Public nursing home charges for over-70s
Kenny questions the handling of charges in public nursing homes and whether the issue was previously known. The Taoiseach says the Attorney General advised that new legislation is required, and the Government is preparing it.
The House will have an opportunity tomorrow to discuss the current position regarding Northern Ireland so I will not raise that issue today.
At the close of the Order of Business last Thursday, the Tánaiste made a significant announcement to the House about the dropping of charges in public nursing homes for people aged 70 and over. The House had no opportunity to debate that matter or discuss it further with the Tánaiste after she made her announcement.
I understand the Government is now considering the introduction of draft legislation on this matter today. Will the Taoiseach say if legislation has been approved and if so, when it will be published? Why was this issue not addressed by the Department in the first instance and by the previous Minister for Health and Children, Deputy Martin, in 2002, when it was first raised? What was indicated by the legal opinion obtained by the health boards and provided by the Department of Health and Children in 2003? What did it say? Does the Government intend to repay the charges drawn down illegally? Given the Tánaiste's statements that these charges would cost the health boards approximately €8 million per month, does this mean that the cost of repaying the illegal charges of approximately €300 million could be much greater than has been estimated to date? If the new legislation is to be drafted or introduced, will it make any reference to the treatment of patients in private nursing homes?
Comment on this
The Government has discussed this matter at some length. The Tánaiste has been working on the matter over the short period since the Attorney General gave his advice. We have to bring forward new legislation immediately to deal with the issue. The Attorney General's advice was that it requires legislation. It can be argued whether this goes back to the 1976 Supreme Court judgment, to other judgments since then or to the legal advice given in more recent years. Whatever about that argument, legislation is now required to deal with the matter. Deputy Kenny has raised this matter with me a number of times over the past five or six weeks. It is the intention of the Tánaiste and the Chief Whip to discuss the matter with the Whips and the spokespersons. Our advice is that we should deal with the matter urgently. If I recall correctly, the figure involved is more than €10 million monthly.
The proposals have been considered today and the Government has decided to outline its strategy to the spokespersons. We have detailed advice from the Attorney General. He has incorporated his advice into the proposals. I hope we will be in a position to go through that legislation in detail later with the health spokespersons to try to process the legislation as quickly as possible.
Comment on this
The Taoiseach said the other day that negotiations should start from a basis of truth. I accept that the Tánaiste had no knowledge of this situation when she was appointed Minister for Health and Children. I assume she had not. However, it is not clear whether her predecessor as Minister for Health and Children, Deputy Martin, had any knowledge of the issue and did nothing about it. The Government's claim that this was an inadvertent consequence of the 2001 Act just does not stand up. If that was the case, why did the Government not do anything about it before this? It is a matter for the Government to introduce primary legislation and to oversee its consequences. It is not good enough to say it is waiting on a health board to seek legal advice. One cannot have a situation where advice given to a health board means that a charge in its area is illegal while being legal in another health board's area which had not opted to take legal advice. Neither may one have a situation similar to that involving AIB where it was asserted that what was good enough in respect of that bank should be good enough for Government.
Will the Taoiseach outline the nature of the legislation to be introduced? Can he confirm that the patients from whom contributions were taken since 2001-02 will be repaid that money and, if so, when may they expect to get it? Will they have it before Christmas if the legislation is to be drafted so quickly? What arrangement does the Government intend to make in respect of the ongoing charge of €10 million a month? From what source will this be funded?
Comment on this
On the first issue, as Deputy Kenny knows, there was advice from one of the health boards. A number of health boards deal with these issues in different ways. Some charge and some do not. They charge in different ways as their systems are dissimilar and that has always been the case. On the basis of the legislation for the imposition of charges on all persons in respect of inpatient services in long-term care in health board institutions, the Attorney General's advice was that the Government did not have this power and primary legislation was required to introduce it.
The Attorney General's advice is that the Government does not have to go back over the period in question. It is not even clear what period would have to be reviewed. Some argue that the first time this was raised was in a 1976 case of the Supreme Court. Others say it was when one of the health boards received its legal advice. The view of the Department and that of successive Ministers for Health and Children is that there should be a payment for care in health boards. In any event, the Attorney General has ended that argument. His firm view is that the legislation to grant the power to have a charge does not exist. That is the issue which must be dealt with in the legislation. The Government would like to deal with this issue immediately. We will outline the details of the proposed legislation to the health spokespersons later today.