Céisteanna—Questions. Oral Questions. - Compensation Tribunal.

Máire Geoghegan-Quinn

Question:

1 Mrs. Geoghegan-Quinn asked the Minister for Health the number of applications which have been made to the hepatitis C tribunal; the anticipated number of cases which are expected to be lodged; the number of cases heard to date; the cases, if any, which have been rejected by the tribunal; the plans, if any, he has to include in the terms of the hepatitis C scheme, provisions for indefinite postponements of hearings before the tribunal; and if he will make a statement on the matter. [17059/96]

Brian Cowen

Question:

29 Mr. Cowen asked the Minister for Health if his attention has been drawn to the concern of some applicants regarding the awards made by the hepatitis C Tribunal; and if he will make a statement on the matter. [16933/96]

Limerick East): I propose to take Questions Nos. 1 and 29 together.

To date 1,631 applications have been made to the Compensation Tribunal, of which 1,483 are primary claimants, 83 are dependants and 65 are carers.

In accordance with the tribunal scheme, claimants must have applied within six months of the establishment of the tribunal, that is, on or before 21 June 1996, or must apply within six months of the date upon which they first became aware of the fact that they have been diagnosed positive for hepatitis C antibodies or hepatitis C virus. In exceptional cases the tribunal may in its absolute discretion extend the time limit and shall do so in the case of any claimant who it is satisfied was under 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. The number of additional applications that may be made to the tribunal cannot be anticipated.

The tribunal has heard 140 cases to date, making 139 awards and disallowing 1 claim. The awards made by the tribunal to date range from £15,200 to £332,756 and no award of the tribunal has been rejected. There is one award which is the subject of judicial review proceedings. The total amount of the awards made to date is approximately £15.5 million.

The scheme provides that the Minister for Health, if he considers it appropriate may amend the scheme, but no such amendment shall operate to remove, restrict or diminish in any way rights or benefits conferred on persons entitled to claim under the scheme in its unamended form. As I have already stated in the House, if I have evidence and I am convinced that the workings of the tribunal are not serving the very best interests of the claimants, or if in my opinion such amendment would improve the scheme, I will use my powers under the scheme to ensure that the tribunal is at all times meeting the needs of persons infected with hepatitis C. As I have already stated in the House, I have been informed by the tribunal that no applicant will be compelled to have his or her case heard without agreement to the date fixed by the tribunal for the hearing. The tribunal has also informed me that to date no hearing date has been allocated to a claimant unless such a date has been sought by the claimant. The tribunal has also informed me that an additional 100 hearings have been scheduled up to 15 January 1997 with a further 40 claims currently awaiting hearing beyond that date. I am satisfied that the tribunal is running smoothly, fairly and efficiently as I had envisaged at the outset.

I would like to inform the House that the Health (Amendment) Act, 1996, came into operation on 23 September 1996. Deputies will recall that this was a central feature of the health care package which I agreed with the various representative organisations.

Persons eligible to receive services under the Act are those, who in the opinion of the chief executive officer of a health board, have contracted hepatitis C directly or indirectly from the use of anti-D product or the receipt within the State of another blood product or a blood transfusion. Eligibility is determined on an individual basis without a means test and applies for the lifetime of the eligible person.

The services to be provided by the health board free of charge to eligible persons under the Act are: (a) general practitioner medical and surgical services; (b) drugs, medicines and medical and surgical appliances; (c) the nursing service specified in section 60 of the Act of 1970 — (home nursing); (d) the service specified in section 61 of the Act of 1970 — (home help); (e) dental, ophthalmic and aural treatment and dental, optical and aural appliances; (f) counselling services in respect of hepatitis C; and (g) such other services as may be prescribed.

At my request each health board has appointed a liaison officer to ensure the smooth operation of the delivery of services under the Act, to act as a contact point for individuals and with the various interest groups whose members will be availing of services under the Act. My Department will continue to maintain contact with the representative organisations and the health board liaison officers to ensure that any initial problems that may arise can be tackled quickly and effectively.

Less there be any doubt about the matter I wish to confirm to the House again that whatever resources that are required to implement the Act fully will be provided by the Government. These new primary care services are, of course, in addition to the special hospital in-patient and out-patient services which have been established and developed over the last two years. A sum of £2 million was provided for these services this year.

There are two other remaining elements in the health care package to which I would like to refer. I have agreed to establish a statutory consultative council on hepatitis C. My Department has had discussions with the representative organisations on the contents of a draft establishment order. A further draft of the order was sent to the representative organisations in recent weeks for their views.

This new draft takes account of the earlier views of the organisations. As soon as I have received their responses to the latest draft of the establishment order, which I believe will be positive, I will be setting up the consultative council.

The final element of the health care package involves the establishment and funding of a special programme of research on hepatitis C under the aegis of the health research board. This programme will include research projects into hepatitis C as it relates to persons infected through the use of anti-D.

I have allocated £100,000 for this year in respect of suitable projects. I understand that there has been a good response to the health research board's public advertisement for research proposals and a decision on projects to be funded will be taken by the board in the near future.

I thank the Minister for his comprehensive reply in regard to which I wish to ask a number of supplementaries. Will all persons screened under the national screening programme who were diagnosed as having hepatitis C qualify for health care and will they be eligible to go before the Compensation Tribunal? What role will the Blood Transfusion Service Board continue to have regarding hepatitis C victims? Will theex gratia payment scheme continue? How will confidentiality be maintained when hepatitis C victims apply for their hepatitis C cards?

(Limerick East): Approximately 58,000 to 59,000 persons were screened. As the Deputy will be aware, the vast majority of those screened negative. Therefore, all those screened would not all be eligible for free health care as there is nothing wrong with the majority of them. The persons who would be entitled to free health care would be those who screened positive.

Under the screening programme.

(Limerick East): Yes. A list of those people is available. There is not any issue outstanding between my officials and the representative groups in regard to those who qualify. That matter is agreed.

On the role of the BTSB and the continuation of theex gratia payment scheme, that scheme was put in place to fulfil a need at a particular time and it is proceeding. I have not asked a question concerning the position of a person who accepts a compensation award. I presume such an award would represent a full and final settlement and such persons would not be entitled to further ex gratia payments, but persons awaiting a hearing will continue to be covered under the scheme. The BTSB also has another role, to quickly provide information in its possession as a result of the screening programme, which would be essential for persons who bring a case before a tribunal or before the courts. The board has the documentary evidence linking particular persons with a set dosage of anti D products or blood transfusions. As the Deputy is aware, all that needs to be established before the tribunal is the link between the blood product or infected blood and the incidence of hepatitis C from which a person is suffering.

We have stressed that confidentiality is required, but it cannot be guaranteed. In terms of the context of the problem, there is a given number of people who are entitled to free medical care. To ensure that this care is given to those entitled to it, but only to those entitled to it, some form of identification is necessary. It has been done by way of application and a specific card. We have liaison officers on the health boards who will, in effect, have a list of the people who are eligible within their own board area and we have stressed that everything must be treated with absolute confidentiality.

In addition, the service will be provided by a person's own GP, and unlike the medical card situation, the service is not confined to practitioners on the GMS list. One may go to one's GP, family doctor, or another doctor who is not on the GMS list, so the confidential relationship which at present pertains between a specific person and their GP, who would now be aware of their condition in respect of hepatitis C or the antibody, would apply.

I am confident that confidentiality will be maintained and we have made it a priority in the operation of the scheme. The Deputy will be aware that the interest groups involved and the individual applicants for this new service are very concerned that confidentiality should be maintained. I have stressed this continually in my dealing on this matter.

What additional resources have been made available to the health boards specifically for the operation, administration and putting in place the services for hepatitis C victims? What details of such services will be available in the annual reports of the health boards, given the Minister advised that there would be details?

Research was to be undertaken and published on the area. Did it get lost or should we expect it shortly? If a member of a family where a victim has died as a result of hepatitis C was to go to the High Court I understand that there would be a ceiling placed on the award by virtue of the fact that the victim was deceased. Is there a similar ceiling for the tribunal or can it assess it based on the arguments put forward?

(Limerick East): Regarding the financial arrangements, hitherto we were running a number of schemes which involved the expenditure of money. One of them was the ex gratia payments to which the Deputy referred. This entailed a small amount of money in its totality and was effectively demand led. On the secondary care side and the acute hospitals, we provided a sum of £2 million in the 1996 Estimate for acute hospitals. This has been sufficient and we know it will be so to the end of the year.

The Health Act, 1996, which came into operation a couple of days ago by commencement order made by me on 23 December 1995, will have also to entail expenditure. However, this is being budgeted out of the general allocations for GMS, but we will be including a new element to cover it.

This is not service based on the medical card, but the type of service which is being provided under the medical card scheme through the GMS is in many ways analogous, except that the GMS scheme is means tested and this is not. This means that approximately 1,600 people have been added on the enormous number of people who have medical cards. The quantum, therefore, is very small but it will be included in the health boards' budgets. The medical and GP side is not a huge cost.

We will have to do an estimate of the costs in respect of the other services which are to be provided. Returning to my initial reply, in terms of GP services, drugs, medicines, etc. I could provide a reasonable estimate now. Furthermore, in terms of additionality it is small, given the kind of budget we are running, and there is no problem in meeting it.

I will be seeking information on home nursing, home health, dental and oral matters etc., in the course of setting allocations for health boards from the liaison officers. It will be different from health board to health board because the number of people affected in some health boards is quite small, while it is substantial in others. We are also trying to continue the situation where those in the functional area of one specific health board have traditionally obtained a service across the boundary. It will, therefore, be flexible. We will provide whatever funds are necessary to provide this service properly and we will work with liaison officers who will be in contact with individual persons in the provision of this service.

An inordinate amount of time has been devoted to this one Priority Question. If more progress is not made now I cannot hope to deal with the other Priority Questions. I am confined to a time limit and there are two other Priority Questions to be dealt with. If they are not dealt with within the time allocated they cannot be put to the House.

(Limerick East): Deputy Geoghegan-Quinn asked two further questions. In the original health package announced we said there would be research into this, which would be conducted by the Health Research Board. The board has publicly advertised for pure research projects. They obtained a number of offers and they will be selecting from those. Their initial budget to allocated grants to project teams in the hospitals or universities is £100,000. Before the end of this year they will be selecting the projects which will be funded. We will continue——

Nearly all the time available to me for dealing with Priority Questions today is now exhausted. I am calling Priority Question No. 2. If I cannot deal with Priority Question No. 3 it cannot be dealt with.