Kathleen O'Meara (Labour)

I welcome the Minister of State to the House to debate this very important legislation. We are here again with this Bill on the thorny subject of charges levied on long-stay patients in public institutions. Let us not forget that we are talking about elderly people who were charged — illegally, as it now turns out. We now know from the Travers report that it had been known about since 1976. I agree that the report states that the Department had been aware from that year that such charges were illegal.

I wish to return to the Travers report and make remarks in that regard in the context of a Second Stage speech on this Bill, as it refers to the specific issue. Let us remember that we are talking about elderly people with eligibility and let us consider the situation before the extension of medical cards to the over 70s. Even before then, eligible people were being charged for staying in institutions.

Another Senator referred to people recently crossing the threshold of his office in Mullingar who had not been paying much attention to their elderly relatives and now wondered whether they might get a few bob out of them. The Senator might be interested to hear that I can recall a woman who came to me several years ago in sheer desperation. She was separated and had a teenager doing his leaving certificate, circumstances that, one might have thought, put enough pressure on her. She was on a low income and her elderly father, who was in need of care, was in a public institution. She was not only getting bills from the institution; she was receiving sharp and threatening letters that caused her deep distress and upset.

When she came to see me she was distraught because she was constantly getting letters from the health board demanding payments for the care of her father which, it now transpires, were illegal. There was clearly no question of his being able to pay and she simply could not pay. I do not think that any compensation could make up for the distress caused to that woman and she is only one example of the situation that obtained and the pressure under which families were put by what we now know was an illegal approach emanating from the Department of Health and Children.

The Travers report makes for extraordinarily grim reading. Unlike Senator Feeney, I have not had the privilege of spending hours listening to the Tánaiste and Minister for Health and Children, Deputy Harney, or perusing the report from beginning to end. However, from what I have read of it, I am extremely disturbed at what has been revealed. As Senator Feeney said, and as the Travers report makes clear, the Department of Health and Children was aware of a serious question mark over the legality of such charges.

However, the issue came to a head around 2001, when the South Eastern Health Board brought to the attention of the Department — because it had to — its extensive legal advice regarding patients in public nursing homes. It then became a major issue in the Department. Then we heard one extraordinary series of events set out by the Secretary General of the Department and a completely different series set out by the former Minister for Health and Children, Deputy Martin. It effectively amounted to a conflict of evidence.

I do not think that we will ever know what happened, but the core issue is that the file disappeared following the famous management meeting at which, it would appear, a decision was made. It is interesting to note that the then Minister of State, Deputy Callely, undertook to brief the Minister and the Taoiseach on the serious issues arising from the meeting regarding that discussion in the absence of the former Minister. It is, therefore, extraordinary to discover that the former Minister, Deputy Martin, said at the very end of his statement that it had not been drawn to his attention, either formally or informally, at any time.

One wonders how business was being done in the Department of Health and Children and how, within a short time of her arrival in the Department, the Tánaiste, this having been brought to her attention on the floor of the House by Deputies Perry and Kenny, was able to get a grip on it very quickly, seeing that action needed to be taken. How was it that there was such inability to communicate properly with the former Minister for Health and Children, Deputy Martin, on such an important issue? It is impossible to understand the reason the Department did not appear to be able to get it through to the Minister, if that was what was required, that this issue needed to be dealt with. The situation was that the Minister was not informed of it, yet according to the notes made at the famous management meeting held in the Gresham Hotel, the Minister of State, Deputy Callely, undertook to brief the Taoiseach and the Minister. I wonder what happened in regard to that briefing, when it took place or to what it amounted.

Another issue of major concern in the report that must be highlighted is the way the Department of Health and Children handled this issue. From my experience as a public representative I am aware that people who refused to pay the charges — the Ombudsman's report notes this also — did not have to pay them despite being sent threatening letters and so on. Page 88 of the report states:

The Department of Health and Children avoided any opportunity to test the legal validity of the practices operated under Circular 7/76 [the original circular] when invited to do so, e.g. by the Registrar of the Wards of Court in 1978 operating under the aegis of the President of the High Court. The approach of the Department was to advise the Health Boards to settle out of Court when the practice of charges under Circular 7/76 was challenged by individuals.

What kind of practice are being referred to here? It appears to be one of when challenged, settle and under no circumstances be accountable or responsible. That way of operating in a Department is appalling. Are other Departments using a similar stratagem?