Camillus Glynn (Fianna Fail)

Fáiltim an Aire Stáit go dtí an Teach. I welcome this Bill which is putting right something that should not have happened in the first place. While it may have taken some time, in this case we should not sacrifice accuracy for speed. It is important that we get it right.

I welcome the ex gratia payments made, which are a gesture of goodwill on the part of the Government to address the matter. Listening to Senator Browne, one would swear on a mass book that his party had never been in Government. Convenient amnesia is a wonderful state of mind and a marvellous defence mechanism, which I suppose we all should employ from time to time.

Getting back to the reality of the matter, I welcome the Bill. I hope that, with the co-operation of all concerned and with mature debate in this House, we will be able to tease out what various contributors view as not in the best interests of those concerned and find a consensus on how to address the issue.

I preface my remarks with the following. We are speaking in the main about people who have spent quite a long time in institutions. As one who in a former occupation would have had quite a good deal of contact with such people, nothing I have heard and experienced over quite a long number of years has changed my view. Although I recognise it is not the purpose of the Bill, I would dearly like to see something done about regular visits to patients in long-stay institutions. I recall that in my time working in long-stay wards, months and years would pass in which many of those patients never received a visitor. The rest of what I have stated about certain relatives is on public record.

I strongly applaud those who regularly visited their relatives in an institution. In many cases, but for the activities of the Society of St. Vincent de Paul, patients would never see a face other than those of the nursing, ward and catering staff, or indeed their fellow residents. I put on record my sincere appreciation of the Society of St. Vincent de Paul whose members unselfishly gave of their time to visit such people.

The Health (Repayment Scheme) Bill will provide for the repayment of public nursing home charges to all those who were wrongly charged and are alive, and the estates of all those who were wrongly charged and died since 9 December 1998.

This scheme will be simple to use and has been designed following consultation with and input from the oversight committee, which played a pivotal role in the compilation of this Bill and the process of ensuring that those repayments are made with the optimum effectiveness and efficiency.

The general scheme of the Health Information and Quality Authority Bill, which will be published in a few weeks' time, will also be part of a public consultation process. That Bill will provide for the establishment within the Health Information and Quality Authority of the office of the chief inspector of social services and a registration system for residential services for children in need of care, for persons with disabilities and for older people.

As I may have mentioned previously in other contributions, we are speaking of people in public institutions who were charged and whose charges were found to be illegal. We must put up our hands and say nostra culpa, and this Bill is all about addressing that irregularity.

However, there were other people who, because they could not find a bed in a public institution, had to go to a private institution. I have met quite a number of people in such circumstances who have come to my office stating that they had to use scarce resources. In one case, the total gratuity an individual received from a local firm was spent on paying for a private nursing home for his late wife because a place was not available in a public nursing home. A test case has been taken, or is due to be taken, in this regard and as the matter is sub judice I do not wish to muddy the waters. This matter must be addressed.

The establishment of the Health Information and Quality Authority, HIQA, and the office of the chief inspector of social services demonstrate the Government's commitment to quality patient care as a key driver of the health reform programme. Part of the work of the chief social services inspector will be to inspect for the first time, public nursing homes as well as private nursing homes, which are currently inspected by the HSE. Clear and uniform standards will be set down for all nursing homes and inspections will be based on compliance with these standards.

Many of our nursing homes, both private and public, provide an extremely high standard of care. However, I regret that in some cases making money has been the main objective. I do not have to remind Members what I am talking about. In some instances, standards were found to be at an outrageously low level. The local councillor or health board member provided a great service in those institutions. I previously made this point to the Tánaiste. It was a great opportunity for them to visit people known to them who were in nursing homes or hospitals and it was a familiar and friendly face for the patients concerned. Perhaps the Minister of State could re-examine this matter.

The repayments will include both the actual charge paid and an amount to take account of inflation. That is only correct. Otherwise it would be a case of giving with one hand and taking back with the other. All repayments to living persons will be exempt from income tax and repayments will not be taken into account in assessing means for health and social welfare benefits. This is to be welcomed. The normal tax and means assessment arrangements will apply to those who benefit from repayments to estates.

The scheme includes a provision to allow those eligible for a repayment to waive their right to a repayment and have the money assigned to fund one-off service improvements for older persons and persons with a disability. That might appear to be a nonsensical provision but a number of people have approached me and stated they do not intend to claim any money back. I admit there are not many people in this category but they do exist.

The application process will be as simple and user-friendly as possible while also providing appropriate safeguards against fraud and preventing the exploitation of those not in a position to manage the repayments which they will receive. The scheme has been designed and will be managed with the aim of ensuring that those who are eligible for repayments receive them as soon as possible. Priority will be given to those who are still alive, and the HSE has begun proactively identifying and drawing up details of repayments due to living persons to enable prompt repayments to be made.

Even when the deduction scheme obtained in long-stay institutions, the portion of the pension or social welfare benefit that was retained was to provide for extra comforts for the patient or resident. The utmost speed should apply in the making of payments so as to ensure the maximum number of living persons are compensated. The application process for estates has been streamlined with the assistance of the probate office. We should applaud the probate office for stepping into the breach as it will help to ensure repayments are made with the utmost speed.

Senator Browne inquired about the number of people involved. It is estimated that approximately 20,000 people who are still alive, and a further 40,000 to 50,000 estates of those who have passed on to their eternal reward, will benefit. The scheme will cost approximately €1 billion and an appropriate allocation for 2006 will be made when the legislation is passed by the Houses of the Oireachtas. There will be an independent and transparent appeals process. I do not know how the appeals process will deal with those people who had to send their relatives to a private nursing institution because they could not get a public bed but I hope a sympathetic view will be taken of the matter.

The Minister may appoint an independent overseer for the administration of the accounts of people who are not in a position to administer them. The governance of the scheme will allow the Minister to receive reports on the operation of the scheme, the appeals process and the fund established to receive donations. These reports shall be laid before each House of the Oireachtas. Legislation also provides that all accounts and funds related to the scheme may be audited by the Comptroller and Auditor General. The system cannot be more transparent than that.

The oversight committee appointed by the Tánaiste to provide an independent input into the design and monitoring of the scheme has been fully briefed on all aspects of the scheme and has provided valuable input into the legislation to date. The committee has approved the contents of the Bill. The establishment of the Health Information and Quality Authority on a statutory basis was one of the recommendations of the health service reform programme announced in June 2004. It was also proposed in the health strategy — Quality and Fairness: A Health System for You. That is another promise on which the Government has delivered.

The general scheme provides for the establishment of the office of the chief inspector of social services as a statutory office within the HIQA. This meets the commitments made in An Agreed Programme for Government in 2002, the health strategy and Sustaining Progress to establish the social services inspectorate on a statutory basis. The office will also monitor standards, except those set in regard to the personal social services which will be monitored or inspected by the Chief Inspector of Social Services. The office is being given the powers to investigate, at the request of the Minister or the executive, the safety, quality and standards of any service, except those registered and inspected by the Chief Inspector of Social Services and the Mental Health Commission, provided by or on behalf of the executive and to make any recommendations it deems necessary.

The office will also have the role of accrediting services and will be able to provide an accreditation service for the private sector. The HIQA will also advise the Minister and the Health Service Executive on the effectiveness of health technology. In addition, the HIQA will have a role in setting standards in regard to information and data on services provided by the Health Service Executive and on its behalf, and the health and welfare of the population, as well as identifying deficiencies in such information.

The chief inspector will continue the social services inspectorate's work of inspecting the child welfare and protection services. It will also be assigned responsibility for the inspection of residential services for persons with a disability and for residential services for older people, including private nursing homes.

I accept that 19 months have passed but it is never too late to do the right thing. This matter has dragged on for 30 years. Various arguments have been made about what was known but as far as I am concerned it was one of the best kept secrets in the public service. In any event, the legislation is before us and we must deal with it. We should try to deal with it as quickly as possible so that the people who were wrongly charged in our institutions — the people who built this State, namely, the elderly — receive the appropriate refunds as soon as possible.