At a time of contracting government finances, economies usually affect the least organised and most vulnerable sections of society. Old people in nursing homes were forced to pay illegal charges. And most of that money has not been repaid. In spite of that, the Government is now preparing to rush a new scheme of nursing home charges through the Dáil. At the very least, these far-reaching measures deserve a vigorous and comprehensive debate.
Exactly a year ago, Minister for Health Mary Harney announced the broad terms of a Nursing Home Support Bill that would reshape the State's duty-of-care to older citizens. Up to 80 per cent of a person's disposable income would be taken in public nursing home charges. For those in private nursing homes, the State would underwrite the extra cost during their lives and then recover up to 15 per cent of the value of homes and other assets after their death. There was little public debate. And the exact details of the legislation were not available.
Ms Harney now intends to circulate details of the Bill next Thursday, the day after the Budget, when it is likely to receive little media attention. If her previous performance is any yardstick, it will be guillotined through the Dáil before Christmas. For this is the Minister who introduced legislation in the pre-Christmas period of 2004 in an attempt to legitimise State charges for nursing home care and to deny repayment of money. That Act was struck down by the Supreme Court. And the rights of citizens with full medical cards to free public nursing home care were vindicated.
The Minister is now preparing to roll back that judgment in what she describes as a "fair deal" on nursing home care. But all clients will pay more, even if charges on asset-rich patients will be deferred until after their death. The alternative option, of funding nursing home costs through a social insurance charge has been rejected. There are some positive elements in what Ms Harney proposes, particularly in relation to the introduction of a standardised assessment system for patient eligibility and subvention in all regions. But preparatory work by the Health Service Executive and the National Treatment Purchase Fund will not be completed for some months yet.
In those circumstances and given the concerns of voluntary groups representing older people, health professionals and social workers, it would be unwise to rush this legislation through the Oireachtas. The Bill has been described as a selective inheritance tax on those who suffer from stroke or dementia. Its terms and implications deserve the fullest consideration.