Dáil debates

Thursday, 22 November 2007

3:00 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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I am grateful for the opportunity to raise this matter and thank the Minister of State, Deputy Brendan Smith, for coming to the House to reply.

The Leas-Cheann Comhairle and the Minister of State will be familiar with this case. In the past ten or 15 years I have repeatedly raised the issue of primary medical certificates and the qualification they entitle to the bearer. There are considerable discrepancies with regard to those who qualify and those who do not. The rules are extraordinarily rigid, yet constituents will on occasion point out that they know somebody who has a primary medical certificate but is in a position better than or equal to the position of the constituent. I wish to raise one such case.

The qualifying guidelines state applicants must be wholly or almost without the use of both legs; wholly without the use of one of their legs and almost wholly without the use of the other leg such that they are severely restricted as to movement; or without both hands or without both arms. We do not have be medical experts to work out that persons would qualify in such extreme circumstances. However, it is extraordinary the guidelines do not refer to persons with the use of one arm and one leg.

In the case to which I refer, the applicant, who was an athletics coach, had a severe stroke. He is not in the business of exaggerating his condition but his brain is working perfectly, he has a functioning role in society and wants to travel to work but cannot afford to do so. The stroke severely restricted the use of one side of his body, as often happens in such cases. As a result, he has had to stop work.

I raised this issue on the Adjournment in June last. The person wrote a plaintive letter to me on 5 November in which he referred to the number of occasions on which he had been examined. In each case the examination consisted of a chat and a kind of walkabout, followed by a medical conclusion — I cannot understand how it works in this fashion. He appealed his case and was called to the health centre on 28 August last and was again unsuccessful, despite the fact that the community health doctor did not physically examine him in any way.

The applicant knows a number of other people in the area who have qualified for such certificates who are no worse or better off than he, although he has had to come to that conclusion without a medical examination. Let us not forget he is an athletics coach and has some knowledge on these matters. He would like to return to work and continue to make a contribution to society. He can do so but he has repeatedly been refused a certificate.

I do not blame the Minister of State for this situation. Will he contact whatever bureaucrat is in control? Once and for all, we need to liberalise the system, let a little clarity into the arena and allow the decision to be made that where persons are severely restricted on one side of the body, the certificate will be awarded. There are countless similar cases.

Photo of Brendan SmithBrendan Smith (Minister of State with special responsibility for Children, Department of Health and Children; Cavan-Monaghan, Fianna Fail)
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I thank the Deputy for raising this important matter. It is not the first time I have heard him speak on this issue and the need to improve the scheme.

The disabled drivers scheme dates back to 1968, when relief from road tax was made available under section 43 of the Finance Act of that year for persons with a disability meeting specific medical criteria. Since then, the scheme has been extended and amended on a number of occasions.

The benefits of the scheme for qualifying persons are set out in the legislation. They consist of full relief in the year of purchase of an adapted vehicle of vehicle registration tax, and VAT subject to limits of €9,525 for a qualifying driver and €15,875 for a qualifying passenger or organisation. In the case of passengers, there is a requirement that the adaptation to the car must amount to at least 10% of the cost of the car. In the case of both drivers and passengers, the vehicle must be retained for at least two years. Second, there is relief from excise duty up to a maximum of 600 gallons per year, or 900 gallons in the case of an organisation; and third, exemption from road tax.

The average total annualised value of these benefits is estimated at around €5,500 per claimant. In the year of purchase of a car, a claimant receives benefits relating to the purchase of the car, fuel relief and road tax. In the other years, the benefits received are fuel relief and road tax. Regulations also provide for the inclusion in the scheme of non-profit organisations involved in the transport of persons with a disability.

In terms of the overall scale and scope of the scheme, the most recent data available from the Revenue Commissioners shows that the total number of claimants in the system in 2006 was around 11,000. This was made up of approximately 4,500 drivers and 6,500 passengers. In 2006, the total cost of the scheme, excluding road tax, was €59 million — an increase of some €9 million on 2005. When road tax is included, the total cost in 2006 is estimated at over €67 million.

The statutory basis for the current scheme is section 92 of Finance Act 1989. The 1994 Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations, made under the 1989 Act, set out the medical criteria, certification procedures, reliefs available to eligible persons, appeal procedures, and other matters. Given the generosity of the scheme, strict medical criteria are set down for qualification. The scheme is not open to all people with a disability. It is available only to people with certain serious permanent physical disabilities, which result in considerable mobility difficulty.

Deputy Durkan has already referred to the medical eligibility criteria for the scheme, as set out in the legislation. It is a fundamental requirement for admission to the scheme that the applicant meets the specified medical criteria and is in possession of a primary medical certificate to that effect. A person who is deemed to satisfy the criteria is issued with a primary medical certificate by the senior medical officer of that HSE administrative area. Possession of this certificate qualifies the holder to claim the benefits of the scheme either as a qualifying driver or a qualifying passenger.

In some cases, the persons concerned do not appear to the senior medical officer to meet the criteria and so the relevant certificate is refused. Where the medical certificate is not granted, the legislation provides for an appeal procedure operated by the Disabled Drivers Medical Board of Appeal. The board is an independent body whose decision is final. The board's members are appointed by the Minister for Finance on the nomination of the Minister for Health and Children.

Considerable efforts have been made in recent years to improve the level of service concerning appeals. There is still some work needed in this regard, but following a period of difficulty in organising sufficient meetings of the Medical Board of Appeal, the Tánaiste reconstituted the board in early 2005. Since that date, the panel of doctors has been incrementally expanded from three to 15 members. This has facilitated more frequent meetings of the board, thus enabling progress to be made in reducing the backlog of appeals that had arisen.

A special interdepartmental review group has reviewed the operation of the disabled drivers scheme. It examined current benefits, qualifying medical criteria, Exchequer costs, relationship with other schemes and similar schemes in other countries. The report also made a number of recommendations, both immediate and long-term, referring respectively to the operation of the appeals process and to options for the future development of the scheme.

In respect of the long-term recommendations, which included the qualifying disability criteria, the issues raised are complex and difficult, as is clear from the interdepartmental review group's report, and they raise fundamental questions about the scope and purpose of the scheme. However, given the scale and scope of the scheme, any possible changes can only be made after careful consideration and with regard to the existing and prospective cost of the scheme, and available resources. The key challenge is to seek to ensure that the current scheme is managed effectively and efficiently, and that any changes introduced ensure the effective use of resources in promoting access and participation for persons with a disability.

At the outset I should have stated that I am replying on behalf of the Tánaiste and Minister for Finance, Deputy Brian Cowen, who is unavoidably absent.

With regard to the particular case that Deputy Durkan outlined, I ask him to send the details to me and I will forward them to the Tánaiste for his further consideration. We all know of particular cases that seem to meet the criteria, but at times it appears difficult to make progress with them. This can be so with individual cases I have come across. I ask the Deputy to communicate with me in that regard.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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I will do so.