Written answers

Tuesday, 4 April 2006

Department of Health and Children

Nursing Home Subventions

9:00 pm

Photo of Richard BrutonRichard Bruton (Dublin North Central, Fine Gael)
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Question 155: To ask the Tánaiste and Minister for Health and Children the cost which she estimated for increasing the threshold on house value to deem a person ineligible for nursing home subvention from €75,000 to €300,000 outside Dublin and €500,000 in Dublin; if her attention has been drawn to the fact that this change has not altered in any way the means assessment being used in assessing eligibility for nursing homes owing to the fact that the €75,000 threshold which she revised had long since fallen into disuse; and if she will make a statement on the matter. [12796/06]

Photo of Seán PowerSeán Power (Kildare South, Fianna Fail)
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The Health (Nursing Homes) Act 1990 and the Nursing Homes Regulations 1993 provide for the payment of subvention for private nursing home care for applicants who qualify on both medical and means grounds. General rules for the assessment of means in respect of an application for nursing home subvention are set out in the Second Schedule of the Nursing Homes Regulations 1993, as amended by the 2005 regulations. Under the regulations the Health Service Executive, when considering an application for subvention, carries out a means test which takes into account the means of the applicant and his or her spouse or co-habiting partner, where appropriate, and the assets of the applicant. The HSE imputes an income of 5% of the estimated market value of the principal residence of an applicant for subvention, unless the residence is occupied by a spouse, or son or daughter aged less than 21 or in full-time education or in receipt of the disabled person's maintenance allowance, blind person's pension, disability benefit, invalidity pension or old age non-contributory pension, and generally does so unless there are exceptional circumstances.

Under the Nursing Homes (Subvention) (Amendment) Regulations 2005, SI 814 of 2005, the HSE may refuse to pay a subvention if the value of the applicant's principal residence is €500,000 or more, where the residence is located in the Dublin area, or €300,000 or more, where the residence is located outside the Dublin area, and the residence is not occupied by a spouse, a son or daughter aged less than 21 or in full-time education or a relative in receipt of a social welfare pension or allowance. It is difficult to estimate the financial impacts, as much depends on individual circumstances but an additional €20 million has been made available for the provision of the subvention scheme in 2006. The recently published Health (Nursing Homes)(Amendment) Bill 2006 is designed to ensure that the existing subvention scheme for private nursing home care is grounded in primary legislation and to help the HSE to implement the scheme on a standardised basis throughout the country. It includes a provision to vary the 5% income imputation. I will consider the issue of housing assets and long-term residential care following the enactment of this Bill and in the light of the report of the long-term care working group.

Photo of Richard BrutonRichard Bruton (Dublin North Central, Fine Gael)
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Question 156: To ask the Tánaiste and Minister for Health and Children the date on which proposals for reform of the nursing home subvention system were submitted to her Department; and the reason it has taken so long to reach decisions on a reform package for the nursing home subvention. [12797/06]

Photo of Seán PowerSeán Power (Kildare South, Fianna Fail)
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The expenditure review of the nursing home scheme which was carried out by Professor Eamon O'Shea was officially launched on 25 June 2003. This report was launched in tandem with the Mercer study on the future financing of long-term care which was carried out by the Department of Social and Family Affairs.

Following on the publication of the Mercer report, a working group chaired by the Department of the Taoiseach and comprising senior officials from the Departments of Finance, Health and Children and Social and Family Affairs was established. The objective of this group was to identify the policy options for a financially sustainable system of long-term care, including improvements in community care, taking account of the Mercer report, the views of the consultation that was undertaken on that report and the review of the nursing home subvention scheme by Professor Eamon O'Shea. This group presented its report to Government, where it is under consideration.

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