Dáil Éireann debate -
Tuesday, 8 May 2012

Vol. 764 No. 3

Domiciliary Care Allowance: Motion

Deputy Catherine Murphy

I move:

That Dáil Éireann:

notes the grave injustice that is the current assessment, review and appeals system for domiciliary care allowance (DCA) which has, since its transfer to the Department of Social Protection in 2009, seen:

-- a continuous escalation in application refusals based on desk assessments carried out by administrators and medical assessors neither of which are required to be qualified specialists in the relevant area of disability;

-- an upsurge in reviews of DCA recipient eligibility which often result in extortionate costs to parents who must, at short notice, obtain expert medical evidence to support the defence of their much needed claim (evidence for which they are often forced to pay private sector experts given the unavailability of public sector options within the short timeframes set out by the Department of Social Protection for such reviews);

-- the development of a staggering 38 week wait period for those seeking an oral appeal of an unsuccessful application or a finding of ineligibility upon review;

-- a situation arise whereby 2,420 applicants and recipients subject to review appealed the Department's negative decision in their case during 2011 alone, 52% of which were successful in their appeal;

-- the unnecessary imposition of an additional emotional burden upon families as a result of being forced to embark upon a lengthy and costly appeal process which, in 52% of cases, upholds the original claim for DCA and proves the injustice of the initial refusal;

-- a persistent failure to inform families of the specific reasons a child does not qualify for DCA, thereby preventing parents from appealing a decision on specific grounds rather than causing a lengthy and costly review of the entire process; and

-- the placing of formal or informal restrictions upon Health Service Executive (HSE) experts precluding them from recommending the provision of a DCA to an individual on the basis of a diagnosis they have made;

deplores:

-- the emergence of a backdoor approach to denying additional supports such as carer's allowance, the respite care grant, the household benefits package and sibling supports as a result of a finding of ineligibility for DCA; and

-- the apparent development of a cynical policy to routinely refuse DCA applications and categorise recipients ineligible in the short-sighted hope of making savings – adding greatly to the anxiety and hardship endured by some of the most marginalised and vulnerable families in the State; and

calls on the Government to immediately reform the DCA system by:

-- returning the administration of this system to the Department of Health;

-- insisting that medical assessors are competent to assess the medical information submitted and are on the relevant specialist medical register (e.g. paediatrics or child psychiatry), remove the "Guide to the Normal Age of Attainment of Certain Activities" currently in use by medical assessors (as compiled by the Office for Population Censuses and Surveys study on Disability in Childhood in the United Kingdom) and ensure that all decisions on DCA applications and existing claims are made by child protection or disability social workers;

-- providing DCA applicants and recipients with access to all documentation held in relation to their claim upon request and within a reasonable timeframe;

-- affording recipients sufficient notice of an upcoming review in order that they may obtain the requisite expert evidence through public sector sources as should be provided for through the ‘Assessment of Needs' procedure under the Disability Act 2005;

-- revoking any and all restrictions placed upon HSE experts precluding them from recommending that individuals and/or families require specific supports such as the DCA;

-- limiting to 7 weeks at most (the Department's target time for the processing of DCA applications) the total time it takes to hear and adjudicate over summary and oral appeals on DCA;

-- publishing the general details of decisions on social welfare appeals (while ensuring the anonymity of those concerned) in satisfaction of the Article 34.1 constitutional guarantee that justice "shall be administered in public" in view of the quasi-judicial status of such appeals;

-- introducing a truly streamlined and human rights focused DCA system which is administered in the understanding of the uphill struggle that is everyday life for those seeking DCA and does not actively exhaust the precious time and resources at their disposal in lengthy application, review and appeals processes; and

-- prioritising the delivery of all necessary resources, supports and funds to children with special needs in order to facilitate them in attaining their full potential as equal citizens of Ireland.

May I share time with Deputies Pringle, Finian McGrath, Joan Collins, Healy and Mattie McGrath?

Acting Chairman (Deputy Joanna Tuffy)

Is that agreed? Agreed.

Deputy Catherine Murphy

I thank the Technical Group for agreeing to table this Private Members' motion, which we have worked on together.

The domiciliary care allowance was never an automatic award. As we often hear from parents, many people found out about it by accident. A person must apply for it. To qualify for the monthly payment of €309, the person caring for a child, usually the mother, had to prove the child had a disability and needs substantially in excess of those of a child of a similar age. The payment was in recognition of the fact the child needed assistance to deal with many of the activities of daily living. Proof was usually in the form of expert opinions or, in some cases, the HSE reviewers actually seeing the child.

Until 2009, the allowance was processed by the HSE. However, new applications from that year were made to the Department of Social Protection. In recent months, parents have been telling us how much they dread the postman arriving with the letter that tells them the domiciliary care allowance is to be reviewed. This is particularly so if a parent's child is on the autism spectrum. There is mounting evidence that children with autism or other intellectual disabilities are being targeted. I acknowledge that those affected are not exclusively in those categories, but they seem to comprise a disproportionate number. That a Department named "Social Protection" is doing this is cynical. It is certainly not offering protection to the most vulnerable group of children and parents.

The process appears to be flawed, in that it follows a medical model when it should be a more holistic one. There is also a social aspect to this matter. We are seeking a short-term solution to the current crisis in which many families find themselves as well as a more inclusive system, one that adopts a social model as opposed to a medical model purely.

There are always choices to be made in politics. I doubt that the top 10% of earners would feel good if they knew that their incomes were being protected at the expense of vulnerable children. Top earners increased their incomes by 8% last year according to the CSO. An additional tax on high earners could have been imposed without any loss in their living standards.

The Minister for Social Protection needed to find savings of €680 million in her budget. The main objective was to protect the headline rate of social welfare recipients. To those who are not dependent on social welfare, this translated into no cuts in social welfare, yet this cannot be achieved because the money needed to come from somewhere. The Government repeatedly made the point that there were to be no tax increases or reductions in headline rates of social welfare. The sin of omission was in not specifying how the savings would be achieved. The changes to the domiciliary care allowance, cuts in the number of people who qualify for carer's allowances, etc. have become evident. Although the Government claimed it was seeking to protect the most vulnerable, it was more concerned with merely giving that impression. Some families are being hurt badly.

The domiciliary care and carer's allowances are not being cut. Rather, they are being eliminated as payments. We have seen a continuous escalation in application refusals based on desk assessments carried out by administrators and medical assessors, none of whom is required to be a qualified specialist in the relevant areas of disability. One parent to whom I spoke last week was refused recently following a departmental review. She told me her six year old son was not toilet trained, attended a special school, was a danger to himself and a flight risk, could not feed or dress himself and could not tie his shoe laces. The list went on. He was turned down. Obviously, he was regarded as having no more need for care than an average six year old. Clearly, this is wrong.

No matter how bad a situation is, parents always hope that matters will improve for their children. However, many tell us that the process is cruel. Many complain about the short turnaround time for reviews. Often, they must obtain medical evidence from private sector sources because it is not available from public sector professionals within the allocated timeframe. In one case, a mother recently told me that it cost €1,000. Someone else told me their professional fees ran to €1,300. If these people did not have the accompanying proof, they would lose their allowances.

Not only is it a costly process for families, it is emotionally hurtful to read about what their children will not be able to do or what challenges they will face. The blackest picture must be painted. We all remember the effort made and the change in people's attitudes during the Special Olympics, where the focus was on the child's ability rather than disability. This review process turns that attitude in reverse and it is taking a toll on many families. One woman described the loneliness of life with her autistic son as he progressed through school. Her days have closed in around her and her circle of friends has, for the most part, dwindled away, unable to meet for coffee or chats even for half an hour. People do not understand and eventually give up trying. On 1 March, the woman's domiciliary care allowance review was submitted and a cloud of panic descended on her household. That cloud has not since lifted and may not until the review has been completed. According to her, the reality of life without it is too great a burden to bear.

The domiciliary care payment is often used to procure therapies that should be available through the public system. As most of us know, however, availability can depend on one's address because of the lopsided and incomplete distribution of health care professionals. One father told me of his five year old son Conor, who has an autism spectrum disorder. Since it is a neurological condition, it cannot be determined by a medical test. Conor has significant issues with communication and is still non-verbal. He needs occupational therapy to satisfy his sensory needs. As the occupational therapy service provided by the HSE is inadequate, Conor attends a private therapist at significant cost to the family. The domiciliary care allowance payment helps to fund these interventions. Were it removed, it would result in the stunting of Conor's development and place his family under tremendous stress and anxiety. These are real children. They are not just statistics.

Once a person appeals the refusal of the domiciliary care payment, the appeal can take approximately nine months or longer to be decided. Not only is the €309 monthly payment discontinued, but the associated carer's allowance is removed from those who qualify for this means tested payment. If proof is needed of the unfairness of the process, it can be seen in the level of success on appeal, with more than 50% of those who appeal being successful. Appeals are made more difficult because of the lack of information. If people are to appeal successfully, they need to know the basis for their refusal. Families are struggling with everyday challenges, including inadequate public services. This additional burden is not fair.

In many cases, a parent must leave work to care for his or her disabled child. In some cases, the carer's allowance is used to pay mortgages. For many families it is difficult enough to struggle with the emotional fall-out of having a child with special needs, without the further cruelty of adding to their financial burdens.

Many parents believe the current treatment of the domiciliary care allowance is a backdoor approach to denying the carer's allowance, the annual respite grant, the home care package and the disability payment for the child when he or she becomes eligible for it. The transfer of the payment to the Department of Social Protection has changed the application process from being a health centred support to a soft target for cuts. Some of those who originally welcomed the move in the belief that it would be considered in a wider context now believe it should be moved back to the Department of Health so that decisions can be made by those who have expertise in the field, including child protection and disability social workers.

Reviews must allow sufficient time for those who care for the child to commission expert reports through the assessment of needs procedure under the Disability Act 2005. Restrictions placed on HSE experts should be lifted. I understand they have been instructed not to recommend in their reports the payment of domiciliary or carer's allowance. That instruction needs to be reversed. The general details of decisions on social welfare appeals ought to be published, while ensuring the anonymity of those concerned, to satisfy the guarantee under Article 34.1 of the Constitution that justice shall be administered in public. We need to see the number and basis of appeals. There is a need to introduce a streamlined and human rights-focused domiciliary care allowance system which is administered in a way that understands the uphill struggle of everyday life for those seeking the allowance and does not exhaust their precious time and resources in a lengthy application, review and appeals process. We must prioritise the delivery of all necessary resources, supports and funds to children with special needs in order to facilitate them in attaining their full potential as equal citizens of Ireland.

We all understand that the economy is in a weak state and that we need to prioritise our expenditure. However, vulnerable people seem to be first in the firing line when it comes to cuts. We are not seeking to end the review process for domiciliary care allowance. We are seeking an end to a dishonest process that is targeting vulnerable children who deserve our protection. This is a flawed process which needs to change if we are to get good outcomes. Our motion does not reject the need for reviews but the system has to be coherent and fair. The parents of these children are in the age cohort which has been hardest hit by the economic collapse. Their hopes and aspirations for better lives for themselves and their children have been dealt a harsh blow from an economic point of view but their hopes have been further eroded by the extra burden of caring for a child with special needs. They need and deserve the support of a caring society.

We were told this afternoon that an official from the Department of Social Protection asked while conducting a review whether a particular child with autism had gotten better. This type of question is hurtful to people who are struggling with the everyday challenge of caring for these children. Too many of us are hearing the same stories. This system is flawed and cruel. There is an urgent need to change it.

Deputy Finian McGrath

Hear, hear.

Deputy Thomas Pringle

I welcome the opportunity to contribute to this debate and thank Deputy Catherine Murphy for moving the motion on behalf of the Technical Group.

Some of the most common queries raised at my constituency office are from parents who are applying for the domiciliary care allowance. They have spent the duration of their children's lives in a struggle to get services for their children and in many cases they have had to struggle to arrange diagnoses so that they can finally prove their children have problems which the system failed or refused to recognise. It is vital that the system recognises these children and their families quickly. It is disheartening to see the level of upset which these families experience in their constant fight to get services and entitlements. No family would chose to have a child with special needs but they should not be forced to struggle against the social welfare, health and education system to provide a decent quality of life for their children.

A couple of weeks ago the Taoiseach stated to the House that children with autism can go to university and lead full lives. That rings hollow to the families who are struggling with a lack of services or a refusal to recognise their children's needs. The system should be reformed to ensure that families receive a fair hearing. It should not be assumed that they are trying to defraud the State or get a benefit to which they are not entitled. It should be assumed from the start that they need assistance and support from the Department of Social Protection. Such an assumption would completely change the atmosphere in which these families currently struggle. The Minister for Social Protection should change the system to ensure that families receive the support and protection they need from her Department rather than constantly struggling against the barriers it erects in their way. They should not have to incur expenses in getting expert opinion when their domiciliary care allowances come up for renewal but should instead be provided as a matter of right with reports from the health care providers who are already dealing with their children. That a departmental official could ask whether a child still has autism betrays a lack of understanding for what families are going through. The Department needs to recognise that. Families should not have to wait weeks or months for their appeals to be processed. I have attended oral hearings with families. It is heart-rending to observe the upset that parents experience in trying to justify their application for support. In fairness to the inspectors, many of them are similarly upset because they cannot understand how the Department can make these decisions.

Something must have gone badly wrong with the administrative system if more than 52% of appeals are successful. Unfortunately, the system appears to be designed to minimise the amount of money paid to families by making them struggle through bureaucratic procedures. The Minister needs to review the operation of the domiciliary care allowance. If it was transferred back to the Department of Health, there might be greater empathy with applicants. As part of that review, the application forms must also be reviewed. In many cases applicants do not understand the amount of information they need to give and the forms do not facilitate that. If at the start they were aware of the amount of information needed, they might be able to short-circuit the process and speed up decision-making.

These parents and children struggle throughout their lives and the system should be able to accommodate them in recognising that children have lifelong disorders and disabilities which are not there to be reviewed. If only parents thought that in two years' time their children would be better and would not need this anymore, they would hand back the domiciliary care allowance in the morning. The system needs to recognise that. When the Minister is carrying out the review I call on her to ensure the system becomes a caring system and not a blockage system.

Deputy Finian McGrath

I welcome the opportunity to speak on this important debate on the domiciliary care allowance and the urgent need to refocus on the children with disabilities and their families. I commend my colleagues in the Technical Group on tabling this motion and I urge all Deputies in the House to consider seriously our proposals. I urge the Government to listen to the families who need the domiciliary care allowance. Treating families in this way is not acceptable. Terms such as "inclusion" and "protecting the vulnerable" are empty and hollow words unless these children are treated in a fair and respectful way. I caution the Government that it could be in breach of the Disability Act, which has clear guidelines. I urge the Government to deal with this issue from a human rights point of view.

The motion highlights that vulnerable families have encountered significant problems in accessing and retaining this vital support since the role of administering the domiciliary care allowance was transferred from the HSE to the Department of Social Protection in 2009. While welcoming the original motivation for transferring this function, which was to ensure consistency and transparency in the way in which applicants from throughout the country were assessed through the institution of a centralised application facility, the lack of appropriate expertise in the field of behavioural and physical disability among deciding officers is causing a problem.

The decision to schedule time for the discussion of this very emotive topic was made by the Technical Group in response to the ongoing and escalating appeals among constituents and representative organisations of children with special needs to pursue the Government with the aim of addressing the worrying escalation in application refusals, rulings of ineligibility for the allowance among those who have come to depend on the payment, and the excessive length of time to hear and adjudicate on appeals.

Representatives from Inclusion Ireland, Down's Syndrome Ireland and the Special Needs Parents Association came to Leinster House today to meet Members from the Technical Group. I thank the parents for making their submissions today and we all listened closely to their stories. A number of parents contacted me directly and I wish to quote a father's view as follows:

My son has an autism spectrum disorder which is a neurological condition and as such cannot be determined by a medical test. This is why I feel the importance of medical eligibility for DCA is so unfair. His diagnosis affects him, and others around him, in a more social way. He has significant issues with communication and at 5 years of age is still non verbal. Along with picture exchange systems, visual schedules and physical prompts he uses Lamh, which is a simplified version of ISL to communicate his needs and desires. This means that not everyone knows how to communicate with my child. As a result, he becomes very frustrated and starts to self harm by banging his head on the nearest object, be it a cushion or a wall, so he needs constant supervision as he has a very high pain threshold and wouldn't stop banging his head. [This is the reality for a parent of a child with special needs.]

We are currently under review for this payment, and our file was received by the Department of Social Protection's medical assessors on the 20th of March. I was informed by the Department that it takes 10/12 weeks to get a decision made by the medical assessors which means we must wait another 5 weeks for a decision from them, then our file will be returned to the department. I don't know how much longer it will be with the deciding officer there before a final decision is made. Which brings me to my first point, why does it take so long for this process to reach a conclusion? It is stressful enough being the parent of a child with special needs without having to worry about where the money is going to come from for next week's OT session, or how am I going to pay for the tax on the car to keep it on the road so that I can bring my child to school?

I also have a letter from a mother of a child with a disability as follows:

The Government have let me down so badly at a time when I really desperately need help. All they have done is added to the stress. I think about the DCA every day. I do not know how long I will have to wait to see if the boy's got it. If he doesn't, I can't get carers allowance and we will not survive financially. Every day is a struggle for us. It's like living in a battle zone, you can never truly relax. I am so ashamed of this country and the way they treat children with disability, the most vulnerable group in society. I am heart sick of having to fight for everything. This is not the way it should be in a civilised society.

Each year 2,500 children are not being assessed by the HSE within the legal time limits. I ask the Minister to consider the wording of tonight's motion. I urge her to listen to the parents and families. I urge all Deputies to support the motion and give all parents of children with a disability an allowance that supports their needs in a compassionate and common-sense way.

Deputy Joan Collins

The budget saw the Government's attempt to cut disability benefit. It also cut the jobseeker's benefit for those aged from 18 to 21 from €188 to €100. We now have the threat to take PA hours away from those with disability and we have had cuts in the one-parent family allowance. These are some of the meanest cuts a government has ever made. However, this must be one of the most vicious attempts to cut from families the lifeline of access to the care and money they need to raise their families.

A number of Deputies have read letters received from parents of children with disabilities and I have one I wish to read into the record as follows.

My son has been diagnosed with Asperger's, Dyspraxia, Sensory Processing Disorder and ADHD. He was refused DCA on lack of medical evidence. I am trying to lodge an appeal but does anyone know what the rate of success of these appeals are? I just feel like I am going around in circles - from trying to get a diagnosis to trying to get him extra help in school. I had to go private for everything. Any advice what to put in an appeal?

We had the same problem nearly 2 years ago with our eldest [son]. He was diagnosed with autism and trying to get anything from the state was an uphill battle. They don't give anything out on the first application. Everything must be appealed and re-reviewed. In our 2nd attempt for the DCA we got a letter of support from his teacher, speech & language therapist, GP and the Brothers of Charity (who diagnosed him initially). All the letters told how bad autism affected him, his sibling and us and how the allowance would benefit us (parents) because of the extra outgoings. The letters told the truth, all be it a darker picture of it.

In today's briefing all the parents made the same point in saying that everything is a battle in trying to get support for their children. They report not being listened to by health professionals when problems first appear at a young age; having to fight for an SNA in school; being refused DCA on first application; having to get costly professional reports for appeals; and having won an appeal then being faced with a review. There is a widespread suspicion among parents that the 50% refusal rate for first applications, of which 50% are overturned on appeal, and the increase in reviews reflect an attitude in the Department of cutting costs and making savings rather than assisting in a sensitive way to ensure that children with special needs and their families are given the support they need.

The term "special needs" may be politically correct.

It can give the impression to many people that we are talking about children who might need a little extra attention to help them keep up in school. The reality is very different when dealing with Asperger's syndrome, autism or attention deficit disorder and often children can suffer from a combination of these illnesses. Organisations representing children and parents, such as Down Syndrome Ireland, Irish Autism Action and the Special Needs Carers Association, are demanding a full review of the whole system. There is a problem with the use of ICD-10 diagnostic codes. While accepting they can be useful for research into statistics, for which there is not even a proper basis in Ireland, their use in determining eligibility for allowances is a major problem.

There is a serious problem if 52% of refusals are overturned on appeal. This causes huge stress and costs for parents. With only 21 days to get professional assessments, reports and advice, people are forced to go to private professionals, with the ensuing costs, because of waiting times for appointments in the public health service. Where public health professionals are involved, there is a considerable cost to the HSE. Another problem with the high level of refusals is that the domiciliary care allowance is a gateway to other benefits such as the carer's allowance, the family home benefits package and others. A refusal of the DCA is a back door to the refusal of these other benefits, which are very much needed by families to support their children in their illnesses.

Time after time, Government Deputies have raised the issue of the problems surrounding the domiciliary care allowance. There must be a proper review of it. Even if the Minister does not want to listen to our motion, and thinks the Government knows better, at least she should call a conference of the parents and ask them what they need and what processes should be put in place. There should be a special unit parents could go to as soon as a child is found out to have an illness, where they can be informed what medical advice they need, what forms they need, what processes are necessary and what timeframe is involved. There should also be a time limit on this; we put in seven weeks to hear and adjudicate on summary and oral appeals. These processes must be put in place to support families.

Deputy Seamus Healy

I support this motion and commend the Technical Group on introducing it. The first thing we must realise is that life for families where there is one or more children with special needs is a daily struggle. All of us in this House see parents on a daily basis who explain exactly what life is like for them. It is a struggle and as parents get older they worry how the children will be cared for after their deaths.

Parents have told us today how they must fight for everything. On many occasions, they are not listened to, particularly early on, and if there had been an early diagnosis there would be a better outcome. Unfortunately, it is often much too late when the diagnosis is made. There are waiting lists for speech therapy and psychological assessments of up to two years. Suddenly the child is five or six, or even in some cases ten or 11, before the diagnosis is made and a person can start to look for the support services. That is a huge problem for parents.

Families in this situation should be supported and should not have to worry about the domiciliary care allowance. As others have said, the loss of the €309 per month domiciliary care allowance leads to the loss of the carer's allowance, as much as €204 per week, and the household benefits package. Those are significant losses. The vast majority, if not all, of these parents will not be working. They will be at home looking after the child. In the event of the domiciliary care allowance being lost, it does not mean the person can go to work. They must stay at home to look after the children but without the assistance of the domiciliary care allowance and carer's allowance to allow them to avail of support services. The Department should, as called for in the motion, review the scheme and ensure a reasonable timeframe is put in place. We have asked for a period of seven weeks, a reasonable timeframe for a decision on these applications.

This is only the tip of the iceberg in the social welfare area. Headline rates have not been changed, which was built up as a huge commitment by the Labour Party in particular before the last election, but that has acted as a smoke screen for dismantling other social welfare services and benefits, services that have been hard won by generations of workers and their unions. There have been cuts in jobseeker's allowance, reductions in the time period for jobseeker's allowance, reduction in the time period for illness benefit, increases in the pension age, increases in the number of contributions for widow's and State pensions, the abolition of the half rate illness benefit, the abolition of the half rate jobseeker's benefit, cuts in the fuel allowance, cuts in heating benefits and they go on and on. I believe the instruction has gone out, be it written, verbal or even unspoken, from the Department that the criteria for all these schemes might not have changed on paper but there is a new strictness in their implementation. That is a scandal and it should be overturned.

Deputy Mattie McGrath

I am delighted to speak on the motion this evening and compliment my colleagues in the Technical Group on tabling it and doing so much research. It is easy to do the research because we all hear stories in our offices from families, parents, single parents and guardians of children with special needs having had their allowances savagely cut.

My late brother was a paediatrician in south Tipperary and specialised in many of these areas. His main findings were that these people, parents and children, just needed someone to listen to them and support them. That is the problem they have now. The sweeping changes and long delays with reviews lead them to have to battle the system. It is bad enough for the parents who have discovered the child they love has special needs without having to fight the State at every turn. The Minister is a compassionate woman and understands this area so I beg her to please look at the sensitivities in this motion and take this area away from the cuts because this is one section of society that needs support and nurturing. We are lucky to have parents caring for their children in the home. What would it cost to keep them in State care?

There is a trick of the light in the Department of Social Protection. It is maintaining headline rates while introducing sweeping cuts. The forms for this allowance are cold and insensitive, and must be filled out with different reports from different medical practitioners, sometimes at enormous cost. We all welcomed the change from the HSE to the Department of Social Protection but we must learn from our mistakes. A mistake has been made here because at least in the HSE medically competent people were available, although they are available to the Department. The timeframe must be reduced to seven weeks because it is too unwieldy and cumbersome and places too much pressure on families. Everything is a constant battle. They have enough of a battle within their own four walls to maintain some level of dignity for their child and themselves so why must they fight the State?

It was a mistake to remove the scheme. We learn by our mistakes and the man or woman who never made a mistake never made anything. The Minister should hand the scheme back to the HSE, much as we might criticise that organisation. This system of rigorous tests and appeals and oral hearings did not obtain at the time anyway, when it was removed. Parents are at their wits' end. They want to care for their child and do not want to fight the State, day in, day out.

As others have observed, this savage cut is a gateway to other cuts. We have heard of Charlie McCreevy and his dirty dozen, fadó fadó. This cut supersedes all other cuts. The removal of this grant aid will become a gateway to all the cuts that were mentioned, such as carer's allowance, half-carer's allowance, and many others. This gate must be closed and sealed. We must do this compassionately and in the interests of the children.

Minister for Social Protection (Deputy Joan Burton)

I move amendment No. 1:

To delete all words after "Dáil Éireann" and substitute the following:

"recognises that the Domiciliary Care Allowance (DCA) scheme represents a very important support to people who live with and care for children with disability and notes that:

— the allowance is now in payment in respect of 26,000 children, an increase of over 2,000 since the Department of Social Protection took over responsibility for the

scheme from the Health Service Executive in April 2009;

— spending on the scheme and the Respite Care Grant, which is automatically paid to all recipients, has increased from €138 million to €145 million between 2010 and 2011; and expenditure on both in 2012 is expected to be in the region of €146 million;

— parents of children who receive the DCA also qualify for Carer's Allowance and the Household Benefits Package, subject to fulfilling certain criteria, and some 40% of those on the scheme receive these payments;

— those who receive the Carer's Allowance and Household Benefits Package, in addition to the DCA and Respite Care Grant, receive a total of €16,742 per annum

from the Department of Social Protection;

recognises the vital role played by spending on social welfare in enabling people to live with dignity and the importance of the DCA in supporting families with children who need substantial levels of care and attention;

notes that the DCA is now a statutory scheme as provided for in the Social Welfare and Pensions Act 2008. The medical criteria set out in the legislation requires that the child has a severe disability requiring continual or continuous care and attention substantially in excess of the care and attention normally required by a child of the same age and the disability is such that the child is likely to require full-time care and attention for at least 12 months;

acknowledges that the Department of Social Protection has in place an equitable standardised application and assessment process whereby all cases are examined and dealt with on an individual basis;

notes that the application process operated by the Department involves the submission of a detailed statement by the parent or guardian of the child, as well as a detailed statement by the child's own general practitioner and any other relevant evidence from qualified experts who have examined the child. This evidence is then assessed by designated Departmental Medical Assessors who have received training in the area of child disability;

notes that the DCA supports 24,000 families and some 26,000 children at a cost of €100 million per annum. This along with the Respite Care Grant payment amounting to €45 million in 2011, represents an increase in spending of some €7 million over 2010;

further recognises that:

— against the backdrop of significant reductions in expenditure on social protection that there have been no cuts in the level of spending on the DCA and that this scheme has been specifically protected from cuts by this Government and that it continues to be paid at the monthly rate of €309.50;

— reviews are paid at the monthly rate of €309.50;

— reviews are an integral part of all social welfare schemes and are necessary to ensure that payments continue to be made only to those who meet the qualifying conditions and acknowledges that there is a structured and fully functional review process for DCA cases in operation in the Department which includes parental and medical input; and

— all social welfare schemes have set conditions and that the receipt of DCA is a prerequisite for the receipt of Carer's Allowance, Respite Care Grant and the Household Benefits package where this is claimed in respect of care given to a child under 16 years old;

acknowledges the considerable steps that have been taken to improve communication with parents and notes the improvements that have been made in this regard resulting in:

— parents now being informed by the Department of Social Protection of the review date that will apply in their case when their claim is initially awarded; and

— parents also being afforded 60 days in which to obtain and return evidence following notification of review. This will address parent's concerns on the time frame allowed and will provide them with additional time to gather supporting documentation or medical reports they may wish to submit in advance of the review date;

acknowledges the significant steps that have been made to speed up the appeal process for all social welfare appeals and notes that the success rate on DCA appeals, at 46%, is broadly in line with that on other social welfare schemes;

affirms that copies of documents are made available to parents on request within a reasonable timeframe;

and further notes that:

— the Minister for Social Protection has instructed the Department of Social Protection to liaise with other relevant Departments, namely the Department of Health, the Department of Education and Skills, and the Department of Children and Youth Affairs, who have a role in providing supports and services to map the availability of services and to examine the scope for greater linkage and consistency in the assessment for such supports and services;

— the Government has established an Advisory Group on Tax and Social Welfare to examine and make recommendations on a number of issues around the operation and interaction of the tax and social protection system to address how employment disincentives can be improved and better poverty outcomes achieved, particularly child poverty outcomes and that the Group is currently examining the area of disability;

— the Department of Social Protection will urgently undertake a policy review of the DCA in order to clarify its objectives, consider whether legislative change is required, and consider whether the current administrative and medical processes need further refinement in view of the outcome of this; and

— as part of this review, the Department will consider the question of the duration of review periods for the DCA, based on the medical condition of the children involved, whilst taking account of other priority demands on the medical resources of the Department."

I appreciate the contributions of all the Deputies who are concerned about this issue. The State pays the domiciliary care allowance, or DCA, to parents or guardians in recognition of what everybody who is a parent would acknowledge to be the absolutely heroic and selfless role parents play in raising children who experience some form of disability. As parents, that has been the experience of all of us, among people we know or from our relatives who have children with special needs. There is no disagreement in any part of the House in that regard.

I offer a brief overview of the scheme, its role and purpose. The domiciliary care allowance scheme represents a very important support to parents and guardians who live with and care for children with a disability. DCA was originally introduced in the early 1970s in recognition of the extra care and attention provided by parents of children with a severe disability, who are cared for in their own home - hence the name. Responsibility for the administration of the scheme remained with the health boards or the HSE until April 2009 although it had been planned to move it much earlier. When it transferred to the Department of Social Protection it was put on a statutory footing. It is important to remember that before this happened the way the scheme was administered varied from area to area throughout the country. The change was made following a review which happened during the Government of Fianna Fáil. The Department of Social Protection is the right home for the scheme given its role in providing income support. The community welfare service was also transferred to the Department following the same review.

Domiciliary care allowance is a monthly payment to the parent or guardian of a child who requires care and attention and-or supervision that is substantially in excess what another child of the same age would receive. The allowance is paid at the rate of €309.50 per month. This rate has been specifically protected by this Government from a reduction of any kind, against the backdrop of significant reductions in expenditure generally. The Department now pays DCA for 26,000 children. That is a net increase of 3,000 children since the Department took over responsibility for the scheme from the HSE in April 2009. Given their notion that the number of children being awarded the DCA has somehow or other been cut or reduced, I put it to Deputies that the figures are entirely different.

Spending on the scheme, and on the respite care grant which is automatically paid to all recipient parents, has increased from €138 million to €145 million between 2010 and 2011. Total expenditure on both payments in 2012 is expected to be in the region of €146 million. I emphasise there have been no cuts to this scheme, neither in the amount nor in the number of children and parents being awarded the DCA, which has gone up by many thousands. During the period from 1 April 2009 to 31 December 2011, a total of 13,552 applications were received from parents or guardians of children with a disability, with 6,298 children being awarded the allowance, amounting to 46% of all claims processed. I will go through the figures again for the Deputies. There are now 26,000 children in 24,000 families who are in receipt of this very important allowance. However, 6,298, or a quarter, of those have been awarded the allowance since it was transferred to the Department. Therefore, the suggestion that somehow or other officials or doctors in the Department of Social Protection are hostile in any way to the parents of children with a disability and are refusing to award the payments to parents is simply wrong. It may be that not everybody who has applied has received the award. I noted carefully that the Deputies who spoke on this almost invariably referenced the issue of children who are on the autism spectrum. I notice they did not mention any other area of disability, whether in respect of either a physical or an intellectual disability. Statements have been made in the House to the effect that there is an effort to stop people entering the scheme but, in fairness to the staff of the Department of Social Protection, the figures do not bear this out. On the contrary they show an increase.

Deputy Catherine Murphy

That is what people tell us.

Deputy Joan Burton

I am just quoting the public figures. Some 6,000 extra children have received the grant. That may not be everybody one would want to receive it but Deputies suggested the numbers were cut.

Deputy Barry Cowen

The changes were for last year.

Deputy Joan Burton

Parents who receive domiciliary care allowance also qualify for carer's allowance and household benefits, subject to fulfilling certain criteria. Some 40% of those on the scheme receive these payments. Those who receive the carer's allowance and household benefits package, in addition to the DCA and respite care grant, receive a total of €16,742 per annum from the Department. It is a very significant and important expenditure and the Department has been very happy to administer it. Many thousands of additional awards have been made since the Department took over the scheme. It is necessary for Deputies to be fair to some of the staff of the Department.

I reiterate, the number of claims in payment has increased steadily over the years, from 11,000 in 2001 to over 23,000 in early 2009 at around the time the Department of Social Protection took over the administration of the scheme. Now the figure is 26,000 children. When they are aged 16 years children leave the scheme and many go on to receive disability benefit. The number, therefore, is a net 3,000 but an additional 6,000 children were awarded the grant.

In 2009, the average number of applications received under the scheme was 92 per week. This compares with 105 per week in 2010, 106 per week in 2011 and 83 per week to date in 2012. This year, it is expected that applications will average out at about 100 per week. More generally, it is also worth pointing out that the Department makes an extensive range of payments to support families with children. In 2011, some €2.08 billion was paid out in respect of 1.13 million children on child benefit. In addition, qualified child increases were also paid to people on social welfare payments in respect of some 495,000 children, with 369,000 at the full rate and 126,000 at the half rate.

I refer to the qualifying conditions for the scheme, or how applications are assessed and reviews conducted. To qualify for the domiciliary care allowance, the child must be under 16 years of age and have a disability requiring care and attention and/or supervision substantially in excess of another child of the same age. The care and attention must be given by another person, effectively full-time. Eligibility for the domiciliary care allowance is not based primarily on the medical or psychological condition but on the degree of extra care and attention the child needs. Each application is assessed on an individual basis taking account of the evidence submitted. No specific condition or disability rules a child in or out of qualifying for the allowance. Applications for children with autism and other intellectual disabilities are treated in exactly the same manner as applications for children with other types of disability.

To apply for the scheme, parents or guardians submit their detailed statement as well as a statement by the child's general practitioner and any other relevant evidence from qualified experts who have seen the child. Parents and guardians choose the GPs and specialists. it is important that the child is treated by his or her doctor or specialist. It would be very strange to do otherwise. Following this, the Department's medical assessor reviews the history of the case, considers all medical reports received and considers the description of the care and attention required by the child, as set out by the parent or guardian. Overall, the award and refusal rates have remained broadly the same over the three-year period in which the Department has been processing claims, with 46% of claims being awarded and 54% refused the allowance.

The review interval recommended by the medical assessor will vary from 12 months in cases where the child's disability is likely to improve significantly because the child is undergoing treatment, to a five or ten-year review date if the child's condition is likely to remain unchanged for the foreseeable future. If a child has a lifelong disability that is unlikely to improve by any significant degree, the Department does not review the case. Reviews form an integral part of all social welfare schemes and are necessary to ensure payments continue to be made only to those who meet the qualifying conditions. We are required to ensure that by the Comptroller and Auditor General. This may be different if it was in the HSE, as some Deputies suggests, but moving this scheme to the Department of Social Protection was generally welcomed as a positive move because it is an income support measure and concerns the care and attention required rather than the medical condition. Cases are reviewed based on either a scheduled review on the recommendation of the medical assessor or on information received about a change of circumstances, which potentially affects the continued entitlement of a case already in payment. Scheduled reviews, on the recommendation of the medical assessor, are based on the prognosis of the child's disability and how care needs may change over time.

Where claims are reviewed, parents or guardians are asked to provide relevant, up-to-date medical evidence and details of the additional care needs of their child. I extended the time allowed for the return of the review form and up-to-date medical evidence from 21 days, as it was under the previous Minister, to 60 days. That addressed the concern of parents who found the shorter timeframe caused difficulty. When the claim is initially awarded, parents are now advised when it will be reviewed. The Department gets in contact with parents three months in advance of the review date to provide a five-month period in which to put together a statement or claim. The information provided by the parent or guardian for review is assessed by a medical assessor and a decision is made based on the medical opinion provided. Where payment is stopped as a result of a review, the parent or guardian is invited to submit any further information to be considered and the information is further examined. The parent or guardian may also appeal the decision directly to the social welfare appeals office.

Positive changes were made to the scheme on its transfer to the Department in 2009. It now operates on a statutory basis with the primary legislation provided for in the Social Welfare and Pensions Act 2008. Prior to the transfer, the eligibility criteria for the scheme was set out by way of a circular from the then Department of Health and Children. The medical criteria - as set out in that circular - stated that children "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 may qualify for DCA". The operation of the scheme on a statutory basis ensures consistency of approach to all claims. It would be a retrograde step for the scheme to return to its previous operational basis. Another significant improvement is that eligibility to the allowance is no longer subject to a means test as was the case under the HSE. I ask Deputies to think about that. The numbers of children awarded benefit under the scheme since its transfer to the Department of Social Protection speak for themselves.

The medical criteria, as set out in the Social Welfare and Pensions Act 2008, is almost identical, requiring that "the child has a severe disability requiring continual or continuous care and attention substantially in excess of the care and attention normally required by a child of the same age". However, prior to taking over responsibility for the scheme in 2009, the then Minister convened an expert medical group to draw up a set of consistent and objective guidelines for use in determining the medical eligibility of children for the scheme. The group was chaired by the Department's chief medical advisor and comprised senior medical personnel from the HSE and eminent professionals in the areas of physical disabilities that affect children and experts in child psychiatry and psychology.

The group considered that the most appropriate way for the Department to conduct assessments for medical eligibility was by assessing evidence submitted by the parent or guardian rather than by individual examination by the Department's medical assessors, who are not involved in the ongoing treatment of the child. The experts in the area recommended this system of assessment. Departmental medical assessors received special training in human disability evaluation.

I listened with great attention to a number of Deputies. Every Deputy referred to the shortage of services. Traditionally, income support has been assessed and delivered separately to services. Deputies referred to the importance of speech and language therapy to some children with autism and autism spectrum difficulties. During the years of a lot of money in this country, there was much emphasis on paying income in cash directly. Perhaps the emphasis in those years should have been on developing and employing speech therapists. It is of great importance to the children about which Deputies spoke. An integrated assessment of need would take account of the need for various health, personal care and educational services and the need, if any, for income support.

Deputies referred to the assessment of need under the Disability Act. My colleague, the Minister for Health, who will be speaking in this debate tomorrow night, is making progress with regard to the assessment of needs of those with a disability.

The advisory group on tax and social welfare is currently examining a number of the issues relating to the operation of the disability allowance and the age threshold. I said before in the House that in my view the parents should be paid the allowance for anyone under 18 years. This is my personal view. I also asked my officials to liaise with their colleagues in the Department of Health, the Department of Children and Youth Affairs, and the Department of Education and Skills, who have a role in providing supports and services to children with disabilities in order to map the availability of services and to ascertain if an opportunity exists for greater connection and consistency in the assessment for such supports and services. It is an issue of income but also it is an issue of services. The Department of Social Protection does not provide services, rather it provides income support.

The Department is also undertaking an urgent review of the allowance policy. I am undertaking this review in order to clarify its objectives, to consider whether legislative change is required and to consider whether the current administrative and medical processes need further refinement in light of the review. As part of this review, the question of the duration of review periods for the allowance will be considered, based on the medical condition of the children involved, while taking account of other priority demands on the medical resources of the Department.

I am aware of the heroic efforts of parents to support their children. I wish to assure the House that I am well aware of the vital role played by the income supports paid by the Department of Social Protection in enabling people to live with dignity and to support their children. The Department does not directly supply services and for many of the parents the services are a critical issue for aiding the progress of their children.

Many of the matters raised in the motion are within the remit of the HSE and the services it provides. I wish to assure the House that the staff of my Department, which works on this scheme, understand the concerns of parents and the pressures they feel in dealing with the challenges in their lives. All claims are dealt with in a professional manner and all cases are dealt with on an individual basis and decided on merit, according to the eligibility criteria set out in the scheme. There have been no cutbacks in this area. There have been no policy of cutbacks initiatives by staff on their own behest or at the behest of anyone else. The fact that more than 6,000 extra children have been awarded the domiciliary care allowance should be acknowledged, considering the comments about the staff and officials in my Department. There have been no instructions issued by anyone in Government to cut back in this area.

Deputy Mattie McGrath

We are not saying that. The Minister should tell the truth about it.

Deputy Joan Burton

The budget was difficult but because of the state of the economy difficult decisions were made with regard to social welfare. Specifically, the domiciliary care allowance and carer's allowance were protected. I said this at the time of the budget because I regarded it as very important to protect those payments. One quarter of the number of children now in receipt of the payment have been awarded it by my Department. I can understand the Deputies' concern about individual cases but to say there is an agenda being pursued by staff in the Department or by medical assessors to deprive parents of children of the domiciliary allowance is simply not borne out by the fact of the numbers.

Deputy Catherine Murphy

I am not making these people up. We are not making these stories up.

Deputy Colm Keaveney

Domiciliary care allowance is payable in respect of children under 16 years of age who have a disability so severe that it requires the child needing care and attention and-or supervision substantially in excess of another child of the same age. This care and attention must be given by another person effectively full-time. In that respect, I salute those carers for their dedication and their commitment to domiciliary care. That care is offered to the child so that the child can deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months.

Eligibility for the domiciliary care allowance is not based primarily on the medical or psychological condition but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. Each application is assessed on an individual basis taking account of the evidence submitted and no specific condition or disability qualifies or disqualifies a child from qualifying for the allowance. Applications for children with autism and other intellectual disabilities are processed in exactly the same manner as applications for children with other types of disability.

The Department's target is to process domiciliary care allowance claims within seven weeks. Currently, the average time period to process a domiciliary care allowance application is eight weeks. We agree with the principles set out in the motion and as outlined by Deputy Joan Collins with regard to the processing of claims. During the first quarter of 2012, the average waiting time for appeals dealt with by summary decisions was 22.4 weeks and 40.9 weeks for those that required an oral hearing. The comparable times for 2011 were 25 weeks and 52.5 week,s respectively. There have been no cuts made to the scheme in recent budgets and the rate of payment remains at €309.50 per month, as reaffirmed by the Minister in her contribution.

Prior to April 2009, the domiciliary care allowance scheme was administered by the Health Service Executive. Since it transferred to the Department of Social Protection, the scheme has been placed on a statutory basis, as provided for in the Social Welfare and Pensions Act 2008. This is to be welcomed. The medical criteria as set out in the legislation requires that in order to qualify for the allowance, the child must be in need of care and attention and-or supervision substantially in excess of another child of the same age. Prior to taking responsibility for the scheme, the Department convened an expert medical group to draw up a set of consistent and objective guidelines for use in determining the medical eligibility of children for the scheme. The group was chaired by the Department's chief medical advisor and comprised of senior medical personnel from the HSE, as well as eminent professionals. The group considered the most appropriate methods for conducting the assessment.

I refer to the statistics associated with the scheme. The domiciliary care allowance is paid to over 24,000 parents or guardians in respect of 26,000 children at a cost of approximately €100 million in 2011 and with the accompanying respite care grant costing a further €45 million. The number of claims has increased steadily over the course of the years, with 11,000 in 2011, 23,000 in 2009 and 26,000 in 2012, an increase of 3,000.

A review policy is an integral part of all social welfare schemes and is necessary to ensure payments continue to be made only to those customers who meet the qualifying conditions. In circumstances where a child has a lifelong disability that is unlikely to improve to any significant degree, I welcome the fact that the Minister has confirmed that a "do not review again" status may be used on that file by the medical assessor.

Service users or clients who are reviewed are asked to provide relevant up-to-date medical evidence and details of the additional care needs of their child. They are now afforded a 60-day reference period in which to return this information to the Department. I am glad to say that where payment is stopped as a result of the review, the family is invited to submit further information in order to secure a payment. Up to now, service users or customers were requested to return medical review forms and supporting information within 21 days. I welcome the Minister's confirmation that the reference period will now be 60 days.

Following a review of the current 21-day timeframe, that extension will provide an adequate opportunity for families to provide supporting evidence with regard to processing the claim. I am delighted that the Minister intends to undertake a policy review of the allowance over the course of the next nine months. It gives the Department an opportunity to clarify the objectives of the policy, to consider what legislative change is required and also consider what refinement of current administrative and medical processes is needed in the context of the existing system. As part of this review, the question of the duration of review periods for the allowance must be actively considered, based on the medical condition of the children involved, while taking account of other priority demands on the medical resources required to underpin adequate and acceptable care for that child. The primary objective has to be the care of those children and the support of their families.

Deputy Barry Cowen

I wish to respond initially to what the Minister had to say about the 3,000 extra claimants' cases since 2009. We acknowledge that but we dispute the review initiated last year by the Department on her instructions. The statistics emanating from that review do not lie. The real stories emanating from that review form the basis of tonight's motion. The Minister spoke about a review of the whole DCA structure, which is supposed to pacify us and those whom we represent. I have no doubt that Members on the Government benches have also been inundated by representations from families who have been affected by this review. I hope the Government side will take cognisance of those statistics and what constituents are saying throughout the country.

A fortnight ago, many families from across the country protested both here in Dublin and in Cork city against what we would term one of the most underhand and vicious cuts implemented by the Government. They were protesting on behalf of the most vulnerable children in society, many of whom are unable to speak for themselves. The covert cutbacks to a payment that these children are utterly reliant upon exposes the cold strategy of the Government to mask its own failures with a devastating series of below-the-radar cuts.

I welcome the Technical Group's motion as an opportunity for us to raise the plight of the families who gathered here two weeks ago, many of whom are in the Gallery this evening. Their profound difficulties with the escalating series of cuts, straining their already stretched resources and undermining their ability to care for severely disabled children, is the human side of insidious cutbacks. For parents of children with special needs, and severely autistic children, the DCA is used for vital services such as speech and language therapists, occupational therapy and other special needs therapies.

These types of key treatments are absolutely essential if these children are to be in a position to get the most out of their lives. At €309.50 per month, the payment represents the difference between making ends meet and things falling apart for families trying to provide a good upbringing for their vulnerable children. Given the severe financial pressure that these families are now under, this motion is a timely chance for the Government to reflect on its policy. On behalf of the Fianna Fáil Party I am calling on the Government to completely reverse its policy on the domiciliary care allowance review process. I ask the Minister to note that we are here to discuss the review process. Deputy Micheál Martin recently pressed the Taoiseach on this issue at Leaders' questions. He outlined the grim nature of the cuts that have been insidiously introduced. Almost 50% of children with autism and special needs have had their payments taken from them. He cited a letter sent by the Department to the parents of one autistic child with serious challenges. The quotation from that letter is indicative of many similar letters sent to such parents, carers and guardians. It stated: "The needs of your child are no different than that of any six year old."

The increasingly draconian restrictions on the domiciliary care allowance are further compounded by hits to the family income supplement and carer's allowance. Families who face major challenges in raising their special needs children must now face further hurdles put in their way by the Government. The DCA is now paid to 26,000 children across 24,000 families, with spending on the scheme and the respite care grant, which is automatically paid to all recipients, reaching €145 million in 2011. This money is an integral part of the budget of the families of those 26,000 children who need this payment.

The Department of Social Protection took over responsibility for the scheme from the Health Service Executive in April 2009. Under this Government, and especially since last year, I make no apologies for saying that it has ramped up efforts to reduce payments under the DCA. The Government review announced over a year ago has prompted a drastic cutback in the DCA. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required that parents provide. Each application is assessed on an individual basis, but the Government is utilising that very process to reduce the number of recipients and lower spending. For example, this January, following a review of their claims, 57 claimants were notified that they no longer qualified for the payment. A savings figure of €326,239 relating to these 57 DCA claims and associated respite care grants has been recorded. This figure will further increase when the savings figure relating to any associated carers allowance is finalised. It is this money that these families need to pay for the therapies and services that are integral to ensuring these children have the opportunity to get the most out of their lives.

The Government reviewed 402 cases last year and cut the domiciliary care allowance for almost half the children involved. The families of 193 of these children were suddenly told that they will no longer receive the payment. Most of these are children with autism over the age of four. The Minister said that Opposition speakers were only representative of children with autism. We are not, but the figures do not lie. These statistics emanate from last year's reviews. These are children with profound learning and intellectual challenges. The DCA was used by their families as a payment to fund vital services. The process did not include any face-to-face assessment of the children affected, so officials had no first-hand knowledge of the care they required. The review also ignored medical evidence of the children's conditions, and the evidence from parents about the level of care and attention the children need. People are justifiably wondering how the decisions on cuts were made.

The difficulties do not stop at the subtle elimination of the DCA for hundreds of families. Appealing the decision takes weeks, and many more weeks than the period suggested by the Government spokesperson earlier in this debate. According to information from the Department, based on figures for the first quarter of 2012, the average waiting time for appeals dealt with by summary decisions was 22.4 weeks, and 40.9 weeks for those that required an oral hearing. Families unfairly hit by an inadequate review process are left for months with no recourse and grave uncertainty about their financial future. In short, the reviews put in place by the Government lack transparency, appear to have taken no face to face assessment of the child in question and have all the appearances of the worst aspects of bureaucracy. Most pointedly, they have hit vulnerable, autistic children the hardest. I emphasise that the statistics that emanate from those reviews point to those facts. A review process that leaves hundreds of vulnerable families who use a payment to provide a better quality of life for their children bereft of support is a flawed review system. The Government must change this compromised review service - not carry out a review that will take another eight months and that will be similar to other reviews called for by this Minister for reviews in the Department of Social Protection.

The steady reduction in the domiciliary care allowance reflects a broader approach by the Government towards covert cuts. It has made hay out of defending headline efforts such as not reducing social welfare rates but in truth the axe has fallen hard on those least able to bear it. The Government policy is to bring cuts in through the back door on the parts of society least able to shout about it, least able to have the massive unions behind them or to have the sort of lobby groups that are needed in order to grab the Government's attention. Behind a slick spin operation the Government has systematically introduced a raft of cutbacks that place a hefty burden upon the shoulders of those struggling to make ends meet and that make a complete mockery of claims that it defends the most vulnerable in society.

In areas such as fuel allowance, family income supplement, community employment schemes, jobseeker's benefit, child benefit and farm assist the Government has slashed with nothing but newspaper headlines in mind rather than the actual impact the cuts will have on the most vulnerable sections of our society. Only a strong public backlash against the callous cuts to the disability allowance forced it to backtrack earlier this year following the budget. Further public dismay at the inevitable impact of community employment schemes cuts prompted another pause by the Minister which is quickly becoming her trademark, as I said earlier in regard to the reviews of several of the entitlements within her remit.

In reality while the slow, covert cuts to domiciliary care allowance have taken time to work their way through the system they are having a devastating impact upon hard pressed families. In a similar vein, carer's allowance is now calculated as income for the purposes of the family income supplement. This will have a major impact on hundreds of families across the country who rely on family income supplement to make ends meet and they will find themselves now ineligible. The devastating impact of these measures across various exposed sections of Irish society show up the fiction of the Government's social protection policy. Last month's calculated effort to deflect attention away from a cut to the one parent family allowance is part of this policy of spin. The Government strategy is to appear to be avoiding cuts while in fact bringing them in covertly. The recent Social Welfare and Pensions Bill is a testament to that strategy but its impact upon ordinary families and its potential in condemning a generation of one parent families to the poverty trap will be felt for many years to come. The insidious nature of the cuts, shrouded by Government spin belies the devastating impact they will have. The domiciliary carers allowance cuts are a strong example of that.

We must highlight that this Government cannot hide from the facts. The Government has abandoned the progressive budgetary strategy developed over the past few years and pursued a regressive policy. The ESRI has studied in detail the impact of the budgets over these past most difficult, financially challenging years. It found that budget 2012 imposed greater percentage losses on those with low incomes. Callan, Keane, Savage and Walshe, as detailed in the ESRI special articles, concluded that budget 2012 involved greater proportionate losses for those on low incomes, reductions of about 2% to 2.5% for those with the lowest incomes, as against losses of approximately 0.75% for those on the highest incomes.

The regressive policy by the Government is a stark contrast, believe or not, to the budgetary policy pursued under Fianna Fáil. The paper I mentioned found that since October 2008 losses imposed by tax and welfare policies have been greatest for those on highest incomes, with a lesser impact on middle income groups and the least impact on those with low incomes, as compared to budget 2012. It found the same pattern prevailed in public sector pay cuts, with the higher paid bearing the brunt.

The Government has failed miserably to emulate this tough but fair approach. Instead it has relied upon spin to mask its covert, insidious cuts that have had a regressive impact upon Irish society placing the burden of fiscal adjustment upon those least able to bear it. Those families affected by the underhand cuts to the domiciliary care allowance know all too well what is a regressive policy.

I would like to take this opportunity to once more call upon the Government to change the policy in regard to the review the Minister initiated last year. The impact upon ordinary families who are trying to make the most of life for their children is too deep. The review process is too flawed and utterly impersonal. The effect on vulnerable children is and will be too devastating. Tonight's motion is a chance for the Minister to come out from behind the wall of spin, acknowledge a mistake and change course. We acknowledge and do not dispute the fact that more cases have come on stream since responsibility for this measure moved to the Minister's Department in 2009. We acknowledge that there have been 3,000 new cases and we welcome that-----

Deputy Joan Burton

There have been 6,000.

Deputy Barry Cowen

-----but what we are disputing is the impact this is having. The statistics emanating from the 400 reviews initiated last year are stark. They are the reason we, members of the Minister's party and Government backbenchers are receiving representations throughout the country. They know too well the effect that this review and the impersonal nature of the review process that is in place is having on these families who have children with special needs and especially on those who have autistic children. I do not say that lightly. As I said before the Minister re-entered the Chamber, that is as a result of the statistics that emanate from those reviews. Fianna Fáil will support this motion and stand beside the most vulnerable members of this society.

Deputy Sandra McLellan

I welcome the opportunity to speak on such an emotive and personal issue this evening. We in Sinn Féin warmly welcome the spirit of this motion but we have concerns regarding some of the proposals that are being put forward. We do not agree with the recommendation from the Technical Group that the domiciliary care allowance should be transferred from the Department of Social Protection back to the Department of Health; this in our view would not benefit these families in receipt of the domiciliary care allowance, in fact we would view this as a counter-productive measure.

Logic would have it that all income support should be placed under the one roof. It is evident that it is at the administration level that changes need to occur. This motion also proposes that all domiciliary care allowance should be made by child protection or disability social workers. This in our view is extremely impractical; due to financial cutbacks we have a severe shortage of both social workers and disability workers. If anything we should be attempting to lighten their load as they are currently severely overworked. What we need are better guidelines and training for deciding officers

According to recent figures from the Department of Social Protection, nearly two out of every three applications for domiciliary care allowance are refused. This stands as a huge 62% refusal rate, which represents a trebling of the refusal rate for children with intellectual disabilities and autism since 2009 when the administration of this scheme was taken over by the Department of Social Protection.

These decisions are coming at a time when families across Ireland are struggling to cope. There is a number of psychological, speech and language, occupational therapy and paediatrician reports outlining the need for extra care for these children and their families, yet these reports are continuously overruled.

Many of these parents cannot work outside of the home and this allowance is their only income in some instances. Like many of my colleagues I have had many parents through my clinics majorly concerned at the thought of losing their vital allowance. For example, just last month a mother of three young girls came to my clinic. Two were autistic. The mother proceeded to tell me that she only receives domiciliary care allowance for one but it is probably only a matter of time before she will get a review. This woman has just been refused domiciliary care allowance for her youngest daughter, yet she has same diagnosis as her sister. The family now awaits a review for the other daughter who is in receipt of domiciliary care allowance and is in great fear of losing it.

Figures from the Department of Social Protection show that domiciliary care allowance is paid to more than 24,000 parents or guardians in respect of 26,000 children. In 2011, 403 reviews were carried out, 187 families were found to be no longer eligible and 52 cases have yet to be finalised.

The combined number of people who appealed review and first time application decisions last year was 2,420, and while 1,259, or 52%, of these appeals were successful, 48% were not. In the past six months 213 domiciliary care allowance recipients have been found on review to be no longer eligible for the payment. This enormous hike in refusal rates illustrates the severe lack of understanding in the Department of Social Protection about these families who desperately need this allowance. This lack of understanding is also reflected in the flawed application process which places more pressure on families applying for a welfare payment, putting them through the stressful ordeal of appeals and oral hearings, not to mention the expense of this extended process on the State.

Parents are not given sufficient notice of the review to gather the supporting documentation from consultants and therapists which is necessary to re-establish eligibility successfully. My colleague, Deputy Ó Snodaigh, has made several recommendations to the Department on areas of improvement, specifically that parents should be granted a period of six months to prepare for the review.

While I welcome the motion, I have concerns about some aspects of the proposals. That said, the huge rise in refusal figures is of great concern, as refusal has a dramatic effect on the daily lives of families throughout Ireland.

Debate adjourned.

The Dáil adjourned at 9 p.m. until 10.30 a.m. on Wednesday, 9 May 2012.