Vol. 662 Tuesday, No. 1 30 September 2008 DI´OSPO´ IREACHTAI´ PARLAIMINTE PARLIAMENTARY DEBATES DA´ IL E´ IREANN TUAIRISC OIFIGIU´ IL—Neamhcheartaithe (OFFICIAL REPORT—Unrevised) Tuesday, 30 September 2008. Business of Da´il: Motion …………………………… 1 Ceisteanna—Questions Minister for Health and Children Priority Questions ……………………………… 1 Other Questions ……………………………… 10 Leaders’ Questions ……………………………… 16 Adjournment Debate Matters …………………………… 23 Business of Da´il: Motion …………………………… 23 Business of Da´il: Motion …………………………… 25 Business of Da´il: Motion …………………………… 27 Order of Business ……………………………… 32 Ministerial Rota for Parliamentary Questions: Motion ………………… 33 Credit Institutions (Financial Support) Bill 2008: Order for Second Stage …………………………… 33 Second Stage ……………………………… 33 Financial Resolution …………………………… 56 Questions: Written Answers …………………………… 57 DA´ IL E´ IREANN DI´OSPO´ IREACHTAI´ PARLAIMINTE PARLIAMENTARY DEBATES TUAIRISC OIFIGIU´ IL OFFICIAL REPORT Imleabhar 662 Volume 662 De´ Ma´irt, 30 Mea´nFo´mhair 2008. Tuesday, 30 September 2008. ———— Chuaigh an Ceann Comhairle i gceannas ar 2.30 p.m. ———— Paidir. Prayer. ———— Business of Da´il: Motion. Minister of State at the Department of the Taoiseach (Deputy Pat Carey): I move: That, notwithstanding anything in Standing Orders, Oral Questions to the Taoiseach shall not be taken today; Oral Questions to the Minister for Health and Children shall be taken now until 3.30 p.m., followed by Leaders’ Questions, and on the conclusion of Leaders’ Questions and the announcement of matters selected for the adjournment, the sitting shall be suspended until 6 p.m. Question put and agreed to. Ceisteanna — Questions. Priority Questions. ———— Promised Legislation. 113. Deputy James Reilly asked the Minister for Health and Children the date she expects legislation on the fair deal nursing home support scheme to be published; the reason for the delay in publication; and if she will make a statement on the matter. [32673/08] 1 Priority 30 September 2008. Questions Minister of State at the Department of Health and Children (Deputy Ma´ire Hoctor): Both the Minister for Health and Children and I are fully committed to introducing the new nursing homes support scheme in 2009. The legislation required in order to introduce the scheme is complex and has involved careful drafting to ensure that the interests of older people requiring residential care are fully protected. The Minister expects to publish the Bill within the next two weeks or so and to bring it before the Houses of the Oireachtas for debate in this Da´il session. On publication of the Bill, further engagement will take place with stakeholders on the details of the new scheme. This will take place under the auspices of Towards 2016. The necessary funding for the scheme will be addressed as part of the forthcoming budget. Deputy James Reilly: This scheme was first announced in 2006 and was to be introduced, we were told in 2007, in January 2008. We are now being told it will be published in two weeks. I hope it will be published on this occasion and that we will have a full and proper debate and plenty of time to consider it, as I requested previously. This is a considerable issue for patients and their families. With regard to the funding for 2008, some \85 million was saved. Was it allocated to the nursing home refund scheme? Where is it now? This is a very important issue for many families. It is not just pertinent to nursing homes but it is having a considerable impact on hospitals. Patients in north Dublin cannot get into Beaumont Hospital because the beds are filled with patients who cannot be discharged. It is a fact that there are 22 long-stay and rehabilitation beds per 1,000 over-65s nationally. In Dublin North, which has the second highest population of over-65s, there are only three such beds. Some days ago, the Minister and I were in a new modern facility in Balrothery in Balbriggan which has 40 spare beds, yet people are screaming for beds in Beaumont and the Mater. Three weeks ago the Mater had 130 people awaiting discharge and the accident and emergency department had discharged all its patients into the day-care beds such that surgery could not take place. This issue is real for people, including an 80 year old man who was sent home from Beaumont Hospital last week. Two days later he had a number of falls, culminating in a fall at 11 p.m., and he was found on the floor at 10 a.m. the next day covered in his own faeces. This man worked all his life and paid his taxes, yet this is all we can offer him. Will the Minister put the funding available for the fair deal scheme in 2008 back into subven- tion to allow people obtain long-stay care for their loved ones and to take the pressure off hospitals? While we do need more beds, there are beds available as we speak without our having to build new ones. Why can we not avail of them? Deputy Ma´ire Hoctor: A number of legal issues led to the undesirable delay that occurred in respect of the finalising of the Bill for Government. Legal issues emerged in the discussions with the Parliamentary Counsel and these had to be cleared before the Bill could come before Government for approval. Thankfully we are now at a very advanced stage. On Deputy Reilly’s question on the \110 million for the scheme, to date \13 million has been allocated from those moneys provided in budget 2008 for the provision of 200 contract beds. Approval was also given to the HSE to utilise a further \12 million in meeting the costs associated with nursing home subventions and existing contract beds. This brings to \25 million the total funding redirected from the nursing home support scheme and committed to nursing home supports in 2008. The intention was that the balance of the \110 million would be used to meet certain other additional costs facing the health services this year as part of the budgetary consolidation measure announced by the Government in July. The necessary funding for the 2 Priority 30 September 2008. Questions scheme dealt with in the Bill, which will be published in the next couple of weeks, is an issue to be dealt with in the forthcoming budget. Deputy James Reilly: There will be no additional funding for the people this year. There is no relief for them. Deputy Ma´ire Hoctor: I have made clear what has been allocated at this point. Health Service Executive Expenditure. 114. Deputy Jan O’Sullivan asked the Minister for Health and Children the information she has been given on plans by the Health Service Executive to reach its budget targets for 2008; if her attention has been drawn to the proposals to cut back on services; if her attention has further been drawn to plans by the HSE to introduce or increase charges to the public; if she has an arrangement in place whereby she would be made aware of such proposals; and if she will make a statement on the matter. [32183/08] Minister for Health and Children (Deputy Mary Harney): In the first half of the year the Health Service Executive identified a projected deficit for this year in the region of \300 million if no remedial action were taken. The executive brought forward proposals to address the deficit and bring expenditure back in line with its Vote. The proposals were agreed by the board of the HSE. I was advised of the measures by the chairman of the HSE and that the goal for the remainder of the year would be to ensure an overall balanced Vote outcome on expenditure while optimising patient services and continuing the reform agenda. These proposals, which were designed to ensure the delivery of the service plan, contained initiatives to further maximise value for money and reduce spending in areas where excess expenditure was occurring. The measures taken included bringing levels of service back in line with the targets set out in the service plan, as well as a range of cost savings in operational overheads. The latter included a reduction in travel and subsistence, a reduction in consultancy and advertising costs and the cancellation of all non-essential training. Other initiatives included increasing the collection of hospital charges and addressing absenteeism. Implementation of these measures is being monitored by the executive and reported in line with the accountability procedures in place for monitoring the executive’s expenditure and implementation of its service plan. These procedures include monthly meetings between my Department, the Department of Finance and the executive, quarterly high level meetings between my Department’s Secretary General, the executive’s CEO and their respective man- agement teams. There is also ongoing liaison between my Department and the various director- ates of the executive. In respect of statutory charges, there were increases in accident and emergency and in bed charges at the beginning of the year. Deputy Jan O’Sullivan: On a day when the Government can find an estimated \400 billion to \500 billion to guarantee the banks their money will be safe, I must question whether the Minister for Health and Children can guarantee in any way that vulnerable patients will be protected from health cuts, service cuts and increased charges. I find it extraordinary that the Minister is standing by — she said she has been advised of measures and that she is having ongoing information meetings. Has the Minister been told increases in charges may be introduced before the end of the year? It has certainly been suggested to me that increases may be proposed to hospital charges and other charges, as well as new charges for people using the health services.