Ceisteanna—Questions. Oral Answers. - Hepatitis C Victims.

Máire Geoghegan-Quinn


1 Mrs. Geoghegan-Quinn asked the Minister for Health the reason less than one-third of the 1,600 people infected with hepatitis C have applied to the ad hoc compensation tribunal in view of the fact that there are less than two weeks remaining before the deadline expires; the reason there has been an addition to the advertisements in newspapers regarding the tribunal outlining that applications will be accepted without supporting documentation; if hearings before the tribunal will be heard on the basis of unsupported applications; and, if so, if such unsupported applications comply with the terms of the scheme of compensation establishing the tribunal. [11761/96]

Michael McDowell


19 Mr. M. McDowell asked the Minister for Health if he intends to establish a consultative council to monitor the health services to hepatitis C victims in view of the fact that he stated he would establish such council by order in December 1995; if so, when; and if he will make a statement on the matter. [11765/96]

Michael McDowell


27 Mr. M. McDowell asked the Minister for Health the way in which entitlement to services under the Health Amendment Act, 1995, will be determined; whether cases for compensation will be determined by a court or a tribunal before the services are granted; and if he will make a statement on the matter. [11766/96]

Liz O'Donnell


32 Ms O'Donnell asked the Minister for Health whether negotiations have commenced with the relevant general practitioners' bodies and health boards to deliver the comprehensive service outlined in the health care agreement between his Department and Positive Action; and if he will make a statement on the matter. [11763/96]

Mary Harney


35 Miss Harney asked the Minister for Health the plans, if any, he has to extend the deadline of 17 June 1996, for victims' compensation claims to the ad hoc hepatitis C tribunal, until after the final court judgment is delivered in the High Court hepatitis C compensation case; and if he will make a statement on the matter. [11769/96]

Limerick East): I propose to take Questions Nos. 1, 19, 27, 32 and 35 together.

It is a matter for each person who has been diagnosed positive for hepatitis C antibodies or hepatitis C virus, as a result of receiving a blood transfusion or a blood product within the State, to decide whether to pursue his or her claim to the courts or to the Compensation Tribunal. The making of a claim to the tribunal under the scheme does not involve a waiver of any right of action. During the course of negotiations between my Department and interested groups in November 1995, it was agreed that the time within which a claimant must apply would be extended, from three to six months, as is now the case in the tribunal scheme. In accordance with the tribunal scheme, claimants must apply within six months of the date on which they first become aware of the fact that they have been diagnosed positive for hepatitis C antibodies or hepatitis C virus or within six months of the date of the establishment of the tribunal, whichever date is the later. In exceptional cases the tribunal may in its absolute discretion extend the time limit and shall do so in the case of any claimant whom it is satisfied was under a legal disability by reason of minority or unsoundness of mind at the time at which such claim should otherwise have been made and who applies to it within six months of the cesser of that legal disability. It is not my intention to extend the time limit for applications any further; the closing date for receipt of applications by the tribunal is the 17 June 1996.

Since its inception the tribunal has accepted application forms unsupported by medical data or records. The tribunal records the applications when received and the claimants or solicitors are requested to supply outstanding documentation as soon as it becomes available. The tribunal had been receiving a significant number of specific inquiries from the general public and from the legal profession querying whether the lodgment of the application form without the supporting medical data or records before the 17 June 1996 was sufficient to comply with the closing date. The addition to newspaper advertisements to the effect that the application form is accepted by the tribunal without the supporting medical data or records was made to ease the concerns expressed by claimants and solicitors who may be experiencing some difficulties in obtaining medical records or reports before the closing date.

Cases before the tribunal are heard in accordance with the terms of the scheme. The tribunal relies primarily on written medical reports in its consideration of individual claims. The claimant must, no later than six weeks before the date fixed by the tribunal for the hearing, submit in writing reports prepared by doctors or other health care professionals who have treated or examined the claimant and relevant reports prepared by other experts on which the claimant intends to rely.

The tribunal has been hearing a maximum of 12 cases each sitting week and I am informed that the hearing of the cases in respect of the applications received to date will carry its workload at least to the end of 1997. Claims can be listed for hearing before the tribunal on lodgment of all the relevant documentation. I have been informed by the tribunal that any application for a priority hearing has been and will be dealt with sympathetically by the tribunal.

The total number of persons with hepatitis C who had received a blood transfusion or blood product who have been identified to date is 1,356. The compensation tribunal has to date received 639 applications — at lunch time today the figure was 652. I have been informed by the tribunal that a substantial additional number of applications is expected before the closing date. Since its commencement the tribunal has heard 63 cases. The awards made to date by the tribunal range from £15,500 to £324,321. A total sum of approximately £6.67 million has been awarded to date by the compensation tribunal and no tribunal award has been rejected. The tribunal is running smoothly, fairly and efficiently as had been envisaged and at this stage has hearing dates arranged until 31 July 1996.

The purpose of the Health (Amendment) Act, 1995 is to provide a statutory basis for the provision, to certain persons who have contracted hepatitis C, of general practitioner services, drugs and medical appliances; dental, ophthalmic and aural treatment and dental, aural and optical appliances; counselling; home nursing and home help services, free of charge and without a means test. The Bill, which passed Fourth and Fifth Stages last week, states:

A health board shall make available without charge to persons who, in the opinion of the Chief Executive Officer of the board, have contracted hepatitis C directly or indirectly from the use of Human Immuno-globulin Anti-D or the receipt within the State of another blood product or a blood transfusion and to persons of such other classes (if any) as may be prescribed.

An amendment giving the chief executive officer of the relevant health board the power to determine eligibility for the proposed services at his discretion was introduced by me on Committee Stage. Its introduction followed discussions with representatives of Transfusion Positive which was concerned that a small number of its members would experience difficulties in acquiring medical records.

In determining eligibility it is envisaged that the chief executive officer's decision would involve,inter alia, consideration of medical opinion submitted by the applicant's treating physician and that of the relevant health board's director of public health, Eligibility for the services proposed does not therefore require a determination by a court or by the compensation tribunal. There may be individuals who, for reasons best known to themselves, might not make a claim to the courts or to the compensation tribunal but who will still be eligible for services to be provided under the Health (Amendment) Bill, 1995, when enacted.

It is proposed that a range of services will be provided under the Act and preliminary discussions have already taken place with some of the relevant bodies. Detailed negotiations cannot commence until the necessary legislation is in place. As soon as the Bill has passed all stages in both Houses, I hope to finalise discussions with the health boards and negotiations with the appropriate professional groups to ensure that the services to be provided under the Act for persons who have been diagnosed positive for hepatitis C will be available to them at an early date.

In December 1995, when I announced the health care package for persons who have contracted hepatitis C, I also indicated that I would establish a statutory consultative council to advise me on matters relating to hepatitis C. A draft establishment order was circulated to interested groups and I am currently considering a number of amendments to take into account the views expressed by them. I will again consult with the interested groups at an early date and following such consultation will formally establish the council. I hope to complete this process as soon as possible.

Does the Minister accept that a significant number of victims of hepatitis C do not have confidence in the tribunal?

(Limerick East): No. There is a certain amount of contention about the tribunal which has been stoked up by unnecessary controversy, much of which was stimulated by the Deputy in this House based on inaccurate information. Some issues are still outstanding between my negotiators in the Department of Health and representatives of one of the interest groups, Positive Action. It is not true to say there is a lack of confidence in the tribunal. To date 63 awards have been made fairly and efficiently and, more importantly, no award has been rejected. That means applicants, with their legal advisers, had enough confidence in the tribunal not only to process their cases through it but to accept the awards in all cases.

Does the Minister know who the 1,356 people are?

(Limerick East): As I said in my reply, that number of people has been identified.

So they are known.

(Limerick East): Obviously I would have to go back on records, but the figure is composed of definite numbers for members of Positive Action, that is the cohort of women infected by anti-D product, definite numbers for members of the Haemophiliac Association of Ireland and definite numbers for the Irish Kidney Association. The variable includes people infected by blood rather than blood product. We are involved in a look-back programme and a national screening programme, which is continuing. That is the source of the 1,600 cases mentioned in the Deputy's question. To date the actual number is that which I have given, and that will increase as tracking and national screening continues. It is our view that the final number is nearer to 1,400 than 1,600. For three cohorts of people we have definite figures and there is a variable in respect of persons infected by blood rather than blood product.

I thank the Minister for confirming that he and the Department know who the 1,356 persons are. Why has it cost almost £1,000 of taxpayers' money per application by way of advertising by the State in national newspapers to target persons, who are already known to the Minister, to apply to a tribunal in which the Minister maintains they have confidence?

(Limerick East): I regard this as a very serious matter. It is one of the most serious issues of compensation in which the State has been involved for a considerable time and it involves enormous amounts of money. While we have very good relationships with the interest groups, it is not sufficient to deal with interest groups alone. Every individual person with hepatitis C or hepatitis C antibodies has individual rights, and not only is there a legal obligation on me but there is a moral responsibility on me to do everything in my power to ensure those people are aware that there is a tribunal in existence through which they may process their claims. I am reinforcing that opinion because only 652 applications have been made to date out of a cohort of about 1,400.

About 400 people communicated by way of initial solicitors' letters which they issued to protect their own position, but there is huge duplication between those and the 652 applications made to the tribunal — those figures have not been cross-matched. There are 1,000 people from whom we have not heard. We have received communication from 652 people plus the number not duplicated, perhaps another 200, and the number of statements of claim before the court is less than 20. There are about 600 people who for one reason or other have not communicated with the Department of Health or the Blood Transfusion Service Board by way of initial solicitor's letter indicating that they demand compensation, and who have not applied to the tribunal. In those circumstances I make no apology for spending money in bringing their rights to people's attention. There is a missing cohort at present and I hope we will receive applications from them in the next fortnight.

Unless there are deadlines, some solicitors will not complete the paperwork, and the fact that there is a deadline will ensure the paperwork is completed. We have made it very clear both in theSolicitors Gazette and in the modified advertisements that a completed application form will be sufficient to meet the deadline and that the supporting documentary evidence can be sent in subsequently. There is no change in procedure; that has been the procedure since the tribunal was set up. We felt it was necessary to advertise that fact because we received many inquiries about whether a completed application form without supporting documentation would be sufficient.

When application forms come in the people in charge of the tribunal, the registrar or secretary to the tribunal, give dates for hearings. A person would need to have sent in their case in writing six weeks before the date of hearing. This is a contentious issue and I do not mind Deputies taking a political run at me on it, but it is not in the interests of women with hepatitis C or hepatitis C antibodies to be discouraged from applying to the tribunal. It is not in their interests for me to change the date. At the rate applications are being processed, there are already sufficient applications before the tribunal to last until the end of 1997.

No injustice will be done to anybody who wants to wait to see what happens in the court case on 8 October. If that case lasts until Christmas it will still be 12 months from a hearing before the tribunal. If an application has been made to the tribunal it may be withdrawn and the person may proceed through the courts. If they proceed through the tribunal and an award is made, having considered the award for four weeks they may say that because they are not satisfied with the award they wish to proceed through the court.

The campaign being conducted to get me to extend the date of 17 June is not in the interests of individual applicants who believe the charges being made. The Deputy is ensuring that the people she purports to represent will go to the end of a very long queue. I have no doubt that she will then be back next year asking me to appoint extra personnel to the tribunal so that people will get an early hearing.

I am very concerned about the inordinate amount of time devoted to this priority question. Almost all the time available for dealing with priority questions has been exhausted on this one question. That places the Chair in a most invidious position and puts in jeopardy the taking of Questions Nos. 2 and 3. I am proceeding forthwith to No. 2.

I wish to ask a final supplementary.

I thought Deputy Geoghegan-Quinn would understand the predicament the Chair is in.

May I ask——

The Deputy can observe the clock as well as the Chair. I am calling No. 2.

On a point of order——

I am on my feet dealing with the rules of the House and I will hear no point of order. Question No. 2 should be replied to now.

I merely want to point out that the reason for the delay is that the Minister made speeches in reply to each one of the supplementaries.

That is too bad.

It is too bad for all the women victims of hepatitis C.

(Limerick East): I would be accused of not giving information if I did not give full answers and when I give full answers I am accused of occupying the time of the House.

We have spent 20 minutes on one question, which is unprecedented in dealing with priority questions.

(Limerick East): The Deputy has organised a debate on this matter for next week. She will have three hours to rehearse these issues next week in Private Members' time.