Dáil Éireann Debate, Thursday - 16 February 2023
83. Deputy David Cullinane asked the Minister for Health if he will put in place a redress scheme for residents of long-term residential disability services who were wrongfully charged for their care; and if he will make a statement on the matter. [7552/23]
View answerThe first question relates to residents of long-term residential disability services who were wrongfully charged for their care. This is part of the long-stay care issue that was at the heart of a number of memos which were published in the Irish Daily Mail a number of weeks ago and have been discussed at the Committee of Public Accounts and the Oireachtas Joint Committee on Health. What work are the Minister and his departmental officials doing to establish if additional residents of residential disability services may have been covered by the redress scheme and may need to be contacted by the Department?
It has been a long-standing principle that people receiving residential care would contribute to the cost through a charge or contribution, based on their means, if any. As we are aware, inpatient long-stay charges which were levied up to 2004 under regulations from 1954 and 1976 were deemed to not have a legal basis. A repayment scheme was established in 2006 and the scope of the scheme, as set out in the Act establishing it, was specifically limited to inpatient charges levied under these regulations.
I understand that the Deputy's question relates to contributions towards household charges in residential care facilities. As these contributions were not inpatient charges raised under the regulations, they did not come under the definition of recoverable charges under the scheme. I am aware that repayments were made under the scheme in respect of residents in a small number of disability institutions following a decision of the independent appeals officer, based on the specific circumstances of these cases.
It is a complex matter and there is further examination. The work is being comprehended within a broader examination of matters recently raised.
The 2011 memo which was published identified 9,000 people with disabilities who may also have been wrongly charged with an estimated liability of €350 million. Yesterday at the Oireachtas Joint Committee on Health, the Secretary General of the Department of Health said he has seen a database that underpins the figure of €350 million, which he believes may be too high as not all of those people may have had entitlement. However, he accepts that some people may have had an entitlement. The 2011 memo is quite explicit in stating that there are and were people at the time who were analogous to those 512 people in those three homes who got compensation, fully settled, provided for by the Department. Those are the three homes the Minister referred to. The memo was very clear. There were other residents with the exact same entitlement. The problem is they never applied under the scheme because they were told they were not entitled. They did not appeal decision because obviously they did not apply in the first place. We need to establish who these people are and if they had a liability under the scheme, as those other 512 people did. We should seek them out and make sure they are properly compensated.
We should all be slightly wary of the estimate. It seems that estimates associated with many of these issues were very high relative to the reality. For example, a €5 billion estimate was put on the repayment scheme and it ended up being less than 10% of that. It would seem that very high estimates were put against many of these issues over time. The issue at hand essentially is whether with regard to the household contributions, which were not covered in the repayment scheme and were judged by the scheme itself to be not covered under it, there are individual cases where the level of care provided would be considered inpatient services rather than household contributions. That is exactly what the Department is looking into.
It needs to be done very quickly. I have seen the 2011 memo which is quite explicit in stating that there are other residents in similar homes who would have a similar if not identical entitlement to the 512 people in those three homes. I accept that the potential liability of €350 million as stated in the memo is a worst-case scenario; it is just an estimation. However, it is very clear that when that memo was written, the Department had knowledge of people who had exactly the same entitlement as those 512 people had. It is an issue of fairness. The Secretary General of the Department of Health said yesterday that while many of these issues are unfair, they are policy issues. It rests with the Minister and the Government to deal with this once and for all. It does not matter if it is 50, 100 or 1,000 people. They are people with disabilities who would have had an entitlement. They accepted that they did not qualify under the scheme, as advised by the HSE and the Department at the time, and yet we know that 512 people did once they appealed it. The Department needs to find out who they are, do the trawl, seek them out and make sure they get what they should have got back in the day.
The Department is looking at exactly those issues. As I said, it will come down to a case-by-case basis. The advice I have is that it would not be applied as broadly as the scheme for nursing homes which were broadly defined as inpatient services. The question really is in what individual institutions, and in what individual cases, were they deemed to be household charges rather than inpatient services.
