asked the Minister for Health the reason a person (name supplied) in Dublin has not been granted full fees and maintenance to attend a school for the disabled by the Eastern Health Board while a similar case in similar circumstances was granted full fees and maintenance for the same school by the Midland Health Board.
Ceisteanna—Questions. Oral Answers. - School for Disabled.
27.
The circumstances were, in fact, different although in neither case was the relevant health board liable for the costs as the original arrangements had not been entered into with the board's consent.
In the Dublin case, application was made to the Eastern Health Board in the first place for a contribution towards the costs on the understanding that the balance would be met by private fund-raising. The health board agreed to make a contribution equivalent to what it would have paid in respect of the handicapped person's maintenance in an appropriate institution in Ireland. This amounted to £1,373.40 in 1979.
In the Midland case there were exceptional factors relating to the well-being of the whole family which, the health board felt, justified the payment of the full cost.
Is the Minister aware that the father of the disabled person in the Midland Health Board area is a medical doctor whereas the similarly if not more gravely disabled person in the Eastern Health Board area has no means, and has no opportunity of getting the fees either privately or otherwise? Having regard to the fact that the person in the Eastern Health Board area is not in financial circumstances as good as those of the person in the Midland Health Board area, does the Minister think it just that we should discriminate against the person in the Eastern Health Board area? Two people who are similarly disabled have been given an opportunity to avail of special services in the school but one health board are willing to pay and the other board are not. I appreciate the Minister's difficulty in trying to get the health board to do something about it but because this is such a serious problem which affects the future welfare of this person will the Minister consider trying to force the Eastern Health Board to help this person? I am sorry about the long question but——
The Chair could not discern any question, it was a long statement. The Deputy must have regard for other people.
Is the Minister aware of this and can anything be done?
I will do what I can by contacting the Eastern Health Board to see if there can be any improvement in that case. As far as the other case is concerned there were particularly difficult circumstances. The family had sold their house to make arrangements and the man concerned had given up his post at the time. It is not quite as the Deputy understood it. The man then suffered a serious coronary and it was in those circumstances that the health board in that case made their decision. If the Deputy wishes me to pursue the Eastern Health Board to see if anything further can be done I will do that.
I accept that, but in the first case the man had the house to sell whereas in the second case there is no father, no one to help this person whose financial circumstances are very bad. I would very much appreciate any action the Minister can take to get this grant for him.
(Cavan-Monaghan): Would the Minister agree that it is highly desirable to have uniformity in the application of various schemes as between one health board and another and that there is no such uniformity at the moment?
I agree that there should be uniformity as long as it is consistent with the principle of subsidiary functions. This is where the problem arises. We must decide in the House whether we want health boards to operate with devolved responsibility. Obviously if this happens health boards will come up with some variations from time to time some of which will be quite novel and will lead to improvements in the scheme generally. I agree that as far as possible we should have uniformity of availability to the patients and people concerned.
(Cavan-Monaghan): Is the Minister aware that in some health board areas people coming to Dublin for treatment can avail of an ambulance service on payment of a nominal sum if there is a seat available and in other health board areas they are simply out if they have not got a health card?
I will make a note of that fact. There are quite a few other variations. Things vary in relation to size and density of the population in health board areas which is something I am concerned about, particularly in relation to the Eastern Health Board area.
(Cavan-Monaghan): In some health boards they consider what they can give and in others they consider what they can withhold.
Question No. 28.