Colm Keaveney (Galway East, Labour)

Domiciliary care allowance is payable in respect of children under 16 years of age who have a disability so severe that it requires the child needing care and attention and-or supervision substantially in excess of another child of the same age. This care and attention must be given by another person effectively full-time. In that respect, I salute those carers for their dedication and their commitment to domiciliary care. That care is offered to the child so that the child can deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months.

Eligibility for the domiciliary care allowance is not based primarily on the medical or psychological condition but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. Each application is assessed on an individual basis taking account of the evidence submitted and no specific condition or disability qualifies or disqualifies a child from qualifying for the allowance. Applications for children with autism and other intellectual disabilities are processed in exactly the same manner as applications for children with other types of disability.

The Department's target is to process domiciliary care allowance claims within seven weeks. Currently, the average time period to process a domiciliary care allowance application is eight weeks. We agree with the principles set out in the motion and as outlined by Deputy Joan Collins with regard to the processing of claims. During the first quarter of 2012, the average waiting time for appeals dealt with by summary decisions was 22.4 weeks and 40.9 weeks for those that required an oral hearing. The comparable times for 2011 were 25 weeks and 52.5 week,s respectively. There have been no cuts made to the scheme in recent budgets and the rate of payment remains at €309.50 per month, as reaffirmed by the Minister in her contribution.

Prior to April 2009, the domiciliary care allowance scheme was administered by the Health Service Executive. Since it transferred to the Department of Social Protection, the scheme has been placed on a statutory basis, as provided for in the Social Welfare and Pensions Act 2008. This is to be welcomed. The medical criteria as set out in the legislation requires that in order to qualify for the allowance, the child must be in need of care and attention and-or supervision substantially in excess of another child of the same age. Prior to taking responsibility for the scheme, the Department convened an expert medical group to draw up a set of consistent and objective guidelines for use in determining the medical eligibility of children for the scheme. The group was chaired by the Department's chief medical advisor and comprised of senior medical personnel from the HSE, as well as eminent professionals. The group considered the most appropriate methods for conducting the assessment.

I refer to the statistics associated with the scheme. The domiciliary care allowance is paid to over 24,000 parents or guardians in respect of 26,000 children at a cost of approximately €100 million in 2011 and with the accompanying respite care grant costing a further €45 million. The number of claims has increased steadily over the course of the years, with 11,000 in 2011, 23,000 in 2009 and 26,000 in 2012, an increase of 3,000.

A review policy is an integral part of all social welfare schemes and is necessary to ensure payments continue to be made only to those customers who meet the qualifying conditions. In circumstances where a child has a lifelong disability that is unlikely to improve to any significant degree, I welcome the fact that the Minister has confirmed that a "do not review again" status may be used on that file by the medical assessor.

Service users or clients who are reviewed are asked to provide relevant up-to-date medical evidence and details of the additional care needs of their child. They are now afforded a 60-day reference period in which to return this information to the Department. I am glad to say that where payment is stopped as a result of the review, the family is invited to submit further information in order to secure a payment. Up to now, service users or customers were requested to return medical review forms and supporting information within 21 days. I welcome the Minister's confirmation that the reference period will now be 60 days.

Following a review of the current 21-day timeframe, that extension will provide an adequate opportunity for families to provide supporting evidence with regard to processing the claim. I am delighted that the Minister intends to undertake a policy review of the allowance over the course of the next nine months. It gives the Department an opportunity to clarify the objectives of the policy, to consider what legislative change is required and also consider what refinement of current administrative and medical processes is needed in the context of the existing system. As part of this review, the question of the duration of review periods for the allowance must be actively considered, based on the medical condition of the children involved, while taking account of other priority demands on the medical resources required to underpin adequate and acceptable care for that child. The primary objective has to be the care of those children and the support of their families.

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