Joan Burton (Dublin West, Labour)

Ba mhaith liom comhghairdeachas a dhéanamh leis an Seanadóir as bheith sa suíochán sin. Is mór an onóir dom a bheith ag caint anseo inniu ar an chéad lá don Seanadóir a bheith ann.

I welcome the comments made by Senators Moloney and Moran in respect of this important issue. In the first instance I wish to state that I understand the concerns that parents and guardians have been expressing in recent months.

Domiciliary care allowance is currently paid to over 24,000 parents and guardians in respect of 26,000 children. The approximate cost in this regard in 2011 was €100 million, with the accompanying respite care grant costing a further €45 million. As the Senators will be aware, some parents are also in receipt of carer's allowance in respect of their children. In addition, the Department makes an extensive range of payments to support families with children. In 2011, some €2.08 billion was paid out in the form of child benefit in respect of 1.13 million children. Qualified child increases were also paid to people on social welfare payments in respect of some 495,000 children.

Domiciliary care allowance is a monthly payment to the parent or guardian of a child with a disability so severe that he or she requires care and attention and-or supervision substantially in excess of that which would be given to another child of the same age. This care and attention must be provided to allow the child to deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months. Domiciliary care allowance cases are routinely reviewed to ensure that the conditions for receipt of the payment continue to be met. Cases are reviewed based on either, one, a scheduled review based on the recommendation of the medical assessor when the claim is initially processed - I emphasise that assessments in respect of domiciliary care allowance are medically based on the advice available from the child's and parents' medical doctors and experts and on the medical experts in the Department of Social Protection who then review medical evidence that has been put forward - or, two, on the basis of information received about a change of circumstances which potentially affects the continued entitlement of a case already in payment.

Scheduled reviews, on the recommendation of the medical assessor, are based on the prognosis of the child's disability and how his or her condition may improve over time. The review interval will vary from 12 months in cases where the child's disability is likely to improve significantly in the short term to a five or ten-year review date if the child's condition is likely to remain unchanged for the foreseeable future. In circumstances where a child has a lifelong disability that is unlikely to improve by any significant degree, a "do not review again" status may be used.

Domiciliary care allowance reviews are initiated with the parent-guardian being asked to complete a "review of medical criteria form", which I want to emphasise, which also requires medical input from the child's GP. The parent returns this form together with any additional recent reports of ongoing medical or therapeutic services the child may be receiving. This information is then sent for review by one of the Department's medical assessors who will provide an opinion to the deciding officer on whether the child still meets the medical criteria for receipt of the payment. The decision of the deciding officer is communicated to the customer in writing and he or she is given the option to appeal to the social welfare appeals office.

Any new or additional information received after the issue of the revised decision and before the appeal is heard is further assessed by a medical assessor. In this way the review process affords parents-guardians every opportunity to provide additional information and to have this information assessed at an early stage with payment restored, where necessary, in advance of an appeal hearing.

I very much welcome this topic being raised. I have heard the concerns of parents and guardians in recent months regarding the domiciliary care allowance review process. Up to now 21 days has been allowed for the return of the completed review form and supporting documentation, with flexibility allowed where some additional time is needed to obtain specific reports. However, following a review of the 21-day timescale, it has been decided to extend this to 60 days and also to inform the parents-guardians when their payment is initially awarded of the review date that will apply to their child's case.