Charles Flanagan (Laois, Fine Gael) | Oireachtas source

It is with reluctance that I will not accept Senator Ruane's amendment. I wish to highlight to the House that during the Second Stage debate earlier this week, I indicated that the Bill arose from the Government decision of May 2018 that the Magdalen restorative justice ex gratiascheme should apply to those women who were resident in one of 14 adjoining institutions and who worked in the laundry in a Magdalen institution. The Government decision was taken to give effect to a recommendation of the Ombudsman. From a technical perspective, the Government decision extended the scheme to a new cohort of persons. As part of that decision, the Government decided to extend to this new cohort all the benefits, including health benefits, which apply to the original cohort of women who were covered by the scheme.

I note that Senator Ruane's proposed amendment makes specific reference to health benefits, as the Senator mentioned in her contribution. This proposal to undertake a review falls outside the scope of the Bill to my mind. I reiterate a point I made on Second Stage. This is a short, technical Bill which deals only with extending the provision of health services to this new cohort of women. It is separate from the Quirke report. The Act provides for a range of primary community health services. The service provided in the context of the principal Act in respect of women who qualify under the scheme addresses the health circumstances that are typical of the over 60 age cohort. Three quarters of the Magdalen cohort were reported as being 60 years or over.

Separate from this circumstance, men, women and children who contracted hepatitis C through the administration within the State of contaminated blood and blood products are entitled to healthcare services under the terms of the Health (Amendment) Act 1996. There are certain eligibility criteria which a person must meet before being awarded the HAA card, including confirmation that the applicant has hepatitis C as a result of having received contaminated blood and-or blood products. The arrangements in respect of the HAA are clearly based on a person having been infected with hepatitis C and, consequently, hepatitis C-specific medicines and treatments are covered by that card.The health and social care services being provided in these respective circumstances are for specifically designated purposes. They are also individually focused to meet the health needs of what I might describe as somewhat or indeed very different cohorts of persons requiring access to packages of targeted health supports. On the matter of the setting up of the ex gratiascheme, Mr. Justice Quirke pointed out that the scheme introduced under the 1996 Act was aimed specifically at those who contracted hepatitis C as a result of contaminated blood transfusions. Some of the benefits were not directly applicable and the scheme would require suitable adaptation. The scheme proposed for the Magdalen women does have such adaptations. People suffering from hepatitis C required some products outside of the normal range of drugs available. In this scheme, provision is being made for a number of health services to be provided by referral by a medical practitioner or nurse. I wish to emphasise that the rationale for this measure is not intended in any way to restrict access, as the focus is firmly on the health needs of the women. Rather, the objective of such referral is to ensure that the healthcare provided will be appropriate and will be co-ordinated so as to enhance continuity of care through the general practitioner, who is the primary contact with the health service for any individual. In this way, referral will ensure that all care provided will be most appropriate to the need of each participant.

The effect of the amendment is to seek to oblige me to carry out a review of entitlements to services provided under two distinct pieces of governing legislation, and to make a report to each House of the Oireachtas on the findings of such a review. It is important to note that the Department of Health has already developed separate packages of targeted health supports specifically designed to meet the respective needs of each particular circumstance, with each then underpinned by the appropriate legislation. As the health supports and the necessary legislative basis to underpin them have already been identified and clearly established, it is unclear what purpose a review in the manner proposed could usefully serve at this time.

Furthermore, the amendment would almost certainly have cost implications on the health service over a period of time. It seems clear that the amendment extends beyond the discrete purpose of this specific legislation; therefore, I am not minded to accept it as submitted. As far as I am concerned and having discussed the issue with some of the women directly involved, the object of this legislation is to give effect to the recommendations of the Ombudsman. That is what the Bill is all about. Having regard to the focus of the Bill, discussions I have had with the Ombudsman, and the need to work through the recommendations of the Ombudsman in a progressive manner, to ensure the women are paid and to ensure the State accepts a measure of responsibility in view of the Ombudsman's recommendations, I do not intend to depart from the fundamental goal of the Bill.