Rather than repeating the details of my statement in the Dáil on the publication of the Travers report, I propose to use this short opening statement to address specific elements of the subsequent commentary on the report's findings. In particular, I will deal with some of the many misrepresentations which continue to be spread about the facts outlined in the report.
While this is a point which has been sidelined so far in the joint committee's deliberations, it is worth remembering that this is an issue which first arose in 1976. There is no doubt that in the subsequent 28 years there were occasions when it should have been addressed. I will mention just a few of the examples detailed in the report. The foundation decision, which lies at the root of this issue, was taken back in 1976. In 1979 the Department's legal adviser reiterated concerns about the 1976 regulations. In January 1982 a specific review of the regulations stated they had no legal basis. In 1987 a legislative change was proposed but not proceeded with. In 1992 a review of long-stay charges was completed and legislative change advocated. In 1994 the health strategy stated the legislative basis for charges was inadequate and promised legislative change. These examples alone involve six separate Administrations.
The Travers report is fair in pointing to systems weaknesses and calling for a new approach to risk assessment within Departments. I strongly agree with the conclusion that the structural reform agenda represents the chance for a new beginning in the Department and this is exactly what it was intended to achieve. As Minister, I was conscious of the enormity of the pressures placed on all parts of the Department and the problems this caused in allowing the proper management of issues. In recent decades there has probably been no time in which the Department has had an opportunity to step back and take a more structured and systematic approach to problems as they arise.
For the Department of Health and Children to manage the sector to the greatest effect, it needs to be able to move away from fire-fighting. The radical restructuring of service planning, delivery and oversight contained in the structural reform programme is specifically designed to achieve this objective and ensure administrative pressures do not lead to errors such as the leaving in place of an illegal charge for 29 years.
It is unfortunate that the basic focus of certain Deputies involved in this inquiry is not to try to understand what happened but to try to do as much political damage as possible. In some cases, facts have been deliberately misrepresented and it is increasingly clear that completely unfounded rumours are being actively spread. Having prejudged the issue before receiving the Travers report, some Deputies are now ignoring or rubbishing the report because it does not say what they want it to say. The amount of time spent throwing around new and unfounded rumours and misrepresentations is becoming ever more obvious.
I will deal first with the CEO MAC meeting of 16 December 2003. The facts show that this was an item listed as being for brief mention, while other issues were intended to and did dominate the meeting. Statements to the effect that this was a major item of discussion are clearly false. I did not miss the item due to being late. The facts show that the very reason the item was taken in my absence was that it was not viewed as urgent or of dramatic significance. After a short discussion, the correct decision was taken by those present that the Attorney General's advice should be sought. There was no statement or implication that there was a major issue of retrospection or that this was an issue which had first arisen in 1976 and had been considered at various times since.
The joint committee should be aware that it was not and is not unusual for legal issues to arise in the health services; they arise all the time. This was, for example, one of the reasons I sought an increase in the legislative expertise available to the Department. Throughout my service as Minister in different Departments I have shown a willingness to address difficult and controversial legal issues as they arose. The core of this issue is that certain Deputies are seeking to claim there was a clarity of information available to me such that I should have intervened immediately. This is simply not borne out by the facts and no amount of background briefing and partisan charges can change this.
If the required information, as outlined in the Travers report, had been available to me or my staff, action would have been taken to immediately address an issue which we only now know has been around since 1976. While the briefing material could not reasonably have been considered by me or many others before the meeting because it was provided so late and in the middle of a crowded schedule, it comes nowhere near giving the level of clarity on the issues that some Deputies have claimed. As the report notes, the briefing material stated there were varying legal opinions on the issue of long-stay charges and recommended the seeking of further advice. The idea that any person who had read the briefing and had been present for the discussion at the meeting must have known about the full nature of this problem simply does not stand up to objective scrutiny.
With regard to the follow-up to this discussion, there is no reason a reference to the Attorney General, which was decided upon without requiring my involvement and did not require my signature, would have been referred to me. In fact, it would have been highly unusual for it to have been referred to me as the information available to the committee has confirmed that direct referral from officials to the Office of the Attorney General was the general and correct procedure adopted in the Department. As a matter of course it was the outcome of advice which was referred to me when relevant and clearly that would have been in the context of a decision being required from me. It is clear that I was not shown or asked to comment on the file.
It was my experience of the officials in the private office that they handled correspondence efficiently. No person from the private office remembers having sight of or handling the file. I have no reason to doubt this. It should be noted that during 2004 lengthy meetings were held on the Health Service Executive legislation, including on one occasion a half-day meeting. At no stage was it ever suggested at one of these sessions that we would consider adding a stand-alone measure relating to long-stay nursing home charges or that such a measure was required to regularise an improper levy.
For the record and in order to deal with some of the innuendoes read into the record by certain Deputies, I have not and do not remove official documents from Departments. The same policy has been followed by my staff. On leaving my last two Departments all records except personal constituency files remained in those Departments.
It is also worth clarifying some matters regarding my advisers. It is not the job of advisers to replace or duplicate the Civil Service. It is not their job to be answerable for every issue being handled at every moment in a Department. Deputies will be aware that the Public Service Management Act underpins the clear distinction between advisers and civil servants. In this country we have chosen a system of political support for Ministers, which gives them dramatically less support than in other countries, and our expectations of them should take this into account. It is not in any way reasonable to expect that advisers should be actively on top of an item presented as meriting brief mention and requiring clarification before a policy discussion would be required.
A certain degree of unreality has entered into the discussion in regard to the interaction between a Cabinet Minister and Ministers of State in a Department. I regularly met the three Ministers of State in my last Department either individually or collectively. The committee will be aware that there has been a move to a system of statutory instruments delegating functions to Ministers of State. This is explicitly to increase the ability of Ministers of State to get things done without always having to refer to their senior Minister for a decision. In practical terms this meant that we met regularly when an issue was live. In addition, we would review the Minister of State's area of responsibility in the context of biannual reviews, MAC meetings, the Estimates process and legislation.
It would have been foolish to have a system requiring more regular review sessions. This would have diverted substantial ministerial and official time away from the full agenda carried by everyone. The agenda of any Minister in the Department of Health and Children is extremely broad. In addition to general work it requires one to react to a great deal of issues which suddenly emerge and require substantial and immediate attention.
The record shows that I was fully accessible to staff and willing to address issues even at short notice. At no time did I shy away from sensitive issues because they might have cost implications or because they might reflect badly on Government. This was a policy I followed at all times. I was the first Minister for Education and Science willing to face up to the State's historical responsibility for the treatment of children in residential institutions.
In the normal course of events with an emerging issue, the relevant officials would seek a meeting with me through my private secretary directly or through an adviser. Where the issue was viewed as being particularly serious the Secretary General would attend in addition to the relevant adviser and officials in charge of the issue. As the record in my diary shows, meetings on matters of substance were noted, specific briefing notes were prepared and a record of decisions that would have been taken. All of the information which has emerged on the treatment of this particular issue confirms that it was at no stage considered serious enough to merit being raised with me in line with this normal practice. The absence of any mention whatsoever of the issue in the October 2004 briefing material clearly confirms that it was not being treated as an active matter involving the Minister. The evidence presented to the committee also confirms this. It appears that this may have been the same manner in which the issue was dealt with at different times since 1976.
In more general terms it is almost impossible to discuss health affairs without discussing eligibility criteria. It is a regular item for discussion in the Dáil and in policy discussions. It has been addressed in every significant statement of health policy for at least the past 20 years. However, this was very different from discussing the specific point that a charge was being illegally levied since 1976 and that action was required to regularise the situation. The facts show that this was not drawn to my attention either formally or informally.
