The Minister for Health today published the long-awaited Nursing Homes Support Scheme Bill 2008 amid criticism from Opposition parties and Age Action.
The Bill published by Mary Harney underpins the “fair deal” nursing home funding scheme and allows older people to pay nursing home fees after death.
The scheme had been due to come into effect last January but was delayed because of legal difficulties surrounding applications for people who no longer had the mental capacity to look after their own affairs.
Although this legal problem has been resolved Ms Harney indicated that the Nursing Homes Support Scheme Bill would be unlikely to proceed through the Dáil this year, and the scheme is not expected to come into force until the middle of next year.
Under the scheme people moving into a nursing home will pay a maximum of 80 per cent their income towards the cost of their care, based on a Health Service Executive assessment of their assets.
If this does not cover the cost, the State pays the remainder and can recover this cost from the sale of the person's house after their death. These costs are levied only up to 15 per cent of the value of the house and their recovery can be deferred until after death of a spouse, cohabiting partner or dependent child or relative.
The scheme is voluntary, and both new and existing nursing home residents are eligible to apply.
Commenting on the Bill, Age Action spokesman Eamon Timmins queried whether it would mean that an older person who is medically assessed as being in need of full-time medical and nursing care but refuses to sign up to the new charging arrangement - under which he would pay 80 per cent of his income and up to 15 per cent of the value of his estate - would be refused essential care by the State.
Mr Timmins continued: "We are anxious that any legal problems relating to this bill are sorted out before it is passed into law. It is in nobody's interest that this legislation would face further legal challenges and delays."
"In effect it means that people who had been paralysed by stroke or who are suffering from dementia will be charged in a completely different way to people who, for example, have a heart attack or are being treated for cancer," Mr Timmins said.
"We accept that the cost of private nursing home care was crippling families and a solution was needed. But we do not accept the solution forwarded by the Government."
But, announcing the Bill with Máire Hoctor, Minister for Older People, Ms Harney said: "I am very pleased to publish this draft legislation. For the first time, it will make the arrangements for financial support for people who need long term care comprehensive, clear and coherent.
‘It is totally fair. It is clear, sustainable and affordable. It covers all persons in need of long term care, not alone older persons. It covers both public and private nursing homes.
However, Jan O’Sullivan, Labour Party spokeswoman on health, said the nursing home bill raises as many concerns as it addresses. She said that there were a number of “very worrying elements”.
“It removes the right to free health care, enshrined in the 1970 Health Act. This singles out the elderly in need of long term institutional care from all other citizens,” Ms O’Sullivan said.
She added that the scheme is ‘resource capped’ – “in other words, if the money runs out, the support runs out.” Ms O’Sullivan added that Labour would “vigorously oppose this”.
Fine Gael welcomed the publication of the legislation but said it would require careful scrutiny and comprehensive debate.
“The complex Bill published today entails an annual cost to the Exchequer of €1 billion and requires careful scrutiny. Fine Gael will endeavour to ensure that this Bill is about providing quality care for long-stay patients, and not destined to become a money-spinner for the Government, said the party's health spokesperson, Dr James Reilly.
Sinn Féin Dáil leader Caoimhghín Ó Caoláin said the Bill contained a complex scheme that fell short of what was needed.
“One thing is certain. This Bill falls short of what is required for the care of older people. As the Bill is published older people are experiencing cuts in services such as the reduction in Home Help hours," the Sinn Féin TD said.
“The complex scheme set out in the legislation published today is no substitute for a comprehensive strategy for the care of older people including fully supported and resourced care in their homes, in the community and, where necessary, in nursing homes.”
