Finian McGrath (Dublin North Central, Independent)
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Question 322: To ask the Minister for Health and Children the situation regarding the nursing home subventions and the elderly owning homes above €350,000; and if she will make a statement on the matter. [35136/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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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 Nursing Homes (Subvention) (Amendment) Regulations 2005.

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 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 certain social welfare pension/allowances and generally does so unless there are exceptional circumstances. The Regulations provide that the HSE may refuse to pay a subvention if the value of the applicant's principal residence is in excess of €500,000 (where the residence is located in the Dublin area) or €300,000 (where the residence is located outside the Dublin area) and the applicant has an income of at least €9,000 per annum.

The Health (Nursing Homes) (Amendment) Bill 2006 which is currently on its passage through the Houses of the Oireachtas, 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 in this regard as agreed with the social partners in "Towards 2016".

Pat Carey (Dublin North West, Fianna Fail)
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Question 323: To ask the Minister for Health and Children the arrangements that will apply to the contributions which nursing home patients on pensions will have to make towards their up-keep; the statutory basis for such contributions; and if she will make a statement on the matter. [35143/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I take it the question refers to the charging of people in long stay care.

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 in-patient services and provided for the levying of a charge in respect of the maintenance of persons in receipt of in-patient services. The Regulations were prepared following extensive consultation with the HSE 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 in-patient 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 1 refers to people in receipt of in-patient 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 2 refers to people in receipt of in-patient 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 HSE 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 HSE can examine a person's overall financial situation in view of the person's reasonable expenditure in relation to themselves or their 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 HSE.