Thursday, 3 July 2008
Seanad Eireann Debate
Senator John Paul Phelan: While I welcome the Minister of State, Deputy Haughey, who is an able Deputy, I wish to put on record my disappointment that while three matters are being raised on the Adjournment, only one concerns education, which is the responsibility of the Minister of State. The other two matters do not concern education. This is a disrespect to the Members who raise these matters. There are at least four Ministers in the Department of Health and Children and the matter I wish to raise is in the remit of that Department. It is poor form that none of the four Ministers could be present to respond. I intend to raise a number of supplementary questions on this matter but Deputy Haughey will not be in a position to answer them.
This matter concerns the relatives of an individual in my constituency who made a claim for recompense under the health repayment scheme but whose claim was refused. I understand a number of families throughout the country are in a similar position. To outline the case I will read a letter I received from the son-in-law of the lady concerned. I have been making representations on behalf of the family. The letter states:
The letter is self explanatory. I have known the family concerned all my life and can confirm that the contents of the letter are true. It is a disgrace. The health board failed in its duty to provide a bed for somebody who was eligible for such and the family was forced to use the New Ross Community Hospital, which is a fine facility. It is a charity that is funded by the people who live in the town of New Ross and in the catchment area of Kilkenny and Wexford. In this case the family was forced to use that facility because no alternative was provided by the health board. This family of modest means is now deemed not to be covered by the terms of the repayment scheme.
That is not fair play. This woman belonged to the generation of people who remained in this country and built it up. It is shoddy treatment by the Department of Health and Children and its agencies, in this case the South Eastern Health Board, that this woman could not obtain a health board bed and, second, that her family is being penalised in this manner after her death. Thousands more families throughout the country are being similarly penalised through no fault of their own. The reason I had hoped for the presence of a Minister from the Department of Health and Children was so I could impress upon them the problem I have with this. It is downright wrong.
Deputy Seán Haughey: I am responding on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children. I thank Senator John Paul Phelan for raising this matter and am pleased to have the opportunity to set out the position regarding the health repayment scheme.
Following consideration of the implications of the Supreme Court judgment of 16 February 2005, the Government approved a statutory based repayment scheme. The Health (Repayment Scheme) Act 2006 provides a clear legal framework to repay recoverable health charges for publicly funded long-term residential care, including contracted beds in private institutions. All those fully eligible persons who were wrongly charged for publicly funded long-term residential care and are alive will have their charges repaid in full. The estates of all those fully eligible persons who were wrongly charged for publicly funded long-term residential care and died since 9 December 1998 will also have the charges repaid in full. Recoverable health charges are charges which were imposed on persons with full eligibility under the Health (Charges for In-patient Services) Regulations 1976 as amended in 1987 or charges for inpatient services only raised under the Institutional Assistance Regulations 1954 as amended in 1965. Only these charges are repayable under the scheme.
The provisions of the Supreme Court Judgment of 16 February 2005 do not apply to individuals in private nursing homes who have entered these homes under the nursing home subvention scheme. Under that scheme, the Health Service Executive is empowered to make a financial contribution to an individual towards the cost of his or her private nursing home care provided he or she qualifies on means and dependency grounds. In the case of private nursing home care the contract is between the individual and the private nursing home owner. All applications received under the scheme must be assessed within this legal framework.
The health repayment scheme was launched in August 2006 and is administered by the Health Service Executive, HSE, in conjunction with the appointed scheme administrator, KPMG-McCann Fitzgerald. The HSE has indicated that as of 20 June 2008, more than 33,400 claim forms have been received, 11,332 payments totalling more than €226 million have issued and 15,088 offers totalling more than €267 million have been made.
The applicant concerned submitted a claim under the scheme in respect of a patient who resided in New Ross Community Hospital. New Ross Community Hospital is funded under section 39 of the Health Act 2004. Section 39 allows the HSE to give assistance to any person or body that provides or proposes to provide a similar or ancillary service to the service the HSE may provide. Any organisation funded under section 39 is not, however, providing services for or on behalf of the HSE and does not have the power to levy health charges recoverable under the scheme. Any payment made by a resident of this institution is not a recoverable health charge and therefore no repayment is due under the Act.
The scheme administrator, having assessed the details of the claim, rejected the application on the grounds that the institution in which the patient resided was outside the parameters of the scheme. Section 16 of the Act provides for an independent appeals process for applicants who wish to appeal the decision of the scheme administrator. The applicant concerned lodged an appeal with the appeals office and was provided with an oral appeal hearing. The appeals officer, having considered the details of the appeal, issued a written decision to the appellant on 13 June 2008. The decision agreed with that of the scheme administrator to reject the claim on the basis that the patient resided in an institution outside the parameters of the scheme.
Senator John Paul Phelan: This is why I would have liked a Minister from the Department of Health and Children to attend. More questions are raised by the reply than I raised in the first place. The final sentence outlines my position. The scheme administrator rejected the claim “on the basis that the patient resided in an institution outside the parameters of the scheme”. Clearly, she did. The health board did not provide a suitable bed in which the person could reside. Not only was the person penalised while alive, but the family is being penalised after that person’s death. I know the family in question and its intention was to get a refund for some of the money it had invested with its mother’s pension to pay for her accommodation and to make a donation to the community hospital in New Ross, a fantastic facility.
The answer was not satisfactory. The Minister of State cannot respond to the issue, but it is a clear case of a family, one example of many hundreds, that has been penalised by the State twice — the State failed to provide a bed and, for this reason, claims the person did not fall within the parameters of the scheme. That is unacceptable and disgraceful.
The Supreme Court issued its judgment on 16 February 2005, in response to which the Health (Repayment Scheme) Act 2006 was passed by the Dáil and the Seanad and signed into law. This position was decided by the Dáil and the Seanad and, in the absence of a Supreme Court judgment or legislation, no one can deal with the case in question.
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