Michael Ring (Mayo, Fine Gael)
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Question 165: To ask the Minister for Health and Children the number of claims pursuant to an Act (details supplied) that are outstanding; the reason they are not being finalised and paid. [44259/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health Service Executive (HSE) has responsibility for administering the health repayment scheme in conjunction with the appointed scheme administrator K.P.M.G. and McCann Fitzgerald.

The HSE has advised my Department that to date over 35,000 applications for living and deceased patients have been received by the Health Repayment Scheme. Approximately 33,000 of the claims received by the Scheme Administrator have been processed, which includes almost 19,000 offers of repayment totalling more than €362 million and in excess of 14,900 payments have been made totalling over €317m. Further offers continue to be issued every week.

The Scheme is progressing as speedily as possible and every effort is being made to settle claims as quickly as possible. However, there are a number of factors which have affected the length of time it takes to process a claim.

A very high number of deficiencies have appeared on claim forms which must each be rectified before they can be processed. It is estimated that approximately two thirds of all claim forms were submitted without some critical piece of information which meant that the claim could not be processed until the Scheme Administrator had written to the potential claimant and requested the information required. In addition, in excess of 75% of all Form of Entitlement forms submitted were deficient. The HSE and the Scheme Administrator has taken a proactive role in addressing this issue — the clearing of these deficiencies demanded significant time and resources on the part of the HSE and the Scheme Administrator so that they could be cleared.

Over 13,400 estates who have lodged claims did not have a grant of representation, as required by law, and the Scheme Administrator has had to establish probate before the claim can be progressed. This is to ensure that the person entitled to claim on behalf of an estate is the person who ultimately receives the repayment. The probate process can typically be a lengthy one — however a special system established for the purposes of this scheme has significantly reduced the waiting period. The majority of certificates of entitlement have now been issued and this has facilitated people in proceeding with the application proper. The requirements of the Health (Repayment Scheme) Act 2006 rightly place a strong emphasis on detail and on ensuring that a person is entitled to make the application and would be the rightful recipient of any potential repayment. For example this would be particularly important in determining who would be eligible in the case of a deceased person where no grant of probate was made and where several family members might make an application for repayment.

The HSE has advised that it is anticipated that the remaining offers, upwards of 300, will be processed by the end of the year. However, it should be noted that the repayments offered cannot be paid until the statutory 28 day period for appeal has elapsed and a completed acceptance form has been returned to the Scheme Administrator. In addition, claimants who receive offers must be given the opportunity if they so wish, to appeal the Scheme Administrator's decision.