Seán Power (Kildare South, Fianna Fail)

I thank Deputies for their contributions to the debate and welcome the broad support from all parties for the introduction of this legislation. I propose to respond to some of the issues raised during the debate.

The enactment of the Bill will be a key milestone in ensuring that repayments will be made as promptly as possible to all those who were wrongly charged for publicly funded long-stay care. As previously noted, the legislation will provide a framework to enable repayments to be made to all those affected who are alive and the estates of those who died since 9 December 1998. Those affected will have all charges levied up to 9 December 2004, the date on which charging ceased, repaid in full.

The scheme incorporates many features designed to make it a more attractive option than litigation. Repayments to those who are alive or their living spouse will not be subject to income tax. Those in receipt of repayments will retain their current social welfare pensions or allowances and their full eligibility entitlement or medical card status. Repayments under the scheme will not be considered when assessing entitlements to subvention.

Ensuring that the Bill contains the significant benefits I have outlined required extensive consultations with many agencies over an extended period, as did the provisions ensuring appropriate safeguards are in place to protect the financial affairs of vulnerable people. A number of Deputies mentioned the delay in bringing the Bill before the Oireachtas. As I noted, it was necessary to contact a number of the individuals concerned to ensure proper safeguards were in place. While all Members would have preferred to have the legislation before the House at an earlier date, the Bill needed to contain the maximum degree of protection for the vulnerable people affected by this issue. While I acknowledge that the process has been longer than expected, this has been due in the main to the complex and sensitive nature of the issues involved and the need to obtain detailed legal opinion.

In recognition of the special needs of those in long-stay residential care, the Bill will introduce appropriate safeguards to protect those who may not have the functional capacity to manage their own financial affairs without having to resort to wardship or the use of widespread psychiatric assessments, which could substantially delay repayments being made. The scheme will apply to fully eligible people, that is, medical card holders and those aged over 70 years, with effect from July 2001. To ensure repayments are made in an equitable manner, those not having a medical card on admission to long-stay care but who fall within the income-means threshold for a medical card will be regarded as having full eligibility for the purpose of this scheme. This will include those in publicly funded long-stay care, patients in public contracted beds in private nursing homes and patients in receipt of inpatient services in community-based facilities.

An outside company with experience in handling mass claims will be appointed by the Health Service Executive to administer the scheme. This company will provide an independent assessment of the amount of repayment due to each applicant and will help to reassure the public that the scheme is being operated in the most equitable and effective way possible.

Following consideration of all the issues, the initial procurement process was terminated in December 2005 as the HSE considered the tenders were unsuitable for a number of reasons, including value for money. The current public tendering process is at an advanced stage and it is expected that a decision on the appointment of a preferred service provider will be made when the board of the HSE meets on 1 June. A number of Deputies referred to the delay in appointing an outside company and some people questioned why it was being appointed. In fairness, however, it is important to have an independent assessment available. While the Department was very much involved in charging those involved, it is important to have an independent body to reassure people that everything is above board. In view of what happened, the HSE has taken the right decision and I am sure we are getting value for money. Hopefully the decision will be taken on 1 June.

Consideration was given by the HSE to the involvement of public sector staff to assist in administering the repayments scheme. However, the time constraints of the procurement process and the potential for significant logistical difficulties and protracted delays, with consequent implications for the commencement of the repayment scheme, did not allow for this option to be progressed. The HSE has also informed the Department of Health and Children that the operation of a repayment scheme of this nature is not one of its core functions and that it would not be in a position to administer a repayment scheme of this magnitude within existing resources without having to divert staff from their normal functions in the delivery of health services.

Shortly after the Supreme Court made its ruling, we announced we would establish this process to refund money. There has been no reason for delaying the process other than to put in place the simplest and most transparent refund system. While it is estimated that in total the scheme will cost close to €1 billion, we have included €400 million in the Estimates for this year.

The application process will be as simple as possible. January 2008 is the deadline for submitting applications, not for making repayments. Some speakers felt the deadline for repayments was 2008 but we are giving people until January 2008 to submit their applications. Valid applications will be paid until all have been dealt with. Fully eligible persons currently in care and those who have left care recently will be readily identifiable by records held by the institution. The HSE will ensure that applications are submitted on behalf of those in the care of the HSE who are unable to make the application themselves due to a physical or mental disability or ill health.

The application process will identify the personal representative in the case of estates and will provide the necessary documentation to help protect the State against fraudulent claims. In her earlier contribution, Deputy McManus referred to legal advice she had received concerning the recovery of money obtained through fraud. The Attorney General has advised that section 17 is not constitutionally questionable because it is, ultimately, the courts which would determine whether the ground exists for the HSE's claim of fraud, and they would never accept a mere assertion by the HSE that it is "satisfied" that the claim exists.

To ensure that those eligible for repayments are aware of their entitlements, an extensive communications process will be developed around the scheme. This will include TV, national and local radio, and newspaper advertisements.

Applicants will be repaid the moneys that are due to them in full, adjusted using the consumer price index to reflect the current value in today's monetary terms. The consumer price index is a widely accepted tool for monetary calculation over an extended period of time. It is used, for example, by the Department of Social and Family Affairs in dealing with underpayments of social welfare entitlements. A precedent also exists whereby in social welfare payments made as a result of the European Court of Justice's equal treatment ruling, amounts were adjusted by reference to the CPI to maintain their value.

The scheme contains a provision to enable those due repayments under the scheme to donate all or part of the repayment, specifically for one-off improvements in public health services for elderly persons and persons with disabilities. It is the intention that the wishes of those donating money will be considered when making allocations from the fund, subject to legal and practical constraints. The HSE is considering how best this can be achieved.

The scheme includes an independent, transparent and user-friendly appeals process. The Tánaiste will appoint suitably qualified independent appeals officers to consider appeals. Regular reports on the operation of the appeals process will be laid before the Oireachtas. All applicants will be advised of their right to appeal and how to make an appeal. Applicants will also be informed of their right to bring a complaint to the Office of the Ombudsman.

The overall costs arising from the long-stay charges repayment scheme have been estimated at approximately €1 billion. An appropriate allocation of €400 million for 2006 will be made when the legislation is passed by the Houses of the Oireachtas and the balance will be required in 2007 and 2008.

While debating this Bill a number of Deputies have referred to the preference of older people in need of care to remain in their own homes. In this regard, an additional €150 million was allocated in last December's budget towards improving services for older people and palliative care. This is the largest ever annual increase in funding for services for older people. Reflecting the new emphasis on home and day care, almost three quarters of that figure — €109 million of the full year costs — are being committed to services in the community.

The investment package is focused on caring for people at home in accordance with their expressed wishes, with additional funding for a number of new and existing community and home-based initiatives, including home care packages, the home help service, day and respite centres, meals on wheels and sheltered housing. Additional funding of €20 million was made available in the 2006 budget for the subvention scheme.

The Department is preparing legislation to update and clarify the present overall system of eligibility for health and personal social services to establish a fair and transparent framework in keeping with a modern health service. The aim is to publish a Bill by the end of this year.

Deputies Twomey and Seán Ryan referred to the proposed establishment of the health information and quality authority, HIQA. Preparation of legislation to provide for the establishment of the health information and quality authority and the office of the chief inspector of social services within the HIQA is well under way. The office will inspect residential services for older people as well as those for people with disability and children at risk. The office will register these homes and will inspect them against standards set by the authority. This process will cover both public and private facilities for the first time. The office will be independent of the HSE. Public consultation on the legislative proposals in the draft heads of the Bill has begun. The closing date for receipt of submissions is Friday, 26 May.

Deputy McGuinness raised the matter of patient private property accounts and he specifically mentioned a complaint that was made to the Department. As is the normal procedure, that complaint was referred to the HSE and will be dealt with by that executive. In view of what Deputy McGuinness said, however, we will make contact with the HSE and ask it to make direct contact with the Deputy and with those who made the complaint. Complaints should be dealt with as quickly as possible through any complaints procedure. If further details are required, we will get them from the Deputy.

Deputy McGuinness also referred to St. Luke's, an establishment I have had the pleasure of visiting on a few occasions. It is an example of how a team should work together.

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