minister of State has been able to achieve in a year, not just in regard to older people but also in the area of mental health, that she will be able to achieve much more over the next four years. I hope she will be able to address some of the major issues to which I referred. I strongly support the legislation and join other speakers in commending the Minister of State and thanking her for her work.

Photo of Micheál CarrigyMicheál Carrigy (Fine Gael)
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The Minister of State is very welcome to the Chamber. I welcome the proposed changes to the nursing homes support scheme, which are long overdue. I am delighted the Bill is being brought through the Houses prior to the recess. It is in line with a commitment we made in the programme for Government and a commitment I gave personally to local representatives of the Irish Farmers Association, IFA, in Longford when we met with them. I am pleased the Bill will be on the Statute Book before long.

For too many years, numerous family farms and businesses had to be sold to fund nursing home care for family members. I welcome these changes to the treatment of farm and business assets in the financial assessment of the means of applicants for the nursing homes support scheme, which will extend the availability of the three-year cap to relevant family-owned and family-operated farm or business assets where a family successor commits to working on the farm or in the business within the first three years of the applicant's time in care. This will safeguard the viability and sustainability of these farms and businesses, notwithstanding that, according to the IFA, only 34% of farms provide a viable income. The family farm or small business is transferred from one generation to another as a means to provide an income return on the hard work involved. It is not a nine-to-five job but seven days a week and 365 days a year. Inheriting the family farm does not amount to a huge cash windfall as some people might think. It is about providing for one's family and then passing on the farm to the next generation.

The nursing homes support scheme represents an annual investment of €1.4 billion by the State in the care of more than 22,000 people. Senator Byrne gave figures regarding our ageing population. We will have significant numbers of elderly people who need to be cared for in the years ahead, at a significant cost to the State. I pay tribute to our former colleague and Minister of State, Jim Daly, for his work on the scheme. As I said, these changes are long overdue. The recommendations in this regard were made up to seven years ago. During that time, many families have endured hardship in trying to meet nursing home charges, often having to sell land to do so. Will there be a hardship fund to examine cases where this has happened or where, as Senator Byrne mentioned, people are already in a nursing home prior to the legislation being enacted?

It is important at this time to thank the staff of all the nursing homes throughout the country for their care of people in need, particularly during the past 15 months. Many of them put their lives on hold to keep our loved ones safe. I experienced this personally when my late mother, Eilish, was in nursing home care during the Covid period.

I have one issue with the scheme and it relates to the term "fair deal". Our system of care for the elderly does not provide a fair deal for all families. I am speaking here on a personal level. Mention was made of care in the home. We need to re-examine our model of care for the elderly. Much of the emphasis when discussing this issue is on the fair deal scheme and nursing home care, when in fact the vast majority of families, including my own, would really like their loved one to be cared for at home. It was just not possible for us to do that for my mother. The option was not really there. When she was diagnosed with dementia in hospital, we were given the option of five hours' care or the fair deal scheme. That was the choice we faced as a family and we had to make a decision. In fact, there was only one decision we could make.

My mother received fantastic care in the nursing home in which she lived. I compliment the staff of St. Joseph's care centre on the top-class care they provided. However, if that type of care could, in some way, be provided in a person's home and be topped up by family members, it would be of great help to people. This is something we must examine as we move forward. It is an option my family would have taken and I know numerous others would be more than willing to do the same if it were available. If I ask only one thing of the Minister of State, it is that she look seriously at that option for the future. It should be something families are able to choose. As well as the likes of communal living, we need to look at providing one-bedroom or two-bedroom homes attached to nursing homes. There is a place in County Mayo - I cannot recall which town it is - where that arrangement is in place. A person can purchase a one-bedroom or two-bedroom house beside the nursing home, avail of the facilities, including medical and dining facilities, but still live independently. We need to take a strong and focused look at the future of care for our elderly. We need to give families a different option. My family, unfortunately, did not have another option. An offer of five hours of care for someone who was unable to walk and care for herself was quite unfair.

Reference was made to the housing adaptation grant. We need to look at cases where half a house has been signed over to a family member and the elderly person has a legal right to remain living there. When it comes to seeking an adaptation grant, if needed, the person is not eligible because the house has been signed over to the relative.Where that legal stipulation is in place in respect of those living in the property, I ask that it be taken into account and that they still be allowed to adapt the house.

Photo of Sharon KeoganSharon Keogan (Independent)
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I thank Senator Carrigy for sharing his personal experience with us today.

Photo of John CumminsJohn Cummins (Fine Gael)
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I pay tribute to my colleague, Senator Carrigy, for his moving contribution. It gives us a real sense of the challenges that are faced by families in deciding whether to try to cope at home or put a loved one into a nursing home that provides great care. I commend my colleague.

I welcome my fellow Waterfordian, the Minister of State, to the House. I compliment her on bringing forward this very important legislation, which will have a significant and positive impact on those families who have farm and business assets and are availing of the nursing home support scheme, commonly referred to as the fair deal scheme. It should be noted that the scheme represents a €1.4 billion investment annually by the State, and benefits over 22,000 people.

As the Minister of State is aware, it has taken a considerable amount of time for the Bill to get to this point. I acknowledge the exceptional hard work done by my Fine Gael colleague, the former Minister of State, Jim Daly, on this Bill. The changes were approved in July 2018 and the pre-legislative scrutiny was commenced in November 2019. Obviously, progress on the Bill was impacted by the general election and Covid-19. It was great to see the Bill pass all Stages in the Dáil yesterday. I am sure it will pass all Stages in the Seanad by close of business tomorrow.

The review of the fair deal scheme committed to reviewing how productive assets are treated for the purpose of the scheme, and whether the sudden illness or disability condition should be removed and the three-year cap applied to productive assets. Currently, the unqualified three-year cap does not apply to productive assets such as farms and businesses, except where a farm or a business owner suffers a sudden illness or disability, and as a result, requires nursing home care. This can, and does, have a significant impact on the viability of family-owned and operated farms and businesses, as a large proportion of the asset's value is owed to the State. As Senator Carrigy rightly pointed out, it has resulted in families having to sell businesses or farm holdings, which is unfair and counterproductive.

Under the proposed legislation and the amendment to the scheme, contributions based on family-owned and operated farm or business assets will be capped at three years, where a family successor commits, within the first three years of the relevant person's time in care, to working the farm or business asset for a period of six years. The intent of the amendment is to ensure that in cases where the productive income of the farm or business is being relied upon as the principal livelihood and the farm or business is being handed down to the next generation, the viability and sustainability of such farms or businesses are protected because there is a degree of certainty about the overall cost of the long-term residential care. There is a dual benefit of the measure in terms of equalisation with other financial assets and also promoting the next generation of business and farm owners. As we move to a jobs-led recovery in the coming years, it is important that this generational shift takes place and we support the younger generation of entrepreneurs that is coming to the fore. A lot of knowledge within families can help to progress businesses and farms.

I will touch on an element of my own brief in housing in the context of the fair deal scheme. I ask the Minister of State to engage with her colleague, the Minister for Housing, Local Government and Heritage, on the issue. I have spoken to the Minister about it. It concerns the treatment of rental income under the fair deal scheme. Currently, participants in the scheme contribute up to 80% of their assessable income. That includes rental income, which means there is no incentive for families to rent out the property. They go through what can often be a traumatic experience of packing up the belongings of their mother, father or relative and putting them into storage. I appreciate that some concerns have been expressed about whether an incentive would push families towards putting older people into nursing homes against their will. That would not apply in the vast majority of cases. If we had a rate lower than 80%, for example, a rate of 20% or 40%, as currently applies to rental income generally, it would have a positive impact in freeing up much-needed housing and rental stock for individuals and families across the country. I ask the Minister of State to take that suggestion on board and address the matter in the autumn.

Photo of Rónán MullenRónán Mullen (Independent)
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Curim fáilte riomh an Aire Stáit. It is not an exaggeration to say that the increasing care needs of our growing elderly population are probably one of the most urgent social crises looming over the Irish State in the next 30 years.

Our ballooning national debt may be at dangerous levels, but it can be inflated away and renegotiated. Climate change, for all the attention it gets, is a problem which will affect people in much poorer and lower lying countries long before it will affect Irish people directly in a serious way, although I do not make light of that. We owe a great debt of solidarity to people in those countries. Even the pensions time bomb, as it is described, is something which may well be manageable with proper State policies and responsible private provision by citizens. However, the reality is that no matter what we do, the demographic make-up of the Irish population is not something that can be changed by legislation. It is a fact of life that the proportion of the population that is elderly and in need of care is going to rise dramatically in the decades to come. The inherent human dignity of our elderly population and the love and respect we feel towards our elders demand that we do the best we can to care for them in old age. This moral duty will exist 30 years from now, as it does today.

Our collapsing birthrate will exacerbate the scale of this challenge, since there will be even fewer people of working age in 30 years' time than there are now, as a proportion of the population, meaning less resources to pay for increasing care needs. The number of births in Ireland fell from 61,000 in 2018 to 56,000 in 2020. We do not talk enough about the implications of those kinds of statistics for our planning of national life going forward.

I welcome the provisions in this Bill. They will go a long way towards alleviating the circumstances of families who face the prospect of their family farm or business being dissipated due to the contributions required under the fair deal scheme. It seems fair to apply the same three-year cap to farms and businesses as applies to the principal private residence or family home of the person in care.

Only a third of Irish farms are profitable and it is far fewer than that again in the west. The same is true for family businesses in the west which, no matter what the sector, are less financially lucrative than in other parts of the country. In order for a family to qualify for the cap, the family successor, who may not own the farm but is still working it, has to demonstrate a six-year commitment to the farm on his or her part. Is that not a very high bar for many people to clear, given that two thirds of farms are not profitable and so many younger farmers now supplement farm work with second jobs?

I have another question that perhaps the Minister of State can answer. It is a question rather than a statement. In terms of the ability of the family successor to qualify for the cap to apply to the farm, family business, country pub or whatever it is, does most of their income have to come from that farm, family business or country pub during that period? The Minister of State is indicating that that is not the case. That is important. It seems that when people talk about rural life, one of the realities is that people have off-farm jobs. The country pub might be a pastime or a means of keeping the family tradition alive and the rural community going. The owner would not necessarily be in it for the money, but there may be all sorts of other motivations for wanting to keep the family business going. The same applies to family farms.The reality is that, for an off-farm job to work, most of the money will have to come from it, while most of the individual's time will be devoted to maintaining the way of life on the small family farm, which may not be so profitable. I detect from the Minister of State's body language that this has been addressed. I will be delighted if it has. It is important that the criteria according to which a person qualifies take into account the fact that the bulk of the earning activity might be from the activity that is not the subject of the cap.

I read an excellent paper last week by Ms Maria Dillon, a solicitor in Galway who is an expert on the care needs of the elderly and vulnerable and their legal rights. She points out several ways that the 2009 Act could be improved. For example, she highlighted a 2016 judgment by former President of the High Court Peter Kelly in the case of M. L. v. D. W., a dispute that centred on the sale of a family home by the person who had enduring power of attorney over the affairs of an elderly person in full-time care under the fair deal scheme. The house was empty, falling into ruin, and had been broken into, and there were still bills for insurance, property tax and so on. The house could not be rented out without imposing further burdens on the owner's family, none of whom lived nearby. The problem, as the Minister of State will be aware, was that selling the house would have converted it into a cash asset, thereby removing the three-year cap and exposing the proceeds to being eroded over time under the terms of the scheme, which was clearly an enormous disincentive to selling. It occurred to me that there must be a large number of families in this position. Surely we should make provision for such circumstances. It is bad for the affected families and bad for society because houses that might otherwise be sold or rented out are lying empty to protect their value. This appears to be addressed in an amendment the Minister of State has tabled but it is a matter I wanted to highlight as one that needs to be addressed.

Another problem, which has only recently begun to emerge, concerns what are called life loans, or what we would know from television advertisements as equity release arrangements. Much of the activity in this area took place 15 to 20 years ago during the height of the most recent property bubble. Essentially, individuals released equity from their homes to assist their children with house deposits. This was called "the Bank of Mam and Dad", but now Mam and Dad are reaching old age and require full-time care. Equity release involves a legal charge being placed on the property, and the small print often requires that the house must be sold if the owner goes into long-term residential care. Therefore, the same problem arises since the home would then be converted into a cash asset and the three-year cap could not be availed of. I believe this is being addressed. If so, I welcome it. It is important to allow the principal private residence to be sold in such circumstances but for the proceeds to be subject to the three-year cap. It is important that rental income from renting out an empty residence be exempt from consideration according to the criteria covering a cash asset. These would be small changes that would not damage the financial viability of the fair deal scheme.

The cost of long-term care and the burden on the families of those in care are going to increase significantly in the years to come. This will inevitably lead to greater contributions being sought from those in care and their families. Therefore, we need to do all we can to alleviate pressure on the scheme and on applicants and their families.

I mentioned the "Bank of Mam and Dad". The caring role I shared in recent years with members of my family meant I saw a certain amount of daytime television at weekends. I deepened my affection for Lieutenant Columbo and others who are regularly shown on certain channels. I frequently saw advertisements for the "Bank of Mam and Dad". How tasteless I find it when I see individuals being encouraged to save up for their funerals so as not to be a burden on those they leave behind. I wonder sometimes when watching some of the advertisements what kind of message they send to older people in society. They are told they need to be selfless enough to make sure they will not cost their loved ones anything when they go. While I accept it is not within the scope of this Bill or any other to deal with this, my observation was a cultural one I thought I would make in conclusion.

Photo of Seán KyneSeán Kyne (Fine Gael)
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I welcome the Minister of State. I congratulate her on her role, her advocacy for this Bill and getting it to this Stage. It is certainly going to be part of her legacy. I acknowledge, as others have, the work of her predecessor, Mr. Jim Daly, with whom I had much contact in my previous role as Government Chief Whip regarding the progression of this legislation as a priority. As with other Bills, it has had a rather tortuous journey. Its general scheme was approved by the Cabinet in June 2019. The changes are outlined in the legislation before us. I acknowledge the work of Mr. Daly. It is important that we do not forget those who ploughed the fields before us. I also acknowledge the work and lobbying of the Irish Farmers' Association, including Ms Maura Canning and Mr. Joe Healy, and others.

I welcome the changes in the Bill and acknowledge the Minister of State's openness to examining issues raised on various Stages in the Dáil and to tabling amendments, as she did. It is a pity this is the last week of the term and that proceedings are a little more rushed than they should be. This is the nature of things, unfortunately.

I welcome the changes to the Bill because business people, particularly farmers, have a great affinity with and affection for the land. It is not about what the land is worth financially but what it is worth emotionally and in the sense of its having been in the family for generations. There is concern that some land could be lost or sold to pay for the care of loved ones. It is quite an emotive issue. Irrespective of what the land is worth, it is needed to generate enough income for a farm to continue in operation. I welcome the cap that has been put in place for farmers and small businesses. It will give peace of mind to people as they go about their business. Very often, a person might have an elderly loved one to care for in addition to other dependants, including children, depending on the circumstances. It was always a matter of the balance and sustainability of the scheme. As Senator Mullen said, the question of who will look after us all will continue to arise. It is a matter of timely access for those who need support.

The appointment or nomination of a family successor is positive. Does a person nominate a family successor when thinking about the fair deal scheme, or should every farmer or businessperson consider the matter in his or her fifties, if that is not too late? One does not know what will happen in some cases. Should the nominee be known within the family and go through a process? Succession planning is important. This could be considered.

Rental income was raised by others. It is an important issue. There are vacant houses with weeds growing around them at a time we need houses in various areas. I acknowledge that not all houses may be suitable, depending on the location. A house may be in the middle of a working farm so it might not be practicable to rent it. Where it is possible to rent a house, it should be considered. Disincentives to renting should be addressed.

I raised the issue of carers in the House previously. There is a broader debate on looking after people at home, where possible. My colleague has spoken about his circumstances. My late father, whose case I spoke about in the House previously, had a debilitating condition. My mother promised him that we would look after him at home. There were seven of us in the family so we were able to do that. My uncle had a stroke on 12 March. He was 88 at the time and had never been in hospital in his life. Just like that, he is now in a nursing home. He is quite content. We just never know when these things will happen, no matter how much planning we do. We are all going to start getting sore knees and hips and eventually we will drop away. Things can happen suddenly. Families may have to deal with issues for which they have not prepared or planned and they may have to run around trying to find information.I welcome this change, which will be important in giving peace of mind in respect of a very important scheme which most families, if not all families, will at some stage apply for and use.

Photo of Sharon KeoganSharon Keogan (Independent)
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I thank the Senator for sharing his story.

Photo of Robbie GallagherRobbie Gallagher (Fianna Fail)
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I compliment Senators Carrigy and Kyne on sharing their personal experiences this afternoon. The Minister of State is always very welcome to the House, but she is particularly welcome this evening with this legislation. I compliment her on introducing this very significant Bill. She and I spoke about the matter when she was first appointed. It is very important to many people. She deserves great credit for ensuring the Bill has been brought to the House in an expeditious manner. I compliment her on that.

I also acknowledge the work of the previous Minister of State, Jim Daly, who is a gentleman. I had the pleasure of him responding to two Commencement matters I had raised on the issue in the previous Seanad. I know the sincerity he had in trying to progress this.

This is definitely a good news day. A three-year cap will now be placed on farm assets or business assets of any kind. As someone who was born and reared on a small farm, I know that sometimes it is a labour of love and does not provide any great financial gain. In many ways the cost of maintaining land may exceed any income it might provide. Five of us were reared on 20 acres of land in Donegal, not far from where Senator Blaney lives.

I know the trauma and stress families face when a loved one needs to go into a nursing home. For some families where income is limited the costs can be excessive. I know of some people who had to sell land which was a very painful undertaking because that land might have been in the family for generations. To be forced to dispose of it to pay for a loved one in care is very traumatic for any family.

I acknowledge others, including the farm organisations, particularly the IFA, who played a role in trying to progress the matter. Age Action was also very much to the fore in trying to find a solution.

For some families the nursing home is the only option for long-term care. Nursing homes deserve great credit for the role they have played in trying circumstances during the battle with Covid. I acknowledge the role they played in that regard. I also acknowledge the role of the Minister of State played in trying to steer those nursing homes through that very traumatic and stressful time for many people.

As Senator Mullen outlined in his contribution, the population is ageing and caring for the elderly will put greater financial pressure on the Exchequer in the future. In an ideal world, everyone would stay within their own family home, in their own community where their friends and connections are. In some cases, unfortunately, there is no other show in town but the nursing home. We are lucky to have them and they do an excellent job.

If possible, every effort should be made to try to ensure that a person would be able to stay within their own home for as long as they would wish and for as long as they are medically fit to do so. The home help service is excellent. I welcome that significantly more funding has been allocated to that sector in recent times. Every penny spent on that is money well spent. Those few hours of home help are saving the State a fortune. In some cases, it might be only 20 or 30 minutes in the morning and 20 or 30 minutes in the evening. There is great scope to expand that scheme much further and to increase the role that those who call to people's houses might undertake.

The last time the Minister of State and I discussed this issue during a Commencement debate, she said she was working to expand the home help service and was considering providing a fair deal for people who wanted to stay in their own homes. Perhaps she might give the House an update this afternoon on the status of that. I compliment her not just on this issue, but on all the work she is doing in her brief. She is doing an excellent job. Bualadh bos.

Photo of Niall BlaneyNiall Blaney (Fianna Fail)
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I very warmly welcome the Minister of State, Deputy Butler. The Bill before the Seanad today marks an important step in the equal treatment for farmers who cannot realise the value of their assets. The Bill will allow for the continuation of their farms when they are no longer able to work due to advancing age. We must ensure fair treatment of farmers, not just when they are producing goods and feeding the island, but also when they can no longer work. The extension of the three-year cap to cover family farm assets is very welcome in this regard. The overall aim of the nursing homes support scheme is that participants contribute to the cost of their care according to their means while the State pays the balance of the cost. Farming should be covered in line with others who have different means of income.

I commend the Bill for two reasons. First, the Bill aims to support family farms and the continuation of family farming. It removes some undue stress on inheritance of farmland. Sustainability of farms does not simply include the sustainability of the environment; it must also include the sustainability of the farm's operation, ensuring that farms can be passed down through the generations. Who knows the land better than those who have lived their entire lives farming on it? We must ensure that the passing down of farmland and all that comes with it is fair and just.

Second, the Bill ensures affordable care to those who have contributed so much of their time and effort to this land. State-subsidised care is a common good that should be offered to all based on means and farmers should be treated no differently. A three-year cap on assets will help to put their minds at ease when it is time to pass their farm down to the next generation without incurring heavy financial cost. State supports must be in place for those who need them and for those who deserve them. Farmers certainly deserve Government support. We cannot have a situation where farmers must decline nursing home support and the provision of quality of care because they fear for the financial well-being of their families if they choose to do so. Farming is the lifeblood of this country. Like Senator Gallagher, I grew up on a family farm in Donegal, which is still in my family's possession.

I thank Senators Carrigy and Kyne for sharing their personal experiences. I also have experience of what it is like to care for a loved one at home. As my father, a former Deputy in the other House, passed away with Alzheimer's, I know what it is like to care for an individual in that position. He and five of his siblings suffered from the same illness. This Bill would provide welcome relief for many families throughout the country.

Like many other Members, I spent countless hours working on farmland in my younger years. Farming does not come easily. It is a laboursome and difficult career for those who choose to pursue it. Farmers should be given plenty of credit. They should not be left behind in quality of life or care after farming. Farmers cannot afford to be run down financially when the farmer needs provision of care. The Government is sending a strong message of support to farmers. The Minister of State today is providing a statement on equal and fair treatment of those who devoted their lives to the production of sustenance.

The proposed amendments to the scheme are very welcome. I look forward to the passing of the Bill to give farmers much-needed relief before the House takes its recess. I commend the Minister of State on addressing the anomalies in the scheme.I have no doubt about the Minister of State's determination and persistence. Her knowledge in this area and the experience she brought to the role has certainly paid off. We sincerely thank her for all the work she has done in delivering this Bill today. I commend the Bill to the House.

Photo of Sharon KeoganSharon Keogan (Independent)
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I thank the Senator for sharing his story and for showing everybody the humanity and the human side to the politicians here.

Photo of Jerry ButtimerJerry Buttimer (Fine Gael)
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I welcome the Minister of State and commend my colleagues for their stories and the humanity they have brought to this debate. This is about citizens, family members, neighbours and people. I commend the Minister of State for her work in bringing this Bill through today. I commend the former Minister of State, Jim Daly, for his term in the Oireachtas in the position that the Minister of State, Deputy Butler, now holds. This is about a fair deal, care and fair treatment of all citizens. I am sorry that Senator Mullen is not here. In advance of the debate, I was reading a submission made by European bishops to the European Union about care of the elderly. It was interesting that they asked for intergenerational solidarity in the green paper on ageing. Some 20% of people in the European Union are over the age of 65. By 2070, over 30% will be over 65. That means that the €1.74 billion being spent by the State will increase. All of us who have elderly relatives understand the need for them to be looked after in the comfort of their own home or in an environment that they are familiar with.

To be fair, I know the Minister of State had a great interest in this long before she became a Minister of State. The issue of care of the elderly, the provision of home care packages and of home help need to be examined on a fundamental level. We need to have an honest debate about the care of our elderly citizens. We must ensure that we always do the right thing. I am not afraid to have a conversation. We should have a conversation about how we can look after people better.

Senator Garvey referred to a retirement village in Clare. We have one in Cork city, in Lapp's Court and Hartlands Avenue. I would love for the Minister of State to go to see it. It is a small, predominantly Church of Ireland community. Elderly people live in little one-bedroom or two-bedroom bungalows with a kitchenette and a sitting room. It is a wonderful place to visit. Senator Mullen was talking about television advertisements. There is an advertisement on television about downsizing and encouraging older people to change from three or four-bedroom houses to different types of accommodation. That is all welcome but it has a profound impact that we need to debate. I hope that we can do that.

My fundamental concern is the delivery of care in community, nursing home and hospital settings. I go back to the remarks of the bishops about intergenerational solidarity. We should look at and discuss it. This is about ensuring that we are fair to businesspeople and the farming community, which we are. I welcome the Bill and the debate. It is also about putting in place a compendium of supports for wider care that can ensure that we provide real, meaningful care to those of our society who are elderly and need care and support. It is one thing to be able to have €1.74 billion on a balance sheet but quality and continuation of that care are issues. All of our offices are dealing with families who are looking for a variety of home care appliances, home help packages and so on. You name it. I hope that through the prism of this debate and the work that we all do, we can help to inform and shape policy for the future that puts the person at the centre. To be fair to the Minister of State, Deputy Butler, she always does that. I mean that genuinely. I have seen her work in opposition and today in government. The former Ministers of State, Jim Daly and Catherine Byrne, also did so. I thank the Minister of State for bringing this Bill through the House.

Photo of Tim LombardTim Lombard (Fine Gael)
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I welcome the Minister of State and acknowledge her great efforts to make sure that this Bill has got this far. I acknowledge my former colleague in Cork South-West, former Minister of State, Jim Daly, who worked hard to make sure that this legislation went through the earlier parts of scrutiny. It is an important day for so many people. My office, like many offices, has been somewhat inundated by people asking when this legislation was going to happen and be signed into law. Will the Minister of State clarify her timelines regarding this legislation? Will there be a 90-day lag or is there a proposed date in mind?

In many ways, this legislation brings peace of mind to a farming and business community that unfortunately, since the set-up of this fair care deal, has felt disenfranchised and that it has been left with a legacy of debt because of the three-year rule. This change to the three-year rule is an important step. It sets out how a family can deal with the issues that so many Senators have mentioned today, such as family members who need to go into nursing care. It gives people peace of mind. People who are not in nursing care settings or are hoping not to go into them for a long time have a fear and worry about what if it happens. This is important legislation because of that. It brings clarity to an issue where there was a substantial liability on small family farms in particular. We have all heard the horror stories about families having to sell portions of land because of exceptionally long-term care, which caused a legacy issue for the entire family.

There are 700,000 people aged over 66 in Irish society. By 2050, more than 1.8 million will be over 66. That shows how the demographics and society are changing. Scenario planning for the future will be a significant issue. That is a big debate that we will have in this House and in the Oireachtas in future, about how we work with community and society to find a competent and caring place for our elderly. I am interested in the Minister of State's view on whether we can amend other schemes in future to have a home care deal that might be a fairer care model and how that can be tied in. People will probably do whatever they can, as my colleagues mentioned here today, to keep their loved ones at home. How can the State help them during those troublesome times? This is a positive step. I ask the Minister of State to clarify those issues if she can. I thank her again for her hard work in delivering an important Bill for society.

Photo of Aisling DolanAisling Dolan (Fine Gael)
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I welcome the Minister of State, Deputy Butler, who has responsibility for older people and mental health. It is great to have the Nursing Homes Support Scheme (Amendment) Bill 2021 here. I thank my colleagues who have given heartfelt accounts. They have spoken openly about their own stories. Farming is a way of life. It is a fantastic way to grow up. My mum and dad gave me values, a love of where I come from, a love of the land and a hard work ethic, from sun-up to sun-down, sometimes. There can be pure joy in it. When I think about July, when I was a kid, growing up, if the silage was in, the hay was done and the turf was in before the Galway Races, that was really good. There was joy in that. Times are changing and our lives are changing. Society is getting older. Our way of life is changing in some of our rural areas, especially in counties such as Galway and Roscommon, where there are now many older people, with the number aged over 65 doubling in the 2016 census.There is such pain for farm families when a loved one may need to move to residential care. Great efforts are made to keep our loved ones in our homes and to look after them but there is an impact when they have to go, and the impact on farm families is potentially the loss of land or issues with managing the break-up of a farm and a family home.

As the Minister of State noted and my colleagues have mentioned, a three-year cap on the financial contributions of family-owned and family-operated farms and businesses when calculating the cost of nursing home care is provided for in the programme for Government. It was worked on a great deal by the previous Government as well.

My colleague, Senator Kyne, spoke about succession and inheritance, which is a crucial issue on which Teagasc does much work. One of those tricky matters, although it is a conversation we all need to have within families, relates to writing a will and talking about what the future will look like. On many small farms, the children grow up and may study in Dublin or abroad and go everywhere else to get jobs, and they will no longer be at home. Could neighbours take over the farm or could other family members step in and help out? It is about putting a plan in place and having those conversations. The legislation is intended to support families in doing that and allow successors to come in and take over the family farm in order that there will be support for the older family members later in life.

Other colleagues spoke at length about their personal experiences of dementia and Alzheimer's disease. I worked on an Horizon 2020 project with the National University of Ireland Galway school of nursing and midwifery. It concerned technology and how important it is for supporting people with dementia and Alzheimer' disease, as well as the chronic nature of the disease and how to support families. I acknowledge another fantastic announcement the Minister of State made this week, relating to the healthy age friendly homes initiative. It will be a pilot programme rolled out to nine counties including Galway. It will target 4,500 homes and examine specifically how to support older people to live independently in their own homes for as long as possible, using technology such as telehealth and telecare to do that, in order that they can live with supports in place.

I had the opportunity to meet some representatives of the Irish Farmers Association, IFA, including Mr. Tim Cullinan, outside the convention centre. I acknowledge also Ms Caroline Farrell, chair of the IFA's family farm committee. They have worked so hard, along with many other farming organisations, to ensure we have this scheme in place before the Houses adjourn for the summer. We often talk about an ageing population. As Senator Malcolm Byrne said, some of us will live to 100 years of age. We are going to live longer but it is not about just that; it is about active and healthy ageing. That is so crucial. Farming, in many ways, is a fantastic way of life because it involves living outdoors and being physically active. As many Senators noted, people who live such lives are at the top of their health, at least until perhaps something happens in their 80s or 90s. They are so independent. We need to support them living independently in their own homes or in residential units. In my area of Ballinasloe, it is about one-bedroom or two-bedroom units in community areas, with supports in place. Clúid Housing has done a great deal for that as well.

How can we support Teagasc with succession planning? I acknowledge that Sláintecare and Healthy Homes Ireland are involved in the healthy age friendly homes programme. How can we support succession planning through Sláintecare and the health communities?

Photo of Sharon KeoganSharon Keogan (Independent)
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I thank the Senator. As always, she was upbeat. I invite the Minister of State to respond.

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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I thank all the Senators for their valuable and personal contributions. The Bill is technical and complex in nature, so I appreciate the support of Senators in facilitating its swift passage through Seanad Éireann. I thank the Cathaoirleach, Senator Mark Daly, the Leader and the Deputy Leader of the House and all the officials, given that there was much toing and froing in the past fortnight to see whether we could find time for the Bill. We have debated Second Stage today and will debate Committee and Remaining Stages tomorrow. I thank each Senator for facilitating that because it was so important that it would happen.

Many Senators spoke about our former colleague, the former Minister of State, Jim Daly. I will tell a little story that few people know. My father and Jim Daly's father were reared beside each other. They grew up together in the small townland of Derrynagree, one mile outside Drimoleague in west Cork. From our very first meeting, Jim and I hit it off and worked very well together. When he was handing over the reins to me, we spoke about the fair deal scheme, statutory home care and housing for older people. I am honoured to carry on the mantle in the context of this Bill. It is amazing our two fathers grew up beside each other in west Cork.

Senator Lombard summed it up when he referred to peace of mind, while Senator Clifford-Lee did so too when she stated that the disincentive is being removed. The Bill is complex but its core aims are straightforward, seeking as it does to ensure fair treatment for farm families and business-owning families, without impacting negatively on the sustainability of the scheme, thereby preserving access to care for those who need it. It is important that we ensure the sustainability of the scheme. It costs €1.4 billion a year, a vast sum to support 22,500 people in nursing homes.

That brings me to the issue of home care, which was raised by Senator Garvey and others. We made a significant breakthrough in home care this year, with a total of €632 million allocated for it. There was an increase of 5 million home care hours, bringing the total figure to 24 million. When I was sitting in opposition for the four years prior to the most recent election, I used to have a go at the then Minister in regard to home care hours. Just before that election, the number of people waiting for home care throughout the country was 8,000. Now, during Covid, the figure has fallen to fewer than 2,000, which is phenomenal.

To respond to Senator Garvey, home care is delivered predominantly on clinical, medical grounds, unlike home help, which does not really exist any more. Nevertheless, I acknowledge the point she made about rural isolation. I have been working on such issues as a member of the loneliness task force and I accept what she said, but we have made substantial progress on home care. The premise of Sláintecare is the right care at the right time in the right place, and that is what we are trying to achieve. I take on board the point the Senator made about having been offered a choice between five years and the fair deal scheme. For some people, it is very difficult to make that decision. I very much welcome the cross-party support for the Bill. The support in the Dáil was similar, where I worked with the Opposition on some amendments to get them over the line.

I will now address a few of the Senators' questions. On when the scheme will commence, I hope the Bill will pass Committee and Remaining Stages tomorrow and it will then go to the President to be signed into law. An amendment provides that the Bill will then be enacted within 90 days. The reason we have provided for the 90-day period relates to the cyberattack having slowed down matters. The HSE has work to do on this, as does the Department of Agriculture, Food and the Marine. I wanted to be fair, so a 90-day period was provided for.

Senator Malcolm Byrne asked about time served and when a successor should be appointed. Once the Bill has been enacted, if a loved one is moving to a nursing home the successor should be put in place immediately. Once a successor has been put in place, if a loved one - someone's father, mother, aunt or uncle, for example - has been in a nursing home for, say, two years, that time will count. The person will have to serve only one further year in the nursing home to reach three years and he or she will have reached the cap. In fairness, 37% of people spend only between six and seven months in a nursing home, although the average length of stay is approximately two and a half years. If a person has been in a nursing home for four years and appoints a successor, the cap is applied immediately. The period spent, therefore, is retrospective.

To respond to Senator Mullen, we are trying to make this scheme as user-friendly as possible. A person will not have to prove that he or she has an income. The phrase used is a "substantial part of the working time", rather than it being based on a proportion of the person's income. As Senator Dolan noted, many family members help on the farm.They help with milking, silage, crops and various other tasks at different times of the year but they may not have an income from the farm. In order to be a successor, one has to have shown an interest and been part of the farm for three of the previous five years but one does not have to show an income. There are cases, for example, in which a son or daughter might have been in Australia or Canada but can come home and be that successor once the farm was in family ownership. All we are trying to do is to make sure the farm or small business is sustained.

I will touch on some of the other matters that have been raised when we deal with Committee Stage tomorrow but I wish to address now the issue of statutory home care because it has come up frequently and we are doing a significant amount of work on it. We hope to bring in a statutory home care scheme next year which will be like the fair deal scheme but in the home. In budget 2021, I got funding for 128 assessors to roll out this international resident assessment instrument, interRAI, programme. That means that those being assessed for their needs will undergo the same assessment no matter which part of the country they live in or the CHO they are in. That will determine applicants' needs. A significant amount of work is being done on that.

I know that we have to deal with Committee Stage tomorrow but I wish to acknowledge that I have received so much support from Ms Fiona Larthwell and Mr. Neil Kavangh, two of my officials who have been with me for the past seven months in driving on this initiative. I thank them once again. I thank the Acting Chairperson for her support. I am delighted that we have reached this stage. The push was on to get the Bill done this week. I did not want to have to come to the Seanad with the Bill in September or October, with the Bill not being enacted until Christmas. It is a positive story. It is correcting an unintended consequence and an anomaly that was there since 2009. It has taken some time to address it. I acknowledge all the people who made representations to me on the issue. I am delighted to get the Bill over the line.

Photo of Sharon KeoganSharon Keogan (Independent)
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I thank the Minister of State for her work on the Bill. It is a testament to her.

Question put and agreed to.

Photo of Sharon KeoganSharon Keogan (Independent)
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When is it proposed to take Committee Stage?

Photo of Lorraine Clifford-LeeLorraine Clifford-Lee (Fianna Fail)
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Tomorrow.

Photo of Sharon KeoganSharon Keogan (Independent)
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Is that agreed? Agreed.

Committee Stage ordered for Friday, 16 July 2021.

Sitting suspended at 6.22 p.m. and resumed at 7.15 p.m.