The next matter is a discussion with officials of the Department of Finance and the Revenue Commissioners on the current operation of the disabled drivers and passengers (tax concession) scheme. I welcome Mr. Pat Murphy and Ms Lynda Finneran from the Department of Finance and Mr. Ciaran Coyle and Mr. Paddy Barrett from the Revenue Commissioners. I draw the attention of witnesses to the fact that while members of the committee enjoy absolute privilege, the same level of privilege does not extend to witnesses appearing before the committee. A written presentation has been circulated and members would like to go straight to questions. The focus of the committee's concerns is the medical criteria.
Disabled Drivers: Presentation.
I raised the matter of the medical criteria in an Adjournment debate ten years ago, but they are still exactly the same. At the time I visited what is now the Disability Federation of Ireland and at the request of the doctors I met people who had been refused tax concessions. They included young people who had suffered a stroke and were desperate to get back to work. In contrast, I remember one young man in attendance who had lost a leg was entitled to a tax allowance. He told me that he had just run a marathon and came in to try to show the unfairness of the scheme. The medical critieria remain the same as they were at that time. Can members do anything to have them changed? How can they be made more practical?
I concur with Senator Henry. I am often amazed at the representations made to me at my clinic. In some cases, I tell people that they must be wrong only to discover, on checking the position, that they are correct. A woman whose husband has only one arm recently informed me that he would qualify for VAT and VRT relief if he had only one leg. It is possible to install equipment in a modern vehicle that would enable a person with one arm to operate it. The Minister for Finance was asked, in a parliamentary question, the reason the scheme is available to those with one leg but not those with one arm but failed to clarify the position in his reply. Why does a person with one arm not qualify for VRT and VAT relief while a person with one leg qualifies? Is it planned to change the rules in this regard and, if not, why? This anomaly must be addressed.
Persons who have suffered strokes or who have illnesses such as multiple sclerosis also visit my clinic. A woman suffering from a condition of which I had never heard - osteitis pubis - recently did so. Apparently, it is common among women in pregnancy to experience displacement of the hip bone but it usually resets after childbirth. It appears that five women in the entire country were unfortunate that this bone did not reset. The woman in question applied to avail of the disabled drivers and disabled passengers (tax concessions) scheme but her application was refused and she appealed a decision. She has been waiting years for the outcome. I understand the appeals board was suspended for a year or thereabouts, which created a large backlog. To be fair, however, significant progress is being made and it is now dealing with 2005 applications. The operation of the disabled drivers and disabled passengers (tax concessions) scheme is unsatisfactory and must be reviewed. It is particularly unsatisfactory that appeals take so long to adjudicate.
I recently dealt with a case involving an elderly woman who had suffered a stroke and was being cared for by her daughter, a single parent with two children at school. The woman in question was paralysed and confined to a wheelchair. Her daughter asked for an exemption from the scheme's rules to purchase a new wheelchair-friendly vehicle that would allow her mother to park closer to supermarkets and other facilities. What is the position in this regard?
Dr. Ray Murphy, who is now retired and whom members may remember, has campaigned on this issue for some time. He has told me that, in the absence of a change in the medical criteria applying to the scheme, there is no point in making an appeal.
The question, therefore, is whether it is possible to have the medical criteria changed, given that there is no point in making an appeal as matters stand.
Mr. Pat Murphy
To put the issue in context, an interdepartmental review group studied the scheme and produced various suggestions. The scheme was introduced in 1968 for a specific purpose, namely, to help people to get to work. During the years, it has been broadened considerably. One can obtain an exemption from VAT, VRT and road tax when one buys a car and one is entitled to reclaim excise on petrol used in operating the vehicle. The scheme is very generous and costs an average of €5,500 per person. There are approximately 9,500 people availing of it and the full cost, including that pertaining to road tax, is approximately €56 million. One of the difficulties with the scheme is that it is so generous. If one were to extend the criteria considerably under the current arrangements, it would be very costly. Allocating another €50 million or €100 million to a scheme for disability would not necessarily be the best approach. The eligibility criteria are medical in nature and, as I am not a medical expert, I will not comment on who can qualify. The senior medical officers in the HSE areas represent the first port of call and decisions are appealed, if necessary, to the Medical Appeals Board.
We are continually examining how we can provide a better scheme to meet the mobility needs of people with disabilities. However, I am not sure the widening of the current scheme would be the best way to do so. The interdepartmental group recommended that the passenger part of the scheme should involve some form of direct payment system. The matter is complex and there are many issues to be examined. We are well aware that people are unhappy with the present scheme. The departmental officials have to answer the parliamentary questions and respond to representations and therefore have no illusions about people's opinion of the scheme. A problem with such a generous scheme is that it is difficult to widen the criteria and ascertain that the money is going to the people who really need it.
Perhaps I could answer some of the other questions.
Very well.
Mr. Murphy
There is a big backlog of appeals. A three-person board was set up to deal with them but the number of appeals increased considerably during the years and, for one reason or another, the board had difficulty in meeting as often as it would have liked. It did not meet for about six months and the chairman retired. Last year, the board was reconstituted and only three people, who must meet together, were nominated to deal with the outstanding cases. The cap on the number of people on the panel was first increased to five and then to ten but it was removed completely in September of last year such that there are currently 17 doctors on the panel. Last April one consultant was appointed on a full-time basis to act as chairperson of the board. A new secretary was also appointed and, to be fair to the board, it is doing significant work dealing with the appeals. It wrote to everyone who had appealed to ascertain if they were still interested in the process. Often, if an individual was not quickly called for appeal, his or her medical situation could have worsened. He or she may then have reapplied through the system at which stage a senior medical officer would have given a primary certificate.
The board established other changes in the process. A new tracking system was introduced. Previously, funding for the board was through the then Eastern Health Board and subsequently the Health Service Executive, HSE. The board is now hosted in the National Rehabilitation Hospital. The Department of Finance recoups the hospital for the costs of the board. Last year, a sum of €300,000 was allocated from that fund and it will be the same amount this year.
When the board was reconstituted in April 2005, people who were contacted on their appeals had been waiting between two to two and a half years. The board is now calling people who appealed 12 months ago. Approximately 480 people have appealed decisions on their claims. Some 150 of those have been called already but for one reason or another were not able to attend. In January and February 2006, the board met 84 people but another 29 turned down the offered appointment. Progress is being made in reducing the waiting time. This will, of course, depend on the rate of future appeals. It will take one to two years to have appeals heard on demand.
If the medical criteria have not changed, there is no point in an individual appealing. Is there any likelihood that they will change? I agree that it is a generous scheme. However, it was initially devised to assist people to return to work. I felt sorry for the young ESB engineer in his 30s who had suffered a stroke and wanted to return to work after recovery. He was one of the neediest cases to receive some relief to return to work.
Will Mr. Murphy send on the information as to what percentage of appeals are successful?
The scheme's medical criteria must be reviewed. They state that a person without both hands or arms qualifies for the scheme. Obviously, a person with one arm does not. What level of flexibility is there in the guidelines? We can all blame the appeals officer, but he or she is simply following the criteria laid down.
I referred to the case of a lady with osteo pubis. She had doctors' and specialists' letters when applying for the concession but they were disregarded at the initial assessment. That can be a frustrating experience. Are people wasting their time getting these letters? Should the guidelines be amended to allow the deciding officials and the appeals officers to take on board independent medical advice?
The same thing happens in the social welfare area. I am always amazed that people with chronic back problems can be told by an appeals officer that they do not have a back problem, even though they have doctors' letters to that effect. I am not too sure what magic powers appeals officers have. However, it seems that in some cases people seeking a social welfare payment or a tax concession are treated unfairly. I am bemused by how independent professional medical advice can be ignored and overruled.
Mr. Murphy
I am not a medical person and I will not pretend to be.
I accept that.
Mr. Murphy
The question of criteria is a policy issue decided by the Minister. I cannot say what is happening.
The bottom line is that the Minister would have to change this for the Department to have the freedom to do anything in this regard.
A person who has no arms qualifies but a person who has one arm does not. I am not a medical person or an intellectual but that does not make sense to me.
It does not make sense to the delegates either but they have nothing to do with changing it.
Mr. Murphy
The criteria were drawn up by medical people.
To be fair to the delegates, we are putting issues to them over which they have no control.
The purpose of the meeting is to establish the criteria. We now recognise that we should try to cut down on the appeal time. However, that is not the issue for us as members of this committee. We are trying to establish what can be done.
Does Mr. Murphy know how many appeals are successful?
Mr. Murphy
It varies from year to year, from approximately one fifth to two fifths, or 20% to 40%.
That is surprising, given that the criteria are so clear and strict.
Mr. Murphy
In some cases, as a result of the lapse of time which could be due to the long waiting list, a person's condition might have changed.
Deputy Neville's point is correct. It is up to the Minister to change the regulations. I suggest that the committee send a letter expressing dissatisfaction with the current guidelines. The committee could quote the example I gave whereby a person with no arms qualifies while a person with one arm does not qualify. We should ask the Minister to change those regulations.
Either way, the Tánaiste and Minister for Health and Children will be here in two weeks' time and we can refer to the issue of changing the guidelines. We will not put these witnesses under pressure this morning.
Is this not an issue for the Minister for Finance rather than for the Department of Health and Children?
It is administered by the Department of Finance but I am sure the guidelines are decided by the Department of Health and Children.
Was the initial legislation drawn up by the Department of Finance or by the Department of Health and Children?
Mr. Murphy
The regulations are made by the Minister for Finance.
That is the problem. The Tánaiste will not answer questions on this. She will say it has nothing do with her.
There is no point in us teasing this out further. The reality is that unless the medical guidelines are changed, there is nothing we can do.
It surprises me that at some stage up to 40% of appeals are successful. I do not intend to sound flippant, but given that the regulations are so strict, how can somebody be incorrect in assessing whether somebody has one arm or no arms? Does Mr. Murphy appreciate my point? The regulations are so clear and concise that there should be a very low level of successful appeals. The regulations refer to persons without both hands or without both arms, and persons without one or both legs. People do not lose a leg or an arm during the time that elapses before the appeal is decided upon.
The chairperson of the board has told us that a good percentage of those that are successful relate to cases where the condition is degenerative. Given the lapse of time and the backlog in cases, there could be a couple of years between the time a person applied and was refused the primary medical certificate and the time he or she appealed in which case the circumstances would have changed. On that basis, he or she qualifies and satisfies the criteria.
We could spend all day arguing about this but the next stage is to write to the Minister for Finance directly expressing our grave concern and asking that the guidelines be changed. Is that appropriate?
I have no problem with that proposal. If Senator Browne proposes it, I will accept it.
I so propose.
However, I see no other function for this committee. The matter has been made clear to us and we thank the officials
Mr. Murphy
I am probably repeating what Ms Finneran said but a number of the criteria use phrases such as "wholly or almost wholly without the use of both legs" and "wholly without the use of one leg". There are no absolutes. There are conditions which could deteriorate over time. There could be a long period of time between the person being refused by the senior medical officer to the time he or she gets the appeals board. Just under 40% is the most recent figure in regard to people waiting for a long period before——
Is it like the Department of Social and Family Affairs where a successful appeal is retrospective to the time of application for appeal?
Mr. Murphy
No. It dates from the time one gets the primary medical certificate.
If somebody is waiting two years for an appeal, he or she only gets the benefit of the scheme from the time the appeal is heard.
Mr. Murphy
It is from the time he or she is given the certificate.
The Department of Social and Family Affairs is clear that if one's appeal is successful, it is retrospective to the time one applied. I would have thought the same criterion would have applied in this case given the long waiting list. If somebody applies for a pension, does not get it and successfully appeals, the pension is backdated to the date of application.
Mr. Murphy
It is a different situation. One is given the certificate, one buys a car and then one claims the relief.
Mr. Ciaran Coyle
Revenue administers the scheme on behalf of the Department of Finance. With Revenue, the clock starts the minute the primary medical certificate is presented. At that stage, one gets a letter of authorisation from Revenue. One buys ones car, gets the VRT off it and claims the VAT back. There is no retrospection. One cannot have a car and get the credit. It is from the day the primary medical certificate is presented to the Revenue Commissioners.
I would not have a problem with that but for the two year delay with the appeals.
Mr. Coyle
I accept that.
It is up to us to pursue a relaxation of the guidelines in the medical area. I thank the officials for clarifying the matter.
The joint committee adjourned at 12.30 p.m. until 9.30 a.m. on Wednesday, 22 March 2006.