Finian McGrath (Dublin North Central, Independent)
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Question 283: To ask the Minister for Health and Children if she will overhaul the subventions to meet realistically the cost of care for those who need it in nursing homes. [37500/06]

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.

There are currently three rates of subvention payable, i.e. €114.30, €152.40 and €190.50 for the three levels of dependency which are medium, high and maximum and these rates apply in all parts of the country. 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.

Additional funding of €20 million was provided for the administration of the Nursing Home Subvention Scheme in 2006. The additional €20 million is to support more basic nursing home subventions and reduce waiting lists for enhanced subventions: it is also to bring more consistency to subventions support throughout the country.

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 for the Government's consideration based on the principles in "Towards 2016".