Vol. 555 No. 2
80 Caoimhghín Ó Caoláin asked the Minister for Health and Children if and when he authorised his Department's circular to health boards sent on 26 July 2002 instructing that monthly payments to parents of children with disabilities should not in future be backdated to the date of diagnosis. [15651/02]
Domiciliary care allowance was introduced in 1973 by way of circular 24/73 and is payable under section 61 of the Health Act, 1970. Following a request by my Department, a national health board working group was established towards the end of 1999. One of the main objectives of this group was to examine all the various disability related allowances which come under the remit of my Department, including the domiciliary care allowance.
During the course of discussions of the national health board working group, the health boards informed my Department that until July 2002 DCA operated on the basis that it was paid to applicants from the date of diagnosis or when care and attention in excess of that normally required by a child of the same age commenced. This was despite the fact that circulars governing the scheme stated that the allowance could be paid in respect of eligible children from the date of application.
The group made recommendations to my Department in May this year with a view to standardising the procedure for the allowances across all the health boards. My Department decided to issue the group's recommendations by way of circulars as departmental policy with effect from 1 July 2002. The DCA circular states that the allowance:
may be paid in respect of eligible children from birth to the age of 16, who have a severe disability requiring continual or continuous care and attention which is substantially in excess of that normally required by a child of the same age. The condition must be likely to last for at least one year. Where medical confirmation is supplied which predates the actual date of application and the Health Board's Senior Area Medical Officer is satisfied that the child required continual or continuous care and attention, substantially in excess of that normally required by a child of the same age, then payment may be made from the date that the Senior Area Medical Officer is satisfied that such additional care and attention was required.
This circular gave effect to what the health boards had informed my Department was already the practice and was issued on the basis of written assurances received from the working group, which included all the health boards, that the cost of implementing the revised circulars on a variety of allowances, including domiciliary care allowance, would be budget neutral. However, subsequent to the circular of 1 July being issued, the Southern Health Board advised my Department that any backdating of DCA, as indicated in the circular of 1 July, would have a cost implication for that board.
The Minister's time is up. The remainder of his reply will be included in the Official Report.
I would be happy to allow the Minister to proceed with the permission of the Ceann Comhairle. It is important that the information is heard.
Perhaps I can proceed by way of a supplementary question.
The Minister may proceed.
In light of this, my Department, while committing to examine the issue further, rescinded the circular of 1 July, replacing it on 26 July with the following wording: "Where a child qualifies for DCA, payment should be made from date of application." When I became aware of the circular of 26 July 2002 I instructed my Department to revert to the position of 1 July 2002 which, as I have already stated, permitted the allowance to be backdated "to a date when the Senior Area Medical Officer is satisfied that the child required continual or continuous care and attention, substantially in excess of that normally required by a child of the same age."
Prior to 1 July 2002 it had been health board policy, supported by my Department, that payments of DCA could be backdated prior to date of application if it was clear that the applicant was not aware of his or her entitlement. In these cases payment of the allowance was backdated to the date where the child would have become eligible.
The assessment of entitlement to and payment of the domiciliary care allowance in an individual case is a matter for the relevant health board. It is a matter for the senior area medical officer in the relevant community care area to decide whether a child qualifies for DCA on medical grounds.
I thank the Minister and the Ceann Comhairle. The Minister will recall that there was widespread concern during the summer recess among parents of children with disabilities at reports that the Department had sent a circular – obviously the circular of 26 July to which my question refers – the effect of which would be that families would lose out financially. The Minister went some distance in explaining how this came about and pointed out that a decision has been taken to redress the matter. Is the current position that the health boards retain a discretion vis-à-vis the retrospection of payment to the appropriate date, namely, the date of first assessment or of the determination of the child's disability? Is it the case that there are different interpretations or applications of the circular between different health boards within the jurisdiction?
Will the Minister also assure the House that services and welfare support for people with disabilities will not only be maintained, but improved this year and these most vulnerable people in our society will not be the subject of the axe wielded by his colleague, the Minister for Finance, Deputy McCreevy?
The policy position is contained in the circular issued on 1 July on the DCA, which states that the allowance may be paid in respect of eligible children. That is covered in the reply. That circular informs the policy to be adopted by the health boards. All this arose from an attempt to streamline and standardise the administration of the scheme emanating from the health boards through the national health board working group which was concerned that there may have been different applications of the scheme in health board areas in the past. The majority of health boards indicated through that working group that they had always operated on the basis of going back to diagnosis. It was in that context that the position was formalised in the circular of 1 July and that remains the position.
In terms of disability generally, we have substantially increased funding during the past four or five years on disability issues, both intellectual disability and physical and sensory disability. These are issues that will continue to receive priority attention.
