Wednesday, 14 June 2006
Health (Repayment Scheme) Bill 2006: Report and Final Stages
I move amendment No. 1:
In page 10, between lines 36 and 37, to insert the following:
"(3) Where the Executive makes an application pursuant to subsection (2)(c)
(i) at least 28 days' notice shall be given to the patient in question and/or, as appropriate, to the patient in question's next of kin, and
(ii) the patient in question and/or, as appropriate, the patient in question's next of kin, shall have the right to be heard at, and to make submissions to, the hearing of the Circuit Court in whose circuit the hospital or other institution, as the case may be, is situated,
in respect of any such application.".
The amendment concerns the fact that the patient has a right to know if the Executive is to take money from his or her private property account. I recently received a query concerning a constituent's elderly mother in a nursing home. She was told that money would be taken from her account to buy her a wheelchair or crutches. Will the Minister of State clarify the position that obtains in such cases? While I understand it may be necessary to take money from accounts every so often for various reasons, I believe it is not warranted for the purchase of an aid or appliance for a person who might only avail of it for a year or two and then leave it behind when he or she passes on. I am concerned that section 9 of the Bill is open to abuse and it is very important that the Department monitor the system to ensure that, where the HSE is removing money from patients' accounts, it, the executive, has clear guidelines determining how much it should remove and the reason therefor.
Patients and their families should know exactly what they are paying for. As far as I was aware, aids and appliances such as wheelchairs and crutches were exempt from the charges. My amendment seeks that patients or, in the case of their being incapacitated, their next of kin will be given 28 days notice if money is to be taken from their accounts.
I second the amendment. This is a rather grudging Bill. None of us wanted to delay its passage because it has taken so long to introduce it and deal with the issue. Those who have had money taken from them for years, not through the fault of the Minister of State but through that of various Ministers and the Department over the years, should be in a position to know what is happening and be given plenty of notice. The Fine Gael amendment goes some way towards ensuring transparency regarding this issue.
It is very disappointing that so little money has been paid to people since we recognised it had been taken illegally. The children of those who are no longer alive may not pursue claims but we have a great responsibility to ensure that those who are alive are informed properly and not treated like children. It should be recognised that they have a right to know what is happening to the accounts.
I am not in a position to accept the amendment because, in certain instances, it may prove difficult to identify and contact the next of kin of the individuals concerned. As an alternative, the Bill stipulates in subsections 9(4)(a) and 9(4)(b) that an account holder will be informed in writing of the intentions of the HSE and that the HSE will place an advertisement in a national newspaper outlining that it intends to apply to court to expend moneys on behalf of patients residing in a certain institution. It is open to any person who so wishes to make an application or submission to court in respect of any such application by the HSE. The court, after considering the matter, will give a direction that the judge considers to be in the best interest of the patient. Section 9(4) is deemed sufficient for this purpose. Deputy Twomey tabled an amendment similar to that of the Senator but it was rejected following much consideration in the Dáil.
The HSE has already begun to examine the regulation of patient private property accounts and has established a working group in this regard to deal with their administration. The main function of the group will be to ensure that the administration of the accounts meets all legal and regulatory requirements; operates in the best interest of patients in as responsive a way as is practical; takes appropriate account of the input of patients' relatives and friends in so far as this is practical; and is consistent with best practice in respect of financial controls, transparent accountability and corporate governance arrangements. It should be efficient and represent value for money in the use of scarce staff and other HSE resources. The HSE will be providing the guidelines, which will be ready pretty soon.
We must be sensible about the scheme. It is not possible to make any payments until the Bill is passed. I appreciate the support we received from Members on all sides in progressing the legislation. As a goodwill gesture, we made an ex gratia payment, of which just under 11,000 people availed. It is not a matter of the Government wishing to delay payment because it is important that it put in place proper safeguards to ensure the money is given to those who deserve it and from whom it was wrongly taken. I hope the announcement of the independent company involved in the administration of the scheme will be made later this week and that the whole process can be completed shortly thereafter. We will see the repayments being made as quickly as possible.
I move amendment No. 2:
In page 13, between lines 32 and 33, to insert the following:
"(9) Any Fund established under subsection (1) shall be so established for an initial period of 3 years only.
(10) After the expiration of 3 years from the establishment of any Fund under subsection (1), the Minister shall make a determination as to whether the Fund should continue in existence."
This relates to the fund accruing on foot of the forfeiture of compensation due to one as a result of one's donating it to the HSE. Fine Gael is concerned that there is no time limit on the spending of this money. In reality, it is most unlikely that it would not be spent but we are specifying that it be spent within a three-year period. It should not be syphoned off for different projects over time. If part of a fund remains three or more years after its establishment, the Minister should make a determination on whether the fund should remain in existence. I propose a time limit on spending the money in the fund.
I do not accept the amendment because it is the intention that not only those who are due repayment will be able to donate money to the fund but that others will also be able to do so. Any money donated to this fund will not be subject to capital acquisitions tax liability. Reports on the operation of the fund will be laid before each House of the Oireachtas. The amendment as proposed would lead to practical difficulties if any money remained in the fund after a period of three years. This fund can accept moneys other than those donated through the repayment scheme and it would not be practical, therefore, to discontinue the fund if money remained in the fund at the end of the three years.
It is envisaged that the fund will be administered by the Health Service Executive, which will include managing and assigning the moneys and accounting for and reporting on the fund. If it is not practicable to assign funds to a specific unit, funding should be ring-fenced for the same service in the same area. The HSE intends, as soon as possible, to establish a working group incorporating representatives of the service areas and finance to agree the criteria for selecting the service improvements that will benefit from the disbursement of the fund.
We are setting up the fund but one would need a magic wand to predict the type of funds that will be made available. We are offering the opportunity to the people making a donation to the fund to express a wish as to the way they would like the money spent and we will try to facilitate that request as far as is possible.
I thank the Cathaoirleach and the Minister of State, Deputy Seán Power. I thank also my colleagues, Senators Browne and Henry, for their contributions and the responsible manner in which they applied themselves to the passing of the Bill. It is important that a situation that has obtained for some 30 years and beyond would be corrected and this Bill seeks to do just that.
My views are on public record. I hope the people who had money taken from them illegally will be in their health to receive it although, regrettably, a number of them will not. I hope the money that goes to relatives will be put to some good use. As somebody who worked in psychiatric services for many years, I applaud the people who regularly visited their relatives and I exhort those who have not made it a practice to do so. Such visits are very important for the mental health and general well-being of these people, although I accept that in some cases relatives cannot do that. I appreciate the support and co-operation of my colleagues on the other side of the House.
I thank Senator Glynn for his comments and the Minister of State and his officials for their help and explanations during the debate on the Bill.
I welcome the passing of the Bill, although I have reservations about some aspects. We will all watch with keen interest the outcome of the court cases concerning those who were forced to go down the private route, who tried but were unable to get a bed in a public nursing home. In one respect I hope they are successful and in another I hope they are not because I am aware of the bill that will arise from that. I hope we have all learned from this experience. This issue has been going on for the past number of years. There was ambiguity over it and we finally have closure on it. It is vital, however, that the money is given to those who are owed it. The State is very quick to take money from anyone who claims an overpayment and it is only fitting that the State would pay back the money overcharged.
It is vital that the Minister examines the issue of nursing home charges to ensure patients are fully aware of what they are liable for in that regard. When one gets a call from a nursing home to say it is taking money out of one's elderly relative's account, be it a father, mother, uncle or aunt, for a particular aid and appliance, one is in a vulnerable position because one must assume the nursing home is telling the truth. We do not want a scenario to arise where people must give back money they should not have been paid and then subsequently cases arise where money was taken out illegally on top of that. We must be careful to monitor that.
I hope this private company — we do not yet know its name — gets the work done within the two years. I still have not received a reply to my freedom of information request. I hope it will be cheaper in the long run, that it will get all the work done within the two year period and that we can all move on. I hope also we will not follow the line of the Army deafness claims, the redress board or other cases where budgets were overrun and timeframes extended.
I welcome the Bill. I would have preferred to see various changes in the Bill but at least it is a start. I hope the private company involved, the HSE and the Department of Health and Children will ensure that those who are owed money get it as soon as possible. Unfortunately, many of them are now deceased but those who are still alive can put it to good use.
I congratulate the Minister of State on bringing the Bill through the House. I have many reservations about it; I am sure we will get many complaints and court cases will arise out of it. This process should be a lesson to us in that the Government and Departments can take money from people quickly and easily but it is very difficult for people to have that money repaid to them.
This is not the only area where this happens. I had an experience in the not too distant past where, having been undertaxed for years, which I was unaware of, I was asked to repay thousands of euro. I was able to pay up but there are people who would not find it quite so easy to pay up. They would have spent what came in to them over the years and then find themselves in a very difficult position. I mentioned it to a woman who told me she had a similar experience and it has taken her 18 months to pay back a much smaller sum before she could get a pension. It is very difficult when money is demanded from one at short notice by a Department. I am not complaining about my case but it would have been nice if they had sent on the pension when they got the cheque from me months ago. These things happen, however, but this has been a very slow procedure for those who had money wrongly taken from them in the past. I hope, as Senator Browne said, that the firm chosen to get involved in the distribution of the money gets into action promptly and these people are repaid the money taken from them illegally as soon as possible. I congratulate the Minister of State and his officials on bringing the Bill through the House.
I thank the Senators for their comments. The issue of repaying this money has attracted much attention for over 12 months. We are happy with the broad support we received from Senators and Deputies as we tried to bring the legislation through both Houses. I thank them for their assistance in that regard and the contributions they made.
I thank the officials in the Department of Health and Children for their hard work. Much of the work involved in drawing up the legislation and much of the consultation that had to take place before the legislation was drawn up goes on behind the scenes and people are not aware of the effort that goes into it but I thank them most sincerely for the hard work they have done.
The Government made a promise, following the Supreme Court decision, that we would repay the money and it was a question of trying to work out the best system to use. The main priority was that, apart from giving the commitment to repay the money plus interest, we would try to introduce a system that was a simple as possible and that people would feel happy making their application. It was clear that the whole application process should be straightforward and we would have as little red tape as possible. We set up a helpline which people could contact to put in their applications and register. We also had the ex gratia payments. We have many of the details on it, therefore, and we are anxious that the moneys be paid out as quickly as possible. We made a promise following the decision of the Supreme Court. I am delighted we are honouring that promise. The legislation has not gone through as quickly as we had hoped, but a number of issues had to be dealt with and it was important that we put in the appropriate safeguards to protect those who might not have the functional capacity to manage their financial affairs. I am quite happy that those safeguards are contained in the legislation. As the Bill is now passed, the legislative hurdle has been cleared. It is now a matter for the processing of the applications to commence. I hope the repayments will be made in the near future. I thank everyone for their assistance in making it all possible.