Tony Mulcahy (Fine Gael) | Oireachtas source

The Minister is welcome. I will be voting in favour of the amendment, unfortunately. It being the Government position one has to do that.

I want to clear up some issues raised by the Minister. Perhaps we should deal with the problem in the first place rather than with the appeal. I state clearly that we should not use a sledgehammer to crack a nut. The Minister rightly pointed out that 16% of young adults may be on illness benefit, invalidity benefit and disability benefit. I will include intellectual disability in that because I am a parent of a daughter who would not be able for any kind of formal work, along with many of her colleagues with whom she goes to work. We must have these issues clearly stated. I would like that 16% figure broken down into those three sections to allow us see what we are dealing with. I know a lot of my daughter's friends and they would not be able for any form of real work. I train a few young men every now and then and give them a hand but that is about the size of it.

The Minister rightly pointed out an issue. I have seen application forms being completed in general practitioner's offices and the people tick the row of boxes. I saw it happen some weeks ago when a young lad with severe autism and severe challenging behaviour just ran the biro straight down the row of boxes as if it was a normal case. I had been with his parents. I visited the house and we reapplied because it had been turned down. When I was helping the mother complete the form and I had seen the child do it, she told me the doctor ticked the boxes straight down and that I was doing it differently. I was doing it differently because the child did not meet any of the normal requirements. There are difficulties in that regard.

Last week in the House I asked a question on the number of medical assessors for domiciliary care allowance and I found out there were 27. I will ask a question tomorrow on the clinical qualifications of those 27 people. I do not want them named but I want to know their qualifications because I have seen applications being submitted on behalf of children with severe autism and severe challenging behaviour. I get many of those applications on my desk, as I am sure the Minister does, but as a parent I probably get more than the average number. Having had a full clinical assessment by clinical psychologists, child psychologists and occupational therapists within the Health Service Executive, HSE, structure from the early intervention services, those children are denied a domiciliary care allowance. There is either a problem with the clinicians who make that assessment through the HSE sector or there is a problem with the qualifications of the adjudicators on the domiciliary care side but there is a problem somewhere.

I do not send in those applications unless there is a stack of reports with them, and I have read those reports from top to bottom. I have visited the homes of those children - three in the past three months - and the three of them were declined. There is a problem. Is the problem with the HSE staff? Are they not capable and qualified people? I am not a clinician and therefore I am not qualified to assess that but I know the minute I look at the child that there is a problem. I am not a fool. I have seen the same thing all my life. There is a difficulty where these are just being fired out, so to speak. I have seen full medical assessments sent in with these applications, and one was included with the form the GP had completed. Obviously, they read the GP form but not the rest of the application.

We cannot come in here and say everything is fine and dandy because this is a global problem. The motion is long in regard to appeals. It is across the entire spectrum. Everything is not right, and there are areas we can correct but rather than get to the appeal stage we should examine the way domiciliary care allowance applications are being dealt with in the first place, who is ticking the boxes and who is turning down the applications because they cannot be right. I have seen these children. It is just not possible.

I have sent some strongly worded letters to the officers recently in which I said that unlike them, I visited the house for two hours, had a cup of tea and watched what the parents were putting up with. There may be a case for assessors doing likewise. Does the domiciliary care allowance assessor pick up the telephone and speak to the clinician who made the original assessment to determine the seriousness of the case?

We must be very clear that there is a cost to disability. I have 20 years experience of it. We should accept that and address it. That is all I ask of the Minister. She is not a miracle worker. I appreciate what she had to do when she came into office. I appreciate the scale of the problem but we do not want to throw the baby out with the bath water. There are those who are on disability benefit and illness benefit who should not be on it. I am not going to say that every application is 100% bona fide; that is not the case. I ask that we look at it and see where we are going wrong. I understand that reassessments of those on domiciliary care allowance are being done and parents have been written to but let us be clear. A child with a moderate or severe intellectual disability - in the past the term used was moderately mentally handicapped or severely mentally handicapped - does not get better. That box must be ticked. Do not deny that family for 18 years. They have enough to put up with.

The same applies to the medical card section. We need to tick that box and not write to 16 year old children telling them to reapply for the medical card when they would not even know their name on the envelope, let alone be able to read the letter inside it. Those are the areas about which we must be more compassionate, and we can do that in our systems. We can tick a box. It is not that difficult, but let us examine what we are doing and where we are going wrong. Let us get back to the beginning in terms of how we make the decisions.

Having read through the Minister's reports I am aware that half of the appeals are being won and therefore it is obvious they are being assessed wrongly.