Róisín Shortall (Dublin North West, Labour)
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Question 293: To ask the Tánaiste and Minister for Health and Children the policy in respect of charges for inpatient services in nursing homes in respect of patients in public nursing homes and patients in contract beds in private nursing homes; the mechanism for levying and collecting these charges in respect of patients who are in receipt of social welfare pensions and those who are adult dependants on their spouse's social welfare pension; and if she will make a statement on the matter. [11102/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The charging for long-stay care under the Health (Amendment) Act 2005 is being implemented by way of the Health (Charges for In-Patient Services) Regulations 2005. These regulations were signed on 14 June 2005 and reinstated charges for inpatient services and provided for the levying of a charge in respect of the maintenance of persons in receipt of inpatient services. The regulations were prepared following extensive consultation with the Health Service Executive and others.

Section 53 of the Health Act 1970, as amended by the Health (Amendment) Act 2005, provides, inter alia, for the levying of a charge where inpatient services have been provided for a period of not less than 30 days or for periods aggregating not less than 30 days within the previous 12 months. In this regard, charging of patients in long-term care commenced on 14 July 2005, which was after the expiration of 30 days after the regulations were signed.

The regulations, in keeping with section 53 of the Health Act 1970, as amended, have provided for two different classes of persons on whom charges can be levied. Class one refers to people in receipt of inpatient services on premises where nursing care is provided on a 24-hour basis on those premises. In this case, a weekly charge can be levied of €120 or the weekly income of that person less €35, whichever is the lesser. Class two refers to people in receipt of inpatient services on premises where nursing care is not provided on a 24-hour basis on those premises. In this situation, a weekly charge can be levied of €90, or the weekly income of that person less €55 or 60% of the weekly income of that person, whichever is the lesser.

These regulations provide for the maximum charge to be levied on either class of person. The Health Service Executive has the power to reduce or waive a charge on the grounds of undue hardship. Under section 1(b) of the Health (Amendment) Act 2005, the Health Service Executive can examine a person's overall financial situation in view of the person's reasonable expenditure in relation to himself or herself or his or her dependants, if any.

The mechanism for levying and collecting charges in respect of patients in receipt of social welfare pensions and also in respect of patients who are adult dependants on the social welfare pension of their spouse, is an operational matter for the Health Service Executive. The Health Service Executive has informed me that the patient has a choice of two mechanisms to pay the charge. The patient can ask the Health Service Executive to become an agent on his or her pension. The Health Service Executive would then cash the pension on a weekly basis and either give the balance of the pension to the patient on the ward or lodge the balance to the patient private property account. The alternative option available to the patient is to receive an invoice from the Health Service Executive on a monthly basis for the charge due. Normally the next of kin would arrange payment of this invoice directly to the Health Service Executive. The mechanisms outlined above can be chosen by the patient in all cases whether the patient has his or her own pension book or where a joint pension book exists in the case of a spouse and adult dependant.

The position in regard to the mechanism for levying the charge in respect of patients who are in receipt of social welfare pensions and those who are adult dependants on their spouse's social welfare is as follows. Section 1(b) of the Health (Amendment) Act 2005 states that the Health Service Executive shall have regard to the person's overall financial situation, including the means of the spouse, if any, of that person in addition to the person's own means, in view of the person's reasonable expenditure in relation to himself or herself and his or her dependants, if any. It is a matter for the Health Service Executive, based on its own legal advice and taking into account the individual circumstances as well as the service being provided, to make a decision on any charges levied.