An end to the "scrappy, inconsistent and unfair system" that the elderly and their families encounter when applying for long-term nursing home care has been promised by the Government.
Minister for Health Mary Harney
The five per cent of people over the age of 65 who require long-term residential care will, in the future, find an accessible, affordable and anxiety-free system, according to Minister for Health Mary Harney.
Speaking today, Ms Harney admitted the current schemes, which have been in place since 1993, are "unaffordable for many, even with subvention". At the moment, some people receive State support of 90 per cent of the cost of their care while others receive nothing. "It's a mess," she said.
Over 21,000 people are currently living in residential homes, both public and private. It costs some of those up to €35,000 per year to pay for their care.
Ms Harney said she had anecdotal evidence that thousands of people per year are being forced to sell their homes to pay for care. Elderly people, their spouses and their children are suffering "undue stress" as a result, the Minister said.
"Everybody will be sure their family won't have to come up with cash to pay for their care," she said, adding that new system will lead to an "equity of treatment between those in public and private care".
The restructure, known as "Fair Deal," will call on everyone to contribute to their long-term care, with contributions "measurably less than their income," from January 1 st, 2008.
Under the new system, elderly people will be assessed by the HSE for their suitability for residential care. The preference will be for home care for all but the most dependent. "Older people do better at home and have a better quality of life," Ms Harney said. "On average, those living in their homes live two years longer." She estimated that at least 20 per cent of those in residential care would be better off being cared for at home.
Those ruled eligible for residential care will be offered a place in either a public or private nursing home. They will be asked to pay no more than 80 per cent of their income, whatever their financial status, with the State covering the remainder. "They will never pay more than the actual cost of care," Ms Harney said.
Any spouse or partner remaining at home will receive a minimum of €200 per week.
Under the current system, residents of homes are required to make a cash contribution of 5 per cent of the value of their homes each year towards the cost of their care.
Under the new plan, these payments will only apply for the first three years of care, will never exceed 15 per cent of the home's value (7.5 per cent if one person in a couple needs care) and will be deferred until the settlement of their estate when the State will recoup the monies owed.
The value of the house will be linked to the Consumer Price Index rather than the property market, Ms Harney said.
An interim reshaping of the existing subvention system will come into effect while the legislation for this change for 2008 is being prepared. It will replace the three tier system of subventions in place at the moment with a single catch-all payment of €300 per week for every resident.
Ms Harney said this and other amendments would give an extra 2,000 people access to healthcare in private nursing homes. A total of €85 million has been set aside to cover this improvement in 2007.
The Minister insisted the changes "will not adversely affect anybody currently in long-term care".
She said there will be 1,210 new long -term beds made available next year, 860 of which will be public.
Legislation "to set and enforce" standards in nursing homes is to be published later this week, she added.