Michael D Higgins (Galway West, Labour)
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Question 306: To ask the Minister for Health and Children if her attention has been drawn to the difficulties being experienced by elderly persons here with regard to nursing home subvention; her views on the general sense of equity in the rules and assessments regarding subvention for the elderly; the reason savings are regarded as income in regard to the rate of ordinary subvention; and her further views on the case of a person (details supplied) in County Galway who has been allocated €11.47 per week to defray their nursing home costs, while those costs amount to €630 per week and rising. [32672/06]

Seán Power (Kildare South, Fianna Fail)
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As the Deputy may be aware, 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, when considering an application for subvention, the Health Service Executive carries out a means test which takes into account the means (including assets) of the applicant and his or her spouse/cohabiting partner, where appropriate. The means test involves looking at the applicant's income for the previous twelve months. Income from all sources is taken into account and is assessed net of PRSI, income tax and the health contribution and the income of a married or cohabiting person is half the total income of the couple. In assessing an applicant's assets the first €11,000 of such assets is disregarded. The HSE may refuse to pay a subvention if an applicant has assets exceeding €36,000, (excluding their principal residence). In relation to the principal private residence of an applicant, the HSE may impute 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 twenty one years or in full time education or in receipt of a social welfare pension/allowance as set out in the 2005 regulations and generally does so unless there are exceptional circumstances. The HSE may refuse to pay a subvention if the value of the applicant's principal residence is in excess of €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).

The HSE has discretion to pay more than the maximum rate of subvention relative to an individual's level of dependency in a case, for example, where personal funds are exhausted. The application of these provisions in an individual case is a matter for the HSE in the context of meeting increasing demands for subvention, subject to the provisions of the Health Act, 2004. The average rate of subvention paid by the HSE generally exceeds the current approved basic rates. The supports paid by the HSE vary from person to person and region to region, depending on nursing home fees for example.

The 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 across the country. In addition, national guidelines on nursing home subvention are currently being developed by the HSE to ensure an even and equitable application of the regulations nationally.

The Government is currently considering new policy on Long Term Care and several principles underlying this were agreed with the social partners in "Towards 2016". These principles include, for example, that there should be one standardised national needs assessment for older people needing care. The use of community and home-based care should be maximised. Sheltered housing options will be encouraged. Where residential care is required, it should be quality care and there should be appropriate and equitable levels of co-payment by care recipients based on a national standardised financial assessment. The level of support for residential care should be indifferent as to whether that care is in a public or private facility. The financial model to support any new arrangements must also be financially sustainable.

The Department is currently drawing up proposals as agreed with the social partners in "Towards 2016".

In relation to the issue of subvention for the individual concerned, the Deputy's question relates to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, the Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.