Ms Laura McGarrigle:

I thank the Chair. In regard to the enhanced medical card and what it provides, head 20 sets out the legislative explanation of what it provides, namely, access to GP services and public acute hospital services, without charge in both cases, access to drugs, medicines, medical and surgical supplies, access to therapies, home help and nursing services, home nursing, and dental, ophthalmic and aural services. Counselling is included just to give it a statutory basis but acknowledging it is already provided outside of this legislation. Access to chiropody and physiotherapy is also provided. The Bill provides access to therapies, GP, acute inpatient services, without charge; access to drugs, medicines, aids and appliances, without charge; and access to dental, aural and ophthalmic services.

Separately, it is worth mentioning that another one of the actions in the action plan is a commitment to further health research to identify whether any further health needs exist in the population of survivors and former residents of mother and baby homes that would need to be captured in any future review or update of services provided to survivors or as part of this enhanced medical card. That commitment is also in place. I hope I have answered the Chairman question but I ask her to let me know if she needs more detail on any aspect.

In regard to the €3,000 payment, this was difficult for the interdepartmental group to grapple with because in January 2021 the Government agreed the commitment to an enhanced medical card for everyone with a length of stay of more than six months in a mother and baby or county home institution. Everybody qualifies for that enhanced medical card but of course it is of limited value to those living overseas unless they spend significant periods in Ireland or move back to Ireland. The €3,000 health support payment is an attempt to acknowledge that reality for the individuals affected. It acknowledges that the Irish State cannot legislate for the provision of health services in other jurisdictions. The reality is that health systems can be very different between jurisdictions and health needs can differ from survivor to survivor. It is accepted that there is no easy answer. The interdepartmental group grappled with this but the health support payment is an attempt to acknowledge the circumstances of those survivors.

In regard to payment rates, as mentioned, the interdepartmental group acknowledged that the payment scheme could not possibly compensate for what was lost and the suffering endured by people. It is just one in a range of measures designed to recognise and acknowledge the suffering but it cannot hope to compensate for it. The group recognised that.

It also decided that the recommended approach to the payment was this general, common experience payment grounded in the non-adversarial approach. In that regard, in terms of looking at something that might be in some way comparable, the IDG noted the payment approach and rates used in the Magdalen restorative justice scheme whereby a schedule of rates was recommended by Mr. Justice Quirke recognising periods of time in institutions with harsh conditions. The IDG would have had regard to that in setting the rates.