Elderly care Bill provides for medical visit cards

Legislation to charge residents of public nursing homes up to 80 per cent of their pensions for long-term care was reintroduced in the Dáil yesterday.

This follows the Supreme Court judgment which found part of the controversial original Bill to be unconstitutional.

The Health (Amendment) Bill also provides for the introduction of the doctor-only medical cards for 200,000 people on low incomes.

Minister of State for Health Seán Power, who introduced the legislation, said the issue of charging for nursing home care "is finally being put beyond legal doubt after almost 29 years".

Health boards stopped deducting payments in December pending the amending legislation and this was costing an estimated €2 million a week, the Minister said.

The introduction of the doctor-visit medical card "fulfils a key Government commitment to ensure that people on low incomes have access to general practitioner services and advice", he said. "It is most efficient to address both issues in the same Bill."

But Labour's health spokeswoman Liz McManus described the card as a "cheap, Lidl-style medical card" and she was "astonished" that Minister for Health Mary Harney was not introducing the Bill in the Dáil.

Fine Gael health spokesman Liam Twomey noted that the former minister of State for the elderly, Ivor Callely, was as "silent as a Trappist monk" on the issue of nursing home charges.

Mr Power said the principle "that it is fair and reasonable that most people should make a contribution to the cost of their long-stay care is a significant and long-standing feature of our system of publicly funded long-term care".

The charges being imposed were an estimated 10 per cent of the overall cost of care, he said. "It therefore represents a modest contribution towards total cost of treatment and maintenance."

A provision would be made in the Bill for the fee to be reduced or waived on financial hardship grounds.

Dr Twomey expressed concern about a reduction in the number of public nursing home-type beds in the system, and he did not want the Minister "to implement a policy which will force patients into private nursing homes - not because the care is substandard, although that issue has been raised a few times - but in terms of the cost to patients".

Ms McManus accused Ms Harney of "desperately trying to wrap the mantle of 11 governments around her for protection" after presiding over the "fiasco" surrounding the nursing home charges.

The Minister's statements about maladministration in the department had opened up "the scenario that cast doubt on the competence, integrity and liability in the civil courts of public officials and public office holders".

Green Party leader Trevor Sargent said the legislation "is in many ways an attempt to mop up, but the health service requires much more than mopping up". He said that "the overall issue of nursing home standards and the provision of public nursing home facilities in particular, requires further debate".