John Minihan (Progressive Democrats)

I join with previous speakers in welcoming the Minister of State and his officials to the House. Just three weeks ago, we discussed ageism. In my contribution, I referred to research that noted the perception that the State does not do enough for older people. I said there was an onus on all of us to take steps to counter ageism, as well as highlighting the positive steps that are being taken specifically for older people. It is hard to know where this Bill and the problem that led to it, fits into all of this.

The Government fully accepts the Supreme Court decision that the retrospective imposition of charges on fully eligible persons for their publicly-funded, long-term care was unlawful. People with medical cards in public nursing homes, welfare homes or in contract beds which were established subsequently in private nursing homes, were illegally charged. That was the heart of the problem. It is right to establish the legal framework for making repayments to those who were wrongly charged and to pass this Bill as quickly as is reasonable, so that those who are due repayment will receive it as soon as possible.

The unlawful practice that brings us to today's legislation has been rooted in law for over 50 years. Health boards in this country have levelled charges for publicly-funded, long-stay residential care under two sets of regulations — one dating from 1954 and the other from 1976. Over the years, health boards, with the knowledge of the Department, continued to levy these charges right up to December 2004. At that point, the Department instructed the health boards, on the advice of the Attorney General, to stop these charges on eligible persons.

I commend the Tánaiste on grasping the nettle on an issue that has gone on for decades. Since doing so, the Government has taken reasonable steps to right the wrong. For example, the Government agreed to payments of up to €2,000 to those illegally charged who were alive on 9 December 2004. The Health Service Executive has paid more than €21 million to approximately 11,000 or more individuals under this plan. The Government is to be commended on providing this scheme which is specifically designed to be more attractive than taking litigation in the courts.

It is correct that repayments to those who are alive, or to their living spouse, will not be subject to income tax, and that those persons in receipt of repayments will retain their current social welfare pensions or allowances and their full eligibility entitlement for medical card status. Furthermore, repayments under the proposed scheme will not be considered when assessing entitlements to subvention.

Most important is the determination by the Government that the repayment process will be as simple and user-friendly as possible. Ironically, when we were discussing ageism here last month, much was made of the issue of stereotyping. The Irish Senior Citizens Parliament, among others, has warned against any generalisations — even those motivated by good intentions — about older people. In considering this Bill, it is difficult not to be mindful of the age and vulnerability of many of those to whom repayments are due. If this makes one guilty of stereotyping, then it is a misdemeanour motivated by a genuine desire on the part of the State to aid vulnerable citizens. One wonders if it is possible to act in such a manner without stereotyping.

There can be no doubt that avoiding an adversarial, inflexible and enclosed scheme is the right thing to do. Given the circumstances, the State should minimise inconvenience and the legal bill incurred by people wrongly charged. The same consideration should, of course, be given to their families, representatives or estates depending on the circumstances.

I am satisfied that many, if not all, representatives have moved beyond the usual political arguments and have instead focused more readily on the intention of the Bill before us. This is a Bill to introduce a scheme to repay wrongfully imposed charges to eligible persons, and it is right that there is broad political support for it. One aspect that has drawn particular attention is the HSE's procurement process for the logistics of the repayment scheme. The HSE's first procurement process generated many expressions of interest to design and administer the scheme. I understand that the HSE decided to re-run the competition for value-for-money and technical reasons.

As a public body, the HSE must, and does, manage its procurement processes independently and on objective criteria. A new procurement process was put in place and advertised in the Journal of the European Union last February. The HSE selected its preferred bidder on 1 June and, as we are currently inside the normal 15-day period when other bidders have the right to lodge objections, I do not wish to comment further at this stage.

Contrary to some views, consideration was given to the involvement of public sector staff in assisting with the administration of the scheme. From what I understand, however, the HSE informed the Department that the time constraints, potential for logistical difficulties and protracted delays made such an option undesirable. Dedicated HSE resources would have to be assigned and HSE staff would have to be specially trained. They would need dedicated supervision and would have to leave their regular duties, which would impact upon regular services. The commencement of the entire repayment scheme could be detrimentally affected, which is something I am sure all Members of the House would rather avoid.

I welcome the legislation. I commend the Government and, in particular, the Tánaiste on demonstrating the political will and ability finally to tackle this issue, which had rumbled on under a number of Governments. Following the Supreme Court decision, the Cabinet sub-committee considered its implications and correctly decided that money received by the HSE from the unlawful imposition of charges would be repaid. Charging for long-stay care has now been put on a statutory footing under the Health (Amendment) Act 2005, which is being implemented.

Of great importance to me and my party colleagues is the recognition by the Government that, regrettably, many of those patients due a repayment have varying degrees of mental impairment. It is imperative that the proposed scheme provides appropriate safeguards to prevent fraud. Though unpalatable to conscience, there are those who would exploit persons who receive payments and are not in a position to manage their own financial affairs. In light of this sorry fact, I welcome the legislation's provisions to allow repayments be placed in patient private property or PPP accounts, although this is not the normal understanding of PPPs. I understand these are to be employed to ensure repaid money is used for the benefit of the patient and that the money held in these accounts can be invested on behalf of the patient. The House will no doubt join me in welcoming the statutory framework to protect patients' interests, particularly where sizeable repayments are made.

The key, of course, is to simultaneously provide safeguards and autonomy for patients. I was heartened to hear the Department's acceptance that clarity and consistency are needed regarding these PPP accounts and I am interested to hear of Government plans to appoint an independent overseer in regard to the administration of these accounts. I hope the Minister will shed light on this issue. I welcome the Bill and commend the Tánaiste and the Government on their work to address a long-running and thorny problem. I hope that on every Stage it is the concerns and needs of the patient that remain our focus as we progress the Bill.