Seymour Crawford (Cavan-Monaghan, Fine Gael)
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Question 180: To ask the Minister for Health and Children the way she came to the decision that €531 a week was the cost of nursing home care in Cavan/Monaghan; her views on whether it is right that an old age pensioner with an income of €209 per week will have to pay €106 of that towards a nursing home caring for their spouse; if it is wrong that someone entering the same nursing home in the year 2006 should be fully covered by subvention and yet this person because they entered in 2007 has to use their full pension plus their spouse's pension to pay for their keep; and if she will make a statement on the matter. [17358/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The matter that the Deputy is referring to is the payment of subvention towards the cost of private nursing home care. The cost of private nursing homes is set by the nursing home and is not determined by my Department. The subvention scheme was introduced to assist with the cost of private nursing home care and it was never intended that a subvention payment would meet the full costs of private nursing home care. The Regulations including limits on income and assets were introduced to ensure that available resources were directed to those most in need. These regulations apply to all applicants for a subvention.

From 1 January 2007 there are no longer three separate rates for subvention. Persons who apply may receive any amount up to a maximum of €300 per week. The payment of subvention is subject to means testing. In addition, the HSE may pay an enhanced subvention to people who cannot afford to meet the cost of care. An extra €30 million has been provided in 2007 for this purpose.

Earlier this year the HSE finalised National Guidelines for the Standardised Implementation of the Nursing Home Subvention Scheme. Under the guidelines, the assessment of means will now be carried out using a national standard financial assessment method.

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 start date for the new nursing home support scheme — A Fair Deal — is 1 January, 2008. This is because primary legislation must be passed in order for the scheme to commence. The Department is currently working on preparing the Heads of the Bill. Some of the benefits and key commitments to individuals as part of A Fair Deal will be:

Nursing home care will now be affordable to every person and fair to all;

For those currently in private care, their costs will be reduced;

Individuals will be asked to make a contribution towards the cost of care, limited by the cost of care;

The basis for contributions will be fair, based on each person's means and assets;

A person's family will not have to contribute towards their cost of care;

Care recipients will not have to sell or mortgage their house to meet the contribution;

A spouse will not have to sell or mortgage the house to meet the contribution;

The deferred contribution from the principal private residence will be capped at a maximum of 15%;

Remaining spouse or partner will retain a minimum income of at least the maximum rate of the State Pension (Non-Contributory), i.e. €200 per week at present.

Under the new scheme the State will continue to fund the largest part of care costs overall.