Letters between Cabinet members in 2001 show the Government was trying to change the law on eligibility for nursing home care, writes Carl O'Brien, Social Affairs Correspondent
Once again there are signs that years before the controversy over charges for nursing home patients arose, the Government was trying to wriggle out of the more costly aspects of providing care for older people.
Letters released to RTÉ News under the Freedom of Information Act in 2001 between the then minister for health, Mr Martin, and the then minister for finance, Mr Charlie McCreevy, show a proposal to change the law on eligibility for nursing home care was discussed.
This followed an investigation by the Ombudsman into the nursing home subvention scheme. If the Government proposals were implemented, they could, arguably, have removed the duty on health boards to provide nursing home beds for older people in private nursing homes if there were not enough public beds, and to pay for some or all of the cost.
While the correspondence may not be strictly relevant to the matters due to be examined by Mr John Travers, who has been appointed by the Tánaiste to examine the management of the illegal charges issue in the Department of Health, they show Ministers were aware that the Ombudsman was unhappy with the Government's narrow interpretation of its obligations.
In one of the letters, Mr Martin said he was concerned at an interpretation by the Ombudsman that any person in need of nursing home care had a statutory entitlement to the service provided by a health board.
"The inference from the report is that if a health board cannot provide a place within its own facilities, it has a statutory duty to provide a place in a private nursing home.
"The Department's interpretation of the legal position, based on legal advice it had received, is at variance with the Ombudsman in the Report..."
"If the interpretation put forward by the Ombudsman was to be generally adopted, it would have considerable resource implications for the health services.
"Based on accepted bed norms, a further 7,000 (approximately) extended care places would need to be put in place by 2006 in order to meet shortfalls in capacity, which obviously has serious cost implications.
"In the interim, if the health boards were to pay the full cost of care for eligible persons currently in receipt of a subvention, it is expected the annual cost, based on current charges, would be up to £100 million approximately," Mr Martin wrote.
"I am currently having the whole area of eligibility for health service, including extended care service for older people, examined as part of the preparation of a new Health Strategy and it is my intention to bring forward proposals in this regard at a later date."