Mr. Stephen Mulvany:

In a way, the HSE is providing a service of last resort here. There are some patients who have capacity and neither need nor want us to mind their patient private property - their own funds. That is entirely okay with the HSE; it is not a service that we seek to provide. It is, however, one that we have to provide for some patients and families. It is quite an extensive service. We seek to safeguard patients' moneys when they are in our care, particularly those who would not have capacity. We provide a service which effectively allows them to have their bills paid, have their social welfare money collected, where applicable, and which discharges the contribution that the State requires them to give to the provider, as well as providing their own "for patient comfort" moneys or moneys for their own use. Our guidelines are very explicit. We make it very clear that this is the patient's money. If patients want to manage their money themselves and have capacity, that is entirely at their discretion. Our assumption is that people do have capacity unless there is a reason to doubt it. That is the why. We only do it where it is necessary or asked for. It is not something we insist on.

In terms of why we have to pay interest now, in the health board days, the advice the health boards had was that, when they were doing this patient private property service as a service of last resort, their legal relationship to the patient was such that the patient would give the health board some money, and the health board minded the money and gave it back to the patient. The advice was that the health boards did not have to give interest. The interest was retained by the health boards to partly offset the costs of providing what is quite an extensive service. At the time, it was offered in over 170 centres.

In around 2004 or 2005, these issues were becoming very topical. The HSE was on the way in. As part of the overall preparation for that change, we got further legal advice which said actually, on balance, the relationship is more likely to be that of a trustee. Trustees are obliged, not just to give back the €100 that was given to them for safekeeping, but also to give interest if it is earned. We set about putting that in place. We established a central patient private property unit for data gathering and a repayment scheme. We have a backlog, in this first instance, of approximately four years' worth of interest, from 2005 to 2008. We now need to repay this money to patients or, in most cases, to their entitled next of kin. That is a big logistical exercise and, unfortunately, in many cases we will struggle to find an entitled next of kin. There is a large piece of work under way to achieve the first two parts of that, namely, the data gathering and calculating the interest. That is to be undertaken this year, I believe. It will take at least to the end of next year or possibly longer to figure out whom can we pay the money back to.