Adjournment Debate.

Nursing Home Subventions.

Mr. Callanan

I thank the Minister of State for attending the Dáil to hear my call for extra funding for nursing home subvention in the western area, especially County Galway, where the level of enhanced subvention has been reduced. I will quote the difference in levels of subvention paid in the different areas. These figures were received from the association of nursing homes and include the full amount of basic and enhanced subvention. The rates are as follows. Those in the eastern area get €680, the southern area, €557 and the north-eastern area, €432, while the rate for the western area is €299 to €310. Clearly, the rates paid in the eastern area are more than double those paid in the west. I accept there may be a small difference in charges, but nothing like this.

Currently, there is a particular problem with the Galway area, where the enhanced subvention is capped at €85, giving a total rate of €275, leaving a major shortfall to be filled by relatives, even after taking old age pension into account. The annual budget for subvention in Galway last year was €9 million, but due to great demand, €11 million was spent. The HSE has now instructed the people involved that they must revert back to the figure of €9 million this year, so there must be a cutback. I call on the Minister of State to provide the money or to tell the HSE to provide the money for the increased enhanced subvention, especially in the Galway area, and to try to make the differences more appropriate so that payments in the eastern area are equivalent to those in the western area.

The criteria for improved enhanced subvention are also being curtailed. If a patient is on a waiting list for a public bed for which he or she is eligible, is offered a public bed and refuses, enhanced subvention payment ceases after a 28-day period. Where a patient's personal moneys have been depleted over the years while in a nursing home, enhanced subvention priority up to a maximum of €85 per week may be granted. This is subject to review. A patient must be resident in a nursing home for a maximum of six months to be in receipt of subvention prior to making an application for enhanced subvention. Exceptional cases will be reviewed by the general manager. This makes matters very difficult for patients in the western area. Nursing home charges have increased substantially in the past few years, but the biggest problem is that the basic subvention of €190 has not increased since the 1990s. This must be reviewed and a higher rate paid.

I thank the Minister of State for introducing the home care packages. I always believed home-based subvention should be brought in, but the home care packages are no doubt as close as the Minister of State can get to this. It means people can be treated in their own homes. I also felt the choice should be there. It is important that people can stay in their own homes and be treated there for as long as possible. I have nothing against nursing homes but if a survey were carried out, I believe most people would like to remain in their own homes for as long as possible. A time may come when that is not possible, but the home care packages are very welcome. I hope the scheme will be expanded to include more moneys in the future. I thank the Minister of State and ask him to review the situation, especially in Galway, and have the subvention rates increased to an acceptable level.

Minister of State at the Department of Health and Children (Mr. T. O’Malley)

I am taking this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. I thank Deputy Callanan for raising the question as it provides me with an opportunity to outline to this House the current situation with regard to the nursing home subvention scheme.

A nursing home subvention may be paid towards the cost of private nursing home care, where a person is unable to meet the cost and where he or she has been assessed as needing nursing home care by the Health Service Executive and where the person has satisfied a means test. The amount of subvention granted will depend on the degree of nursing home care required, that is medium, high, maximum, and the amount of the person's assets, including property, stocks and shares, savings and so on. The rates of subvention payable are as follows: medium dependency, €114.30 per week, high dependency €152.40 per week and maximum dependency, €190.50 per week.

The nursing home subvention scheme was introduced to assist with the cost of private nursing home charges and was not intended to cover the entire cost of nursing home care. Under Article 22.3 of the Nursing Homes Subvention Regulations 1993, the HSE may enter into an arrangement with a registered private nursing home to provide inpatient services under section 52 of the Health Act 1970. In making an arrangement with a private nursing home under Article 22.3, the HSE may pay more than the maximum rate of subvention, as mentioned already, relative to an individual's level of dependency, for example in cases where personal funds are exhausted, in accordance with Article 22.4 of the Nursing Homes (Subvention) (Amendment) Regulations 1996. The application of these provisions, however, is a matter for the HSE in the context of meeting increasing demands for subventions.

The average rate of subvention paid by the HSE generally exceeds the current approved basic rates mentioned above. Spending on the nursing home subvention scheme has increased from €5 million in 1993, when it was introduced, to in the region of €140 million in 2005. Additional funding for services for older people and palliative care amounting to €150 million was allocated in the 2006 budget. This is the largest ever increase in funding for services for older people and demonstrates the Government's continued commitment to older people and putting them at the centre of health policy now and in the future.

The investment package is primarily focused on caring for people at home, in accordance with their expressed wishes. This is in line with international trends and reflects the growing independence of older people who want to stay living in their own communities. However, for those requiring residential care, the Government has allocated an additional €20 million towards the nursing home subvention scheme for 2006 to provide for extra subvention payments and address the variations in payments in different areas, as alluded to by Deputy Callanan.

The Department of Health and Children is working on primary legislation to expand the policies and principles of the subvention scheme to facilitate implementation of the scheme by the HSE throughout the country and it is intended to bring this legislation before the Oireachtas in the near future.

The thresholds contained in the Nursing Homes (Subvention) Regulations 1993 regarding an applicant's assets and the value of an applicant's primary residence were increased by regulation on 14 December 2005 to bring them into line with today's values.

A working group chaired by the Department of the Taoiseach and comprising senior officials of the Departments of Finance, Health and Children and Social and Family Affairs was established following publication of the Mercer report, Study to examine the future financing of long-term care. The objective of this group was to identify the policy options for a financially sustainable system of long-term care, taking account of the Mercer report, the views of the consultation undertaken on that report and the review of the nursing home subvention scheme by Professor Eamon O'Shea. The report of the group has been submitted to Government and is being considered.

Hospital Services.

Mr. McGinley

I thank the Leas-Cheann Comhairle for again allowing me to raise this important matter, namely, the continuing crisis in Letterkenny General Hospital, where patients on trolleys are a regular feature of hospital life and operations and appointments are cancelled on a daily basis. What has precipitated tonight's debate is the report carried out by a United Kingdom health care consultancy firm, Tribal Secta, into the situation in Letterkenny General Hospital. The report has not been published and is not available yet, but some of the findings are reported in today's media. The report is an indication of the way the hospital has been more or less abandoned in recent years.

Let me be clear on one issue, however. The report does not negatively reflect on the staff in Letterkenny General Hospital. On the contrary, they are complimented for their dedication to duty while working in almost impossible conditions. Any person who has been treated in Letterkenny General Hospital as an inpatient or an outpatient will vouch for the commitment, dedication, professionalism and sincerity of the staff who try their best to put up with the current conditions at the hospital.

The report details a litany of problems, difficulties, infrastructural deficiencies and shortcomings at the hospital, concluding that the accident and emergency department is "not fit for delivering emergency care in the twenty-first century". What an indictment that is. The report also finds that during the first six months of 2005, more than 1,100 admissions to the hospital had to be cancelled. Since then, the situation has deteriorated and is almost out of control. Patients on trolleys are the rule rather than the exception.

The report focuses on the accident and emergency unit and finds that it is incapable of meeting the demands on its services. The hospital's day-case ward is regularly used as a holding area for accident and emergency patients, resulting in the cancellation of elective procedures. Emergency and urgent admissions are given priority over elective work and cancellations are now routine, due to the rising number of patients requiring admission. The report also states that patients have had operations cancelled up to three or four times. I am aware of a patient who has had to endure five cancellations in four months.

It is not simply an accident and emergency crisis, but a whole hospital crisis that stems from the core problem of a chronic shortage of beds in Letterkenny. This shortage initiates a chain reaction of over-crowded wards leading to overcrowding in the accident and emergency unit, which spills over into the day-case ward and eventually even into the coffee dock. This chain reaction and its knock-on effects is the everyday situation in Letterkenny.

In truth, what has been found by the consultants is nothing that we have not been aware of for many years. While we did not need consultants to tell us what is happening in Letterkenny General Hospital, their report nevertheless highlights the crisis and might provoke the Government into seriously addressing the situation. While the hospital has been given approval to go to tender for the construction of a new accident and emergency department, this will not become available for at least three or four years. The report strongly recommends interim improvements, such as the provision of a temporary building to expand the treatment space now available to the accident and emergency department. I strongly support the adoption of that recommendation, which would relieve difficulties in the short term. The provision of the new accident and emergency block and 60 or 70 additional beds is the only long-term solution.

We need to plan for the future, given the age profile of the population of Donegal, which has a higher than average percentage of people over 65. Elderly people have recurrent illnesses and need continuous treatment. There will be increased and more incessant demands on the facilities in Letterkenny General Hospital in the next ten to 15 years. This is not the first, second or even the third time I have raised this issue this year. I will keep raising the matter until I get an acceptable response that will give some hope to the people who have to depend on the services, often unavailable for many, in Letterkenny General Hospital. I seek an immediate response and definite news from the Minister of State.

Mr. T. O’Malley

I am taking the adjournment on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

Tackling the current difficulties with accident and emergency departments is the Government's top priority in health. The service being provided to some patients in accident and emergency departments is unacceptable and must be improved.

The objectives are to reduce the numbers waiting for admission, the time spent waiting for admission and the turnaround time for those who can be treated in accident and emergency departments and do not require admission.

The HSE is continuing to implement the ten point action plan. In addition, it has been agreed with the HSE that a number of additional measures will be implemented by the executive. These include the setting of performance targets for individual hospitals. In terms of implementation, the HSE is tackling the issue on a hospital-by-hospital basis and is developing hospital-specific, time-based targets related to accident and emergency units and delayed discharges. The executive is also engaged in the development of financial incentives linked to performance in these areas and the development of additional targeted initiatives aimed at delivering an immediate and sustained impact.

In the immediate term, the HSE is introducing a series of measures to improve facilities for patients and staff in accident and emergency departments. Long-term care beds are being secured from within the private sector to facilitate the discharge of patients who have completed the acute phase of their care. The acute beds that become available as a result of this initiative will be ring fenced for those patients awaiting admission in accident and emergency departments. Funding is being made available within the capital programme to develop admissions lounges to ensure that patient privacy, dignity and comfort are preserved while awaiting admission to an acute bed.

The HSE has established a dedicated task force to oversee the implementation of the framework for improving the efficiency and effectiveness of services in our accident and emergency departments. The task force will support individual hospitals, including Letterkenny General Hospital, in identifying specific problems and addressing them. It will work with hospitals to introduce a system of whole hospital performance measures to improve the patient's journey, not alone through the accident and emergency department but through the hospital system, from admission to discharge.

Letterkenny General Hospital serves an estimated catchment population of more than 137,000 and employs almost 1,300 whole time equivalent staff. The Government is committed to the development of acute hospital services at Letterkenny General Hospital. Since 1997, the Hospital's annual allocation has increased by €60 million. In 2005, the hospital treated nearly 20,000 more in-patients and day cases than in 1997. There are now 550 more staff at the hospital and 70 more beds than in 1997.

With regard to accident and emergency facilities at Letterkenny General Hospital, the Tribal Secta report found that the hospital needs a larger, purpose-built, accident and emergency department to allow proper triage, streaming and care of accident and emergency patients. The HSE intends to provide a new accident and emergency department and medical admissions unit at the hospital. The medical admissions unit will streamline the processing of acute medical emergency patient referrals, ensuring that patients are prioritised on the basis of need and, where necessary, admitted to an acute in-patient bed. This project is currently at design and planning stage.

In the interim, the HSE has approved capital funding for the provision of 30 beds for Letterkenny General Hospital. These beds will be provided by way of a modern modular building to be erected on the campus of the hospital. A planning application has been submitted and tender documents are in the process of being completed. It is intended that this modular building will be procured through an accelerated tender process, with a view to having the beds available for use before the end of 2006. This development, which is in addition to 11 new beds already opened this year, will increase capacity at the hospital from 313 to 343, an increase of almost 14% from the start of the year. It is expected that current capacity pressures at the hospital, including pressures in the accident and emergency department, will be greatly alleviated under this initiative.

The HSE has also had detailed discussions with the hospital with regard to implementing interim measures to improve the facilities at the accident and emergency department, as recommended in the Tribal Secta report. A number of proposals are being examined, including the options for increasing the space and providing additional facilities for the accident and emergency department by relocating other departments at the hospital.

Decentralisation Programme.

Mr. Costello

I welcome the Minister for Finance and the Minister of State at the Department of Finance to the House. It is a rare honour.

The decision by the former Minister for Finance, Mr. McCreevy, to decentralise thousands of civil servants, announced in his budget a number of years ago, was a political decision that has caused chaos in the lives of thousands of civil and public servants and their families. That was the legacy of the great free marketeer we had as Minister for Finance for many years. Essentially, it was a question of putting profit before people, without much consideration as to their lives, and making a contribution towards winning the next general election for Fianna Fáil. We see how he has gone on to Europe to introduce the services directive. He has had more opposition there than he had in this country. Perhaps that is a reflection on all of us.

My point is about the 400 FÁS employees in Dublin, only six of whom have opted to transfer to Birr, County Offaly. Interestingly enough, this is the constituency in which both the Minister for Finance, Deputy Cowen, and the Minister of State at the Department of Finance, Deputy Parlon, are both representatives. They have special responsibility for decentralisation.

The key to the issue is that decentralisation was presented and promoted as a voluntary transaction and agreement by the people concerned. However, every FÁS employee who seeks a promotional post must first sign a contract to move to Birr, which immediately renders the transfer compulsory. A gun is being placed to the head of every person who feels they can take a step up the ladder.

FÁS is the only State agency using promotional posts to compel people to decentralise. That is the bottom line. It is not the Civil Service; it is a public service agency. The members of FÁS are not civil servants; they are public servants. It is the one agency using the promotional posts mechanism to compel people to transfer to Birr.

The Labour Court intervened in this matter and decided in favour of the FÁS employees. However, the Department of Finance will not allow FÁS to implement the Labour Court recommendations. The only explanation I have for this is that the Minister and Minister of State responsible for decentralisation have Birr in their constituency and, come hell or high water, they are determined to ensure that the people from FÁS transfer there as soon as possible, perhaps before the next general election. This is a disgrace and an insult to many of the public and civil servants who have served the State so well over the years. They must now uproot themselves and their families and live in an area to which they specifically decided they did not want to transfer, at whatever stage in their career they may be.

Decentralisation is good. I am in favour of it. However, enforced decentralisation is anti-democratic. It is more akin to a form of dictatorship if people have a gun to their heads in terms of whether they will decentralise. That is not a voluntary system. This sector of the State agency FÁS is at the core of this compulsory transfer mechanism now being used. Will the Minister for Finance tell the House why, if the Labour Court could come to an agreement and decide in favour of the FÁS employees, he and his Department were not prepared to accept the decision and act accordingly?

Minister for Finance (Mr. Cowen)

I am pleased to have this opportunity to update the House on the position regarding the decentralisation of FÁS. Under the Government's decentralisation programme, FÁS is due to move its head office to Birr, County Offaly. FÁS is one of the seven State agencies identified as early movers by the decentralisation implementation group from among the 30 agencies covered by the programme.

It would be helpful to refer to the Labour Court recommendation to which the Deputy refers. In its recommendation in a dispute between SIPTU and FÁS concerning decentralisation and FÁS contracts of employment, the Labour Court considered the written and oral submissions of the parties. The court also noted the terms of the company and union industrial relations procedures agreement and stated it was of the opinion that FÁS was in breach of the consultation procedures provided for in that agreement. However, it made no ruling on the substantive issue of the relocation clause. Instead, it recommended that the matter be referred back to the appropriate central body, at which level the issues should be teased out with a view to arriving at agreed long-term solutions in consultation with all of the parties involved.

Before Easter, discussions between the parties were held on two occasions under the auspices of the Labour Relations Commission, LRC, to see whether progress could be made. Media comment by SIPTU suggested that an initial agreement was reached at the Labour Relations Commission from which the Department of Finance subsequently withdrew. I want to clarify that no agreement was reached at the LRC between the parties at any stage during the discussions. At the first session, a draft text was prepared by the industrial relations officer following a series of discussions with both sides. However, this written text was not seen by the employer side before it was presented to the union.

Differences remain between the parties which must be addressed through further dialogue. It would not be helpful at this point to get into details on the elements of the negotiations. Naturally, I strongly support using all the established consultation and dialogue mechanisms and I hope that further discussions will lead to a resolution.

Decentralisation is a voluntary programme. From the outset, guarantees have been given by the Government that all employees not wishing to transfer out of Dublin will be facilitated with an alternative post in Dublin if the situation arises. Promotions policy must take account of the reality of decentralisation.

Mr. Costello

There is the rub.

Mr. Cowen

They are the facts.

Mr. Costello

Six people are prepared to move.

Mr. Cowen

We recognise also that there is a need to address the concerns of people remaining in Dublin.

The Deputy refers to the low take-up rate of staff in FÁS. The data to date indicate that the number of internal applicants is low. However, the Deputy may also be aware that some unions represented in State agencies have effectively opposed the central applications process. This has resulted in a lack of co-operation in the collection of data on the real levels of interest in the decentralisation in those agencies.

I will take the opportunity to update the Deputy generally on progress with the programme. He claims to agree with it. I was a Member of the House when a decentralisation programme was cancelled by a Fine Gael-Labour Government, subsequently resumed by a Fianna Fáil Administration and successfully implemented. Significant progress continues to be made in the implementation of the decentralisation programme. More than 10,600 civil and public servants have made applications through the central applications facility to relocate. The central applications facility continues to receive new applications every week. It is anticipated that interest will increase further as building and timetables firm up.

On the property side, for which the Minister for State has responsibility, site or building acquisition negotiations have been completed in 17 locations. Contracts have been received for an additional six locations. Suitable sites have been identified in a further 15 locations and negotiations to acquire have either commenced or are close to commencement in these locations.

Agreement has been reached on a number of human resource and industrial relations issues in the Civil Service which has enabled progress on the transfer of staff and promotions. Discussions are ongoing in other areas. Actual movement of staff within and between Departments and offices is now under way, with almost 1,400 staff already assigned to posts which will decentralise. All decentralising organisations have produced implementation plans setting out the detailed arrangements they are putting in place to plan for relocation while also ensuring business continuity.

Thirty State agencies are due to decentralise under the most ambitious programme instigated by the State. I am satisfied that good progress has been made in planning for the relocation of these agencies.

The decentralisation implementation group has identified seven agencies, where issues such as the location, mix of staff, business and size of the organisation were favourable, as early movers. In general it has recommended that a more individualised approach be taken to this element of the programme.

I recognise that progress in human resource issues has not been as rapid in the State agencies as in the Civil Service. The Civil Service has had the opportunity to develop an understanding of the decentralisation process over the years from previous and very successful programmes. The experience gained by Civil Service bodies is important in ensuring that the State agency programme can be carried through.

The decentralisation implementation group recognised that proposals for inter-organisational mobility are a new development for State agencies, but it indicated that it is precisely this type of ground-breaking initiative which is needed to give impetus to the implementation of the programme. The process is facilitated by the engagement, through discussion and dialogue, of staff interests. I am happy that issues in dispute in FÁS can be addressed and that its decentralisation programme can remain on track.

Deputy Costello has made certain assertions which have no foundation in truth or fact. They remain assertions. Based on what I have said, I am sure he will take due consideration of the assertions and perhaps retract some of the more outrageous allegations.

Mr. Costello

Please spell them out for me.

Mr. Cowen

I am a former Minister for Labour and I know what industrial relations are about. I have always worked through the machinery. At no time have I sought to influence a scenario which does not respect the legitimate interests of everybody with regard to this matter. I have stated in my speech that it is through dialogue that we will deal with these problems. The assertion made by the Deputy that there is some attempt to change the voluntary nature of the programme is not correct.

I have outlined in my speech the question of State agency employees moving to other activities if they wish to remain in Dublin, which is consistent with the decentralisation programme. It is a new experience and it will require a groundbreaking initiative. We are prepared to work with the concerned interests, including unions, on all these matters.

Mr. Costello

Will these people have to sign a contract for promotional posts?

Mr. Cowen

The political assertions made by the Deputy are, as usual, without foundation.

An Leas-Cheann Comhairle

Deputy Connolly has the next item. He has five minutes.

Mr. Cowen

I have answered the matter factually.

Mr. Costello

They are compulsory.

Mr. Cowen

The Deputy is either mischievous or ignorant of the facts. I think it is mischievous.

Mr. Costello

Why do these people have to sign a contract to move to Birr?

An Leas-Cheann Comhairle

I call Deputy Connolly.

Mr. Cowen

The Deputy should get his facts right.

Mr. Costello

The facts are right. I find it hard to see why FÁS is on industrial action if that is the case.

Services for People with Disabilities.

Mr. Connolly

I thank the Ceann Comhairle for selecting this item for debate. The issue of banking difficulties for people with intellectual disabilities was brought to me by a senior social worker who is very concerned about recent new practices in banking circles. He indicated that there were no difficulties with current customers who had intellectual disabilities. The arrangements they have will be maintained.

With regard to opening a new bank account, these people require a certain level of assistance, which varies at times. This relates in the past two years, in particular, to people with intellectual disabilities who try to open an account, transfer an account between banks or try to establish third party mandates. Some banks have made it especially difficult for people with a disability to open, operate or maintain a bank account.

Difficulties exist with regard to third party mandates, which are necessary in some cases. In the case of people with disabilities, it is understandable that they would need a third party mandate. Some banks have equated people with intellectual disabilities to persons of unsound mind. That terminology belonged in mental health legislation, and people with intellectual disabilities do not come under that heading. I have that terminology in a letter from a bank. It is a sad reflection if banks typecast people in this way. The issue needs to be addressed.

Some banks also believe that people with intellectual disability are incapable of conducting their own affairs, and therefore third party mandates are not appropriate. They contend that these people do not have the intellectual capacity to sign mandates or the capability to give informed consent. Regrettably, I have an instance of this being brought to my attention in letter form. The banks write to clients in this regard.

It is a reasonable expectation to have and operate a bank account. It is a basic right. The banks and the Health Service Executive should meet to reassess the issue and form some type of policy which would be beneficial to the person with an intellectual disability. Such policy should be practical and operational, giving dignity back to the person with an intellectual disability.

This matter needs to be urgently addressed. It is all the more urgent given that the nursing home moneys are now coming on stream. The same type of issues will have to be addressed in that case. Will the lofty ideals of the banks continue when such large volumes of cash will be determined? One would think at times that the banks possibly do not want the hassle of looking after a small account which bankers may feel is not appropriate to certain circles. The issue of informed consent will present difficulties. The people involved may not have the same level of caring people to look after them. People may come out of the woodwork to get their hands on the nursing home moneys. We must address the issue now as the time is appropriate.

The stance of the banks is at odds with the approach of the Health Service Executive which promotes a rights-based social model of care focused on independent living. It raises equality issues and a possible violation of the right to equal citizenship for people with an intellectual disability. Recently we passed legislation which was supposed to help safeguard people with intellectual disabilities. It is not progressing a cause in this instance. We should return to it to see how it affects people at operational level.

Banks probably have their own policies and reasons, perhaps relating to cash laundering, but at local level the people caring for individuals with an intellectual disability should have some authority. It is part of the educational process and integrating these people back into society. It relates to keeping these people in society. That is what these issues are about. The operation of a bank account and education are real life issues which we should advocate to people. Large financial institutions should not put impediments in place.

The banks should formulate a clear policy. It is almost like they are indicating that they do not want the hassle of a small account. Much paperwork and obstacles are put in place. These people with intellectual disabilities have the same right as anybody else to have and operate a bank account. I ask that the Health Service Executive and the financial institutions address the matter together.

Mr. T. O’Malley

On behalf of the Minister for Justice, Equality and Law Reform, who cannot be in the House tonight, and for the benefit of the House in general I am pleased to respond to the matter raised by Deputy Connolly. We have come a considerable distance in implementing the agenda of mainstreaming and equality for people with disabilities, and the legislative framework in respect of people with disabilities has advanced significantly during the tenure of this Government.

The Employment Equality and Equal Status Acts were instrumental in protecting people with disabilities against discrimination. From there, the Government moved to positive action measures to enhance the participation of disabled people in society by introducing the national disability strategy in 2004. This is focused on the implementation of a strong new legislative framework of requirements of public bodies to enhance services for people with disabilities as provided under the Disability Act 2005. A multi-annual investment programme of €900 million in the period up to 2009 in the health services area forms part of the strategy. The strategy also comprehends the Comhairle (Amendment) Bill, which provides a new legislative basis for the provision of advocacy services for people with disabilities. While much of the reform I have mentioned relates to the public sector and the services it provides, in many of our day-to-day transactions the service to people with disabilities is improving, with a greater focus now on services for those with different needs. There is much still to do in this area but progress has been made.

In dealing with the important issues raised by the Deputy in this motion, I also speak about the role of the Irish Financial Services Regulatory Authority. The Financial Regulator was established on 1 May 2003 and is responsible for the regulation of all financial services firms in Ireland, including banks. The Financial Regulator has an important role in the protection of consumers as it is a distinct component of the Central Bank and Financial Services Authority of Ireland with clearly defined regulatory responsibilities.

In the area of consumer protection, the main tasks of the Financial Regulator are to help consumers to make informed decisions on their financial affairs in a safe and fair market and to foster sound, growing and solvent financial institutions that give consumers confidence that their deposits and investments are secure. In providing consumer protection, the focus of the Financial Regulator is on problem prevention through providing consumer information and education about the costs, risks and benefits of financial products, monitoring competition in the market for financial services and working with the Competition Authority. The Financial Regulator also promotes the interests of consumers of financial products and imposes and enforces rules on financial services firms regarding how they deal with consumers, particularly how they sell financial products.

The Financial Regulator has been examining issues around access to financial services and one of the main issues highlighted by consumers is the difficulty in opening bank accounts. As part of its consumer education mandate, the Financial Regulator has taken a number of specific initiatives to inform consumers about the costs, risks and benefits of various financial products. These have involved publishing consumer guides and cost surveys on financial products and fact sheets, including a fact sheet entitled How to Open a Bank or Building Society Account, all of which assist consumers in making financial decisions that are in their own best interests.

Further, the Health (Repayment Scheme) Bill 2006 will regulate patient private property accounts by introducing a statutory framework to protect patients' interests, particularly in the context of large repayments that may be placed in these accounts. The Deputy may be aware that this Bill is on Second Stage in the Dáil. It is intended to make the application process as simple and as user friendly as possible while providing appropriate safeguards against fraud and preventing the exploitation of those not in a position to manage the repayments they will receive. The legislation will provide for the regulation and administration of patient private property accounts to ensure the money in these accounts is used for the benefit of the patient and that money held in these accounts can be invested on behalf of the patient.

The Minister for Health and Children may also appoint an independent overseer for the administration of these accounts and receive reports on, among other things, the operation of the scheme and the appeals process. These reports shall be laid before each House of the Oireachtas. The legislation also provides that all accounts and funds related to the scheme may be audited by the Comptroller and Auditor General.

Finally, in the wider context of legal capacity in general, I can inform the Deputy that as part of its current programme of work, the Law Reform Commission has been engaged in important research on the matter. In May 2005, the Law Reform Commission published a consultation paper entitled Vulnerable Adults and the Law: Capacity, and convened a well-attended conference in December 2005. In its consultation paper the Law Reform Commission examines capacity in context, approaches to legal capacity, legislative reform, existing legal mechanisms to address loss of capacity, capacity to contract, personal relationships and capacity to make health care decisions.

I understand that two central elements will form the basis of the Law Reform Commission's final report. The first is the question of how the law should approach the concept of capacity to make decisions. The second considers what structures are needed to support vulnerable persons when they come to make these decisions. The final report, which will contain recommendations and draft legislation, is expected to be published later this year. The report will receive early attention by my Department and by other relevant Departments.

The Dáil adjourned at 9.15 p.m. until 10.30 a.m. on Thursday, 4 May 2006.

Dáil Éireann díospóireacht - Wednesday, 3 May 2006