Tuesday, 14 July 2015
Topical Issue Debate
Residential Institutions Redress Scheme
I cannot believe we are in the Chamber discussing this again. This is another circumstance which, to my mind, represents an utter betrayal of the women who survived the Magdalen laundries. In their youth these women were violated and abandoned by the State. They had to fight for decades to receive redress for the damage done to them by the State. Now, we are about to implement this redress scheme, but what do they find?
Let us put first things first. The medical card they have been issued with is effectively branded. It is stamped in clear writing that the scheme relates to people eligible under the Redress for Women Resident in Certain Institutions Act, thus identifying them as Magdalen survivors. I cannot believe how anyone dreamt this up. I assume the justification is that this entitlement will give concessions that other medical cards do not give - I will deal with that point. If that is the justification, it could easily have been done by an initial or something like that. The idea that these women should have their privacy breached in circumstances involving their doctor, pharmacist, the person who finds their handbag on the bus, or a grandchild, who picks up the card and asks her granny what the words mean, is absolutely outrageous. These branded medical cards must be withdrawn. I would love to see an answer to the question of who dreamed it up. I simply do not know but I expect there should be a public apology for that aspect of it.
The second aspect is equally important. These women were led to believe by Mr. Justice Quirke and others that they were entitled to a medical card with benefits equal to the benefits of those under the Health (Amendment) Act scheme. Under the HAA scheme the supporting documentation ran to 58 pages setting out the benefits available to people on that scheme. The additional documentation for this scheme runs to five pages. As Justice for Magdalenes has said, it amounts to not much more than an ordinary medical card, which 90% of the women have anyway. The drugs, medicines and appliances are restricted to what is on the reimbursement list anyway. There are no complementary therapies, no counselling without a general practitioner referral, no counselling for family members, no appeals or complaints board and nothing for the women overseas.
This absolutely needs to be addressed. It represents a betrayal of these women. The scheme itself is completely inadequate. As organisations like Amnesty International, the Irish Council for Civil Liberties, the National Women's Council of Ireland and Justice for Magdalenes have pointed out, it is not actually human rights compliant at all. These women deserve more. My appeal to the Minister of State, and that of Justice for Magdalenes, is for emergency legislation to address this shortfall and ensure the scheme is in line with what Mr. Justice Quirke recommended. Those involved point out that 512 women have waived their right to legal action in anticipation that they would secure the full benefits. What they have got instead is a branded medical card and that is completely unacceptable.
I thank the Deputy for raising this issue. The Deputy will be aware that the Government accepted all the recommendations of the Quirke report and established an ex gratiarestorative justice system. In that context, the Government set up a range of payments and supports for the women who worked in these institutions. Payments of up to €100,000 are made to these women, depending on their length of stay in the laundries. In addition, the Department of Social Protection is making pension-type payments to these women. I understand from the Department of Justice and Equality that over 500 applicants have received lump sum payments to a value of approximately €20 million to date. Mr. Justice Quirke also recommended that legislation be introduced regarding the provision of health services to Magdalen women. To that end, the Minister for Justice and Equality brought the Redress for Women Resident in Certain Institutions Act 2015 through the Oireachtas. The Act sets out the primary and community health services that are made available free of charge to these women. These services include GP services; prescribed drugs, medical aids and appliances; dental, ophthalmology and aural services; home nursing; home support; chiropody; physiotherapy; and counselling services. A woman qualifies for these services where the Minister for Justice and Equality has determined that she is eligible under the restorative justice scheme and the woman has accepted a formal offer made to her under the scheme.
The HSE has contacted the qualifying women directly to issue them with the redress for women resident in certain institutions, RWRCl, card on the basis of information provided by the Department of Justice and Equality about the acceptance of an offer. The HSE has also provided information to the women about the health service. In this way, participants in the ex gratiascheme receive their RWRCI card to enable them to access easily the primary and community health services free of charge.
I imagine the Deputy will appreciate that the Redress for Women Resident in Certain Institutions Act 2015 was debated and approved by the Oireachtas earlier this year. Under the legislation, a medical card is not being awarded to the women. Mr. Justice Quirke did not recommend that Magdalen women should be awarded medical cards. In fact, the judge pointed out that most of the women already hold a medical card, as the Deputy has already stated. Therefore, we did not issue them with medical cards. Instead, a specific card is provided to the women to ensure they can access the health services without any charge, as set out in the Act.
The separate RWRCI card is warranted because the women benefit from a greater range of entitlements than under the medical card. The cards provided to Magdalen women were intended to be similar in manner to the HAA cards. The shorthand name of the HAA card is based on the underlying legislation. The HAA cards are issued on the basis of the Health (Amendment) Act 1996. The 1996 Act provides certain health services to persons who contracted hepatitis C from a blood product or blood transfusion. In this case, the Redress for Women Resident in Certain Institutions Act 2015, which this House approved without a vote earlier this year, provides primary and community health services without charge to women who were admitted to and worked in certain institutions.
In the same way, these cards are called RWRCI cards as a shorthand description of the Act. It will be relevant to the Deputy to note that it was never intended to cause any offence or embarrassment by referring to the Act on the card. However, I accept that putting the full title of the Act on the card identifies the holders in a way that the Health (Amendment) Act card does not. I only saw the card this afternoon. I am completely open to changing the title as it appears on the card if this is what the women want. It will only require a small effort to correct it and I am happy to ensure it will happen. I hope this puts the issue to rest.
I will not conclude with what is contained in my script. I must state that had I seen the card in advance, it would not have been issued. I have given instructions in respect of it. I am not certain that we should withdraw the card, but Mr. John Hennessy, director of primary care in the HSE, will meet relevant stakeholders to determine what the design should be.
Like the Deputy, I do not understand why the full title should have been on the card since the card had to be used for identification or to hand to the secretary of the general practitioner. The initials would have been enough. We do have to indicate that the card is different. This is important, but it was equally important to settle on the form of identification.
I have been centrally involved in the Magdalen issue, as Deputy Clare Daly knows. Really and truly at this late stage, identification in the manner in question is not appropriate. We will ask the director of primary care to sit down with the relevant authorities to address the issue. However, this is not even needed as we all know instinctively how we would go about it. What is required is being done.
I am not certain that I want the women to return their cards, but I am saying to the Deputy that new, more appropriate cards will be issued.
I actually believe it was important to give the Minister of State the extra time to contribute so forcefully and agree with the points I was making. I fully appreciate her bona fides on the issue of identification. The identification was outrageously insensitive, almost cruel, thoughtless and really clumsy. That somebody made this mistake was just ridiculous after all the women had been through. I fully acknowledge that the Minister of State has said she will address the issue and I am glad that it is happening. This will be best achieved through consultation with those involved.
The bigger issue for many of the people affected is obviously the shortcomings of the scheme. We discussed them at the time of the passage of the legislation. It is still the case that the women are very disappointed by the shortcomings. While I appreciate the nuanced statement of Mr. Justice Quirke that the card was not to be a medical card but a health services card, this led the women to believe they would have far greater entitlements than would be afforded with an actual medical card. In actual fact, it gives them little more and is not in any way on a par with the HAA card. Perhaps we have had this debate before, but when the women see the entitlements written down, the disparities are driven home. I would like to see this issue addressed through emergency legislation, although I know that is not very likely to happen. However, I am at least glad that one aspect of the issue is being addressed.
Since we were so anxious to do exactly what Mr. Justice Quirke had asked us to do, the legislation was very prescriptive. What was not prescribed, of course, was what happened in regard to the card, the health services card. I hope we will rectify the matter as quickly as possible. It would not be appropriate to ask the women themselves to return the cards. I am not certain how that would work, but I am saying the new card, when issued, will be anonymised as much as possible, although I am not certain it will be more discreet. It will have to be identifiable as being different from the other card. We all accept this.