Dáil debates

Thursday, 29 November 2012

Topical Issue Debate

Vaccination Programme

3:10 pm

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Fianna Fail)
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I would have expressed disappointment that the Minister for Health is not present, but with everything taken into account I may have more confidence in the assurances provided by the Minister of State, Deputy Brian Hayes. The final report of the national narcolepsy study steering committee was published on 19 April 2012. The report was commissioned following concerns about an increase in narcolepsy among those who were administered the swine flu vaccine Pandemrix. The report found that the risk of narcolepsy was 13 times higher among those given the swine flu vaccine than in unvaccinated individuals. At the time of the epidemic, approximately 900,000 people were vaccinated. The report states that symptoms developed between two weeks and 20 months after vaccination and there was increased risk of narcolepsy among young people aged between five and 19 years.

Inevitably, a campaign group was set up to represent families who believe their children have been affected. The group, which is called Sufferers of Unique Narcolepsy Disorder, SOUND, represents more than 30 children and their parents. SOUND has been seeking health and educational supports, as well as a compensation programme. I raise this matter on behalf of the group and I am aware that other Deputies have also raised it by means of parliamentary questions. Correspondence received by my colleague, Senator Thomas Byrne, from the parent of a sufferer describes the difficulties that arise. The correspondence states that the final report of the national narcolepsy study steering committee concluded that the higher incidence of narcolepsy among children and adolescents was associated with vaccination with Pandemrix. The Minister for Health subsequently gave a clear commitment to the members of SOUND that a paper would be presented to the Government prior to the previous summer recess to propose a package of supports for those affected. SOUND was later advised that the paper had been delayed but would be put to the Dáil in September 2012. It was then delayed until October. The most recent communication with SOUND is that a statement will be made by the Minister in the next four to six weeks, with no mention of the proposed paper or further consultation with SOUND. The parent was most disappointed at the lack of follow-up by the Minister and was concerned for the future of his teenage daughter.

Notwithstanding the children's referendum, children with narcolepsy due to a State-sponsored vaccination programme appear to have been forgotten. What does this say about the Government's commitment to children? The correspondent's daughter was vaccinated against the H1N1 virus in November 2009 and, following 18 months of fear, anxiety and misdiagnosis, was conclusively diagnosed with narcolepsy as a result of the vaccination.

This means that for this family the journey began three years ago. The chronic condition is not curable and is managed with lifetime medication, with only limited success. The daughter suffers constantly from narcolepsy and frequently also suffers cataplexy attacks - complete loss of muscle tone - and has recently begun to experience disturbing night terrors. Her quality of life and her ability to fulfil her potential in sport, education and normal social behaviour have all been dramatically diminished by this terrible consequence of the State-promoted vaccination programme. The quality of life of her siblings has also been adversely affected by her condition, as has normal family life. The parent believes that the Minister, his Department and the HSE are reneging on their collective duty and, in particular, on the Minister's personal commitment to this child and the other children, adolescents and young adults, to meet the needs of their particular circumstances.

3:20 pm

Photo of Brian HayesBrian Hayes (Dublin South West, Fine Gael)
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I thank Deputy Ó Fearghaíl for raising this and for providing me with the opportunity, on behalf of the Minister for Health and Children, to outline to the House the importance of the issue raised.

The Minister's priority is to ensure that the children and adolescents affected are provided with services and supports to meet their health and medical needs. The Department is working closely with the Health Service Executive and the Department of Education and Skills to address the needs of those affected by narcolepsy following Pandemrix vaccination. The Department is engaged with the support group SOUND, which represents those affected. Meetings have been held by the Minister, Deputy Reilly, and his Department with representatives of SOUND.

The HSE provides a wide range of services and supports to those affected, including access to rapid diagnosis, clear treatment pathways, temporary medical cards and reimbursement of expenses incurred. Multidisciplinary assessments, which allow for appropriate individualised health and educational supports to be put in place, have commenced. The National Educational Psychological Service, NEPS, is also engaging with the HSE and with the individual schools and parents of children concerned to identify and provide educational supports for the children and adolescents affected.

The Department of Education and Skills has held a number of meetings with SOUND to outline the range of educational supports that may be provided for children with narcolepsy, subject to an assessment of their needs. These supports can include special arrangements at State exams, access to special needs assistant support, additional learning assistance in schools, information for schools regarding this condition and home tuition support for children who have missed a significant amount of time in school due to illness.

A meeting was held recently between SOUND and representatives from the Higher Education Authority national access office and the Department of Education and Skills higher education unit on the issue of assistance that may be made available for young adults with narcolepsy in third level education. Students with narcolepsy may access the disability access route to education, DARE, scheme, which offers enhanced access routes to third level education for pupils with disabilities. Support may also be provided to pupils in colleges through the disability officers at third level colleges. The association for higher education access and disability, AHEAD, group, which works to promote full access to and participation in further and higher education for students with disabilities and to enhance their employment prospects on graduation, will also provide assistance to SOUND on these matters.

The Department of Health is considering all possible supports that may need to be put in place for those affected. Any such supports require the Minister's approval and the consent of the Minister for Public Expenditure and Reform. I assure the House that this matter continues to be a priority for the Minister and the Department of Health.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Fianna Fail)
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I appreciate the bona fides of the Minister of State, and if nothing were to come from this discussion other than perhaps a commitment from him to promote this issue with Government, I would be happy.

The response from the Minister lists the supports that are generally available within the health and education systems to children or young people with disabilities. The people in question here are people who are suffering from disabilities as a result of a vaccination given to them by the State. The State has a responsibility to address that situation. The Minister gave the organisation to understand that he would do that. He has given three different timescales for the introduction of a proposal to address the specific needs of those affected, but he has not honoured those commitments.

Having been involved for a number of years with the 33 thalidomide survivors and having heard the commitments made by the Minister, as a Deputy, when he and I served on the health committee in the previous Dáil, I believe the parents of children affected by narcolepsy have little reason to be optimistic the Minister will address their problems if he proceeds along the same lines along which he has proceeded to date in dealing with the survivors of thalidomide. We would, however, have some confidence if we thought the Minister of State would raise, promote and make progress on this matter. We could take some little hope and optimism from this debate based on that.

Photo of Brian HayesBrian Hayes (Dublin South West, Fine Gael)
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I thank Deputy Ó Fearghaíl for raising this matter in such a constructive way. He recognises, as does the Government, the State's responsibility to the people who have been affected this way as a result of the vaccination to which he referred. He must also recognise that the response must be multi-departmental, because it involves young people and adolescents who must interact with a number of different services, including health and education services. As a consequence, the issue must be approached in a multi-departmental manner.

On behalf of the Minister for Health and Children, I can assure the Deputy that the Minister is preparing a memorandum for the Government on this issue. I understand the memorandum will set out all of the issues in terms of additional supports required for those affected by narcolepsy. I also understand the memorandum requires the consent of the Minister for Public Expenditure and Reform and that the Department of Health and Children is in contact with the relevant officials in the Department. As Minister of State at the Department of Public Expenditure and Reform, I assure the Deputy that I will raise this matter not only with the Minister for Health and Children but also with the Minister for Public Expenditure and Reform, Deputy Howlin. It seems that in order for a memorandum to come to the Government setting out additional supports for these people, it requires the approval of both of these Ministers, as these supports will require additional funding. I will raise the issue with both Ministers.

I propose to take Questions Nos. 73 to 83, inclusive, together.

The Central Bank has informed me that it does not track the number of borrowers falling within the MARP process but does track the number of alternative arrangements, and the nature of the arrangement, put in place across the regulated industry and which is published quarterly by the Central Bank. The Central Bank Code of Conduct on Mortgage Arrears, the current version of which came into effect from 1 January 2011, was issued under the provisions of section 117 of the Central Bank Act 1989. The Code applies to the mortgage lending activities of all entities regulated by the Central Bank, except for credit unions, in respect of loans which are secured by the borrower’s primary residence. The Code sets out the framework within which a regulated mortgage lender must engage with a borrower who is in arrears, or pre-arrears, in respect of a loan secured on the borrower’s primary residence and who is co-operating with the lender.

This revised Code sets out new and more detailed requirements that a lender must comply with when dealing with mortgage holders experiencing genuine arrears and financial difficulties. In particular, it provides that each lender must establish a Mortgage Arrears Resolution Process (MARP) and use this framework when dealing with its mortgage holders experiencing difficulty. This framework provides for a number of steps such as:

- communication with borrowers;

- the use of a standard financial statement to obtain financial information;

- assessment of the customer’s circumstances by dedicated arrears support units;

- resolution, which require the lender to explore all options for an alternative repayment arrangement in order to determine the most viable option in each case, and

- an appeals process, which initially will be an internal Appeals Board within the institution, to reconsider the matter if the borrower is not satisfied with the proposed resolution response. There is then the further option if necessary, to appeal to the Financial Services Ombudsman after the internal appeal process has ended.

MARP, therefore, is not a scheme as such but rather is a process put in place to govern the interaction between mortgage borrower and lender in circumstances where the former is experiencing genuine difficulty and allows both parties to assess the current situation with a view to coming to an optimal solution. In particular, a lender is required to explore all options for an alternative repayment arrangement to determine which options are viable for each particular case.

Other protections offered to borrowers under the CCMA include the following:

- all cases must be handled sympathetically and positively by the lender;

- a lender must not apply to the courts to commence legal action for repossession until every reasonable effort has been made to agree an alternative repayment arrangement with the borrower;

- where a borrower co-operates with the lender, the lender must wait at least 12 months from the date the borrower is classified as a MARP case before applying to the courts to commence legal action;

- each branch or office of the lender must have one person responsible for dealing with borrowers in difficulty and must also have a dedicated Arrears Support Unit to deal with all MARP cases;

- lenders are restricted from imposing charges on arrears arising on a mortgage account in arrears where the borrower is co-operating with the lender;

- all communications about arrears and pre-arrears must be provided in a timely, clear and consumer friendly manner, e.g. information booklet providing details of MARP and dedicated section on website.

Quarter 2 2012 Mortgage Arrears Stats published in August shows the number of mortgages secured on Private Dwelling Homes (PDH’s) which are in arrears. This is also broken down into restructured number and type. . The publication of Quarter 3 data is expected in mid-December, will also include information on Buy to Let properties for the first time.

Regarding complaints to the Financial Services Ombudsman, I am informed by that Office that it introduced a policy last April in response to a number of complaints being submitted to his Office regarding mortgage arrears/pre arrears, to deal with such cases. This policy states that a complainant must first engage with the financial institution in question and fully exhaust the MARP process. The Financial Services Ombudsman will not investigate such complaints where the MARP process has not been exhausted. This gives both parties the opportunity to re-engage with the process and find, where possible, an alternative resolution. If a complainant uses the MARP process, with either party failing to come to a resolution, the complainant can revert back to the Financial Services Ombudsman. In that regard, the above procedure has proved relatively successful as it ensures that the respective parties engage with one another, before referral to the Ombudsman’s Office. However, there have been cases where MARP has been exhausted, and the Ombudsman followed up by investigating such complaints. Thus far, there have been 6 not upheld, with 5 partly upheld. There have been no cases where the Ombudsman fully upheld such a complaint.

The Central Bank also informed me that a review of lenders compliance with the CCMA was carried out by it in 2011, focussing on charges imposed by lenders. Please see a link to the Press Release on the outcome of this review below.

Also attached, for information, is a link to the CCMA and the Central Bank’s Consumer Guide to dealing with your lender below.

The Central Bank has informed me that it will commence a review of the Code of Conduct on Mortgage Arrears in the first quarter of 2013. The Central Bank would normally conduct a review following a reasonable time after implementation and the Code will require updating due to the introduction of the Personal Insolvency Arrangement insolvency framework as provided for in the Personal Insolvency Bill which is currently before the Oireachtas as well as longer term mortgage resolution options. The review will take into consideration recent developments that may be relevant to the issue of mortgage arrears.