The transport and mobility needs of these individuals were not adequately catered for at that time, although there have been significant developments since. As the Ministers stated on that day, were we to design a solution to meet the mobility and transport needs of people with physical, sensory, intellectual and mental health disabilities today, it is extremely unlikely that we would establish schemes of this type.
The Ombudsman recommended that the Department of Health revise both schemes to make them compliant with the Equal Status Acts by removing the age limit and using a broader definition of disability in respect of eligibility for both schemes. It has proven extremely difficult to resolve this matter. Several policy options have been considered in detail. These have raised significant issues, including the feasibility of extending eligibility under the schemes.
As was outlined at the previous hearing before the joint committee, the best data available to the Department indicate that the cost of such an extension could be as much as €100 million per annum in the case of mobility allowance and €200 million over a three year period in the case of the motorised transport grant. In that context, the Department considered the possible expansion of the eligibility criteria within the current budget of €10.6 million. However, given the number of people who would then be eligible, the resultant payments would be so reduced as to make them almost meaningless. The Government came to the conclusion that an extension of either scheme would create serious financial pressure on the health budget in the current climate and be unsustainable.
It is important also to emphasise that the Department of Health accepts the position taken by the Ombudsman on this matter. Her position on how these schemes have been operated is clear. I acknowledge the inequalities in the schemes as they have operated. I acknowledge the fact that schemes under the auspices of the Department must comply with the Equal Status Acts. I also acknowledge that it would have been preferable if these issues had been addressed before now. However, I must also acknowledge that the possible additional costs - direct and indirect - of expanding the eligibility criteria for the schemes are completely unaffordable without very significant additional funding, which is not available, or by cutting already scarce health and personal social services to people with disabilities, older people and those with mental health difficulties. Clearly, that is not an action we were prepared to take.
I assure the committee that the Department has made many efforts to resolve the difficulties without imposing undue hardship on those who have been reliant on the supports. This has been at the centre of the Department’s efforts to find a solution which would be financially affordable and legally sound. However, despite these efforts, the risks to the State as identified by very strong legal advice were too great. The Government, therefore, reluctantly made the decision to close the schemes to further applications with effect from close of business on 26 February last.
It is important to outline for the information of the committee the full details of the Government’s decision. The mobility allowance and motorised transport grant have been closed to any further applications with effect from close of business on the day of the Government’s decision. The mobility allowance will continue to be paid for a further four months in respect of those already in receipt or those whose application has already been received and who are found to qualify. The motorised transport grant will also be paid to those whose applications have already been received and who are found to qualify. No further applications will be accepted for either scheme. At present, up to 4,700 people are in receipt of a mobility allowance payment and will continue to be until the four month period has elapsed. A total of 300 people each year had been in receipt of a motorised transport grant up to the date of closure of the scheme.
The Minister and the Minister of State have instructed the Department of Health to lead a review of the issues and to seek a solution or solutions as to how best to meet the mobility and transport needs of all those who require support, within the budget available. A review group has now been established for that purpose and met for the first time on Thursday, 21 February. Both the Minister, Deputy James Reilly, and the Minister of State, Deputy Kathleen Lynch, attended the meeting and outlined the complexities of the issues now faced. The group is independently chaired by Ms Sylda Langford and includes representatives of people with disabilities, relevant Departments and State agencies, including the HSE and the National Disability Authority. The membership includes those who can best assist in designing a solution, and additional input will be sought from others if required. The group is meeting again tomorrow afternoon.
It has been agreed that the group will work in a number of stages, commencing as a priority, led by the Department of Health, with a review of the issues around the mobility allowance and the motorised transport grant and devising an appropriate solution. Once this first phase has been completed, the group will continue its work under the leadership of the most appropriate Department to examine wider issues around transport for persons with disabilities.
As part of the initial stage of the review, the Health Service Executive will examine the circumstances of all those currently benefiting from the schemes to ensure the identified solutions will encompass their priority mobility needs. In addition, the HSE has been instructed to contact each individual who has been in receipt of the payments to notify him or her of the Government’s decision and the actions now being taken.
I assure the committee that the closure of the schemes is not an action the Government wanted to take and the decision was not taken lightly. The Government considered every possible configuration to keep the schemes in payment. This included an option of allowing those in receipt of the mobility allowance to retain it on a more permanent basis and to close the scheme to new entrants. However, the Government was advised that this would be legally unsound. We asked if the scheme could be redesigned. Again, the advice was that this would be legally unsound, in particular as regards the very broad definition of disability in the Equal Status Acts. It would not be possible to state that only one category of people with disabilities could continue to receive the allowance while others who are included under the definition of disability in the Equal Status Acts could not.
The Department of Health, the Minister, Minister of State and the Government are aware of the significant concerns the closure of the schemes has brought. It is in that context that the Department has been active in seeking a solution to this issue which would avoid the necessity for such a decision. As I have stated, attempts have been made for some time to resolve the issues around the schemes. Advice has been sought on a number of options to address the difficulties, all of which have been found to be legally unsound or financially unaffordable.
It is important that I outline for the committee the consultations which have taken place since I last appeared before it on 6 February. Department of Health officials met representatives of the Disability Federation of Ireland, the National Federation of Voluntary Bodies and the Irish Wheelchair Association following the committee meeting and outlined to them the considerable legal and financial difficulties around the schemes. At the meetings, the input of those organisations was sought to help find a solution or solutions within the available funding.
Together with officials, I met the national council of the Disability Federation of Ireland on Wednesday, 27 February. The closure of the schemes was one of a number of issues discussed. Broader consultation will be undertaken as part of the project group’s work to ensure as wide a range as possible of views and inputs are taken into account. In seeking a solution which will address the transport and mobility needs of those who require supports, the Department is concerned about the group of people who are currently benefitting under the schemes. We must also equally consider, however, the broader group whose needs the Ombudsman has recommended must be looked after on an equitable basis.
The challenge is to find a solution which will best meet these needs within the budget available. However, it must be emphasised that as the Taoiseach, the Minister, Deputy Reilly, and the Minister of State, Deputy Lynch, have all stated, the funding of €10.6 million currently allocated to the schemes will be reinvested in its entirety in the solution or solutions which will be identified by the group. The Government’s decision commits that this allocation will remain in place to service priority mobility and transport supports for those most in need. The review group will therefore seek solutions which can be delivered within the available funding.
I assure the members of the committee that if the Department could have found an easy solution to this problem, we would have found it. We must comply with the Equal Status Act; that is clear. A fundamental truth is that it was not possible to allow the two schemes to continue as they had operated, given the significant financial risks to the State. The only way we can address this is to devise a transport solution that will best serve those with priority needs in the future.
I know from the letter of invitation that the committee is disappointed at not being informed, either at the meeting of 6 February or in the intervening period, that suspension of the schemes was being contemplated. I would like to reassure the committee that no solution or decision was made on this matter when we spoke last. It is not possible to predict decisions that ultimately are matters for Government in advance of such decisions being made. We were clear to the committee that the situation was serious, and at the centre of our thoughts were the people in receipt of those payments. Also in our thoughts, however, are this year's school leavers, who will require a placement in September, and our efforts to find places for them with just €4 million in additional funding. All of these decisions are being made in the context of the HSE finding in the order of €800 million in savings in 2013 alone. We are trying to protect as many core health and personal social services as we can in the face of growing demands and diminishing resources. In that context, we were pleased to protect the €10.6 million budget which has been allocated to these schemes to help us to find an appropriate solution. To continue to operate these schemes as they have been in the face of potential legal challenges was ultimately a risk we could no longer afford.
I thank the committee for its attention and I will be happy to answer questions members may wish to put to me or my colleagues.