Breeda Moynihan-Cronin (Kerry South, Labour)
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Question 43: To ask the Minister for Health and Children the position regarding the 2005 introduction of charges for long-term residents on medical cards in mental health institutions; if she has satisfied herself that residents and their families are informed and supported by the Health Service Executive regarding changes; if her attention has been drawn to the pressure applied to medical card holders to pay bills; and if she will make a statement on the matter. [12011/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health (Charges for In-Patient Services) Regulations 2005 provide the statutory basis for the imposition of charges for persons in receipt of inpatient services whether or not such persons have full (medical card) or limited eligibility. These regulations provide for two different classes of person on whom charges can be levied and the maximum charge which can be imposed in respect of each class. With effect from 14 July 2005, charges may be levied on persons who are in receipt of in-patient services in premises where nursing care is provided on a 24 hours basis, and in premises where nursing care is not provided on a 24 hour basis. The Regulations provide for a different level of charge in respect of each class, as set out below.

Class 1 refers to people in receipt of in-patient services on premises where nursing care is provided on a 24 hour basis on those premises. In this case, a weekly charge of €120 can be levied or the total weekly income of that person less €35, whichever is the lesser. Class 2 refers to people in receipt of in-patient services on premises where nursing care is not provided on a 24 hour basis on those premises. In this situation, a weekly charge of €90 can be levied, the total weekly income of that person less €55 or 60% of the weekly income of that person, whichever is the lesser.

In July 2005, the Health Service Executive (HSE) informed all patients (or their representatives) currently in their care that patients could be liable to pay a weekly charge in line with the 2005 regulations. Patients were advised that the amount of the weekly charge was subject to a financial assessment. Patients admitted after July 2005 are informed that they may be liable for a charge under the 2005 regulations and that a financial assessment will be completed.

The purpose of the financial assessment is to ascertain the weekly income and outgoings of the patient to ensure that payment of the charge does not cause undue financial hardship to the patient. Following the completion of the financial assessment, the HSE informs the patient and/or his/her representative of the charge that will be raised in respect of in-patient services. This letter includes information on how the charge is calculated.

The patient or his/her representative is also advised that they should contact the local administrator if they believe that payment of the charge would cause them undue hardship. Where appropriate, next of kin or patient representatives are also informed of the process in place for raising the charge and given the opportunity to advise on any expenses the patient incurs on a weekly basis. The patient, or their representative may also appeal the charge applied if they are unhappy with the decision.

The patient or his/her representative are advised that they have a choice regarding how the charge is collected. The HSE can invoice the patient or their representative on a monthly basis or the patient may choose to ask the HSE to become an agent on their Department of Social and Family Affairs payment book. If the patient chooses the latter, the HSE arranges to deduct the charge from the DSFA weekly payment. The remainder of the money from the DSFA weekly payment is either given to the patient or lodged to the patient's individual Patients Private Property Account, whichever is more appropriate.