Seanad Éireann díospóireacht -
Wednesday, 22 Feb 2012

Vol. 213 No. 11

Adjournment Matters

Social Welfare Code

Senator Denis Landy

I welcome the Minister to the House. Is the Minister for Social Protection in a position to consider the provision of social welfare support for once self-employed people who now find themselves unemployed? As the Minister is aware a large number of people who were formerly self-employed and who are now unemployed are entitled to only a limited range of social welfare supports.

The importance of providing support for people who are unemployed or unable to find work by virtue of illness etc. cannot be overstated. However, this facility is not available to the self-employed. Self-employed people pay PRSI at the S rate of 4%. People who come under this category include farmers, professional people, certain company directors, people who run their own businesses, sub-contractors and a range of self-employed people.

Class S PRSI contributions provide cover for widow's pension, the contributory pension, maternity benefit, adoptive benefit and bereavement grants. However, it does not provide cover for jobseeker's benefit. The Minister will agree that while this cover is welcome, it is limited in scope. In the past decade, self-employed people have made a considerable contribution to the country and the economy. It is safe to say that the small and medium-sized enterprises have been the backbone of the country and will remain so.

If we recover economically there is no doubt the SME sector will lead the way in that recovery. Unfortunately, we have seen a stark contraction of this sector in recent years. Many businesses have closed and many self-employed people have found themselves out of work. They do not appear on the live register. In the third quarter of 2011, some 12,900 self-employed people lost their jobs.

Extending social welfare protection to self-employed people achieves at least two objectives. First, it secures a measure of social justice which I believe the Minster has a deep interest in pursuing. It is not right that self-employed people should have to use their life savings or the earnings of their partners. This is a matter of fairness. Second, it reduces the risk for those entrepreneurs who wish to start up their own businesses by providing a safety net. This makes perfect sense at a strategic level as well. We are committed to building an indigenous sector based on small- and medium-sized enterprises. However, we must put in place structural reforms to do so. Many reforms are needed and I release the Minister is playing her part in this area. Providing social welfare support for self-employed people should be a part of this process. I have spoken to many people in the sector who have confirmed that they would be more than happy to pay full PRSI. I call on the Minister to give consideration to this proposal.

Minister for Social Protection (Deputy Joan Burton)

As the Senator stated, self-employed persons are liable for PRSI at the class S rate of 4%. This entitles them to access long-term benefits such as the State contributory pension and widow's, widower's or surviving civil partner's contributory pension. Ordinary employees who have access to the full range of social insurance benefits pay class A PRSI at the rate of 4%. In addition, their employers make a PRSI contribution of 10.75% in respect of their employees, resulting in a combined rate of 14.75% per employee under full-rate PRSI class A. For employees earning less than €356 per week, the rate of employer's PRSI is 4.25%. It may be noted that self-employed workers generally achieve better value for money by paying social insurance compared to employees.

The 2005 actuarial review of the social insurance fund found that a self-employed contributor can expect to receive more than ten times what he or she contributes to the social insurance fund compared to the employee who, on average, receives only three times what he and his employer contribute. This is despite the fact that the range of benefits available to employees is greater. In this context Senator Landy should note that the market cost of an inflation-linked annuity with €12,000 per year in initial benefits is in excess of €300,000 without any associated survivor's benefits. The figure of €12,000 is the approximate value of the State pension to which self-employed people gain access by virtue of the PRSI currently paid. Any changes to the PRSI system to extend the full range of social insurance benefits, including jobseeker's benefit, to self-employed people would have significant financial implications and would have to be considered in the context of a much more significant rise in the rate of contributions payable.

I established the advisory group on tax and social welfare last year to meet the commitment made in the programme for Government. The advisory group will examine and report on issues involved in providing social insurance cover for self-employed persons to establish whether such cover is technically feasible and financially sustainable. In addition, the actuarial review of the social insurance fund, which is due to be completed in 2012, will examine this matter. This will be most helpful in the discussion.

Self-employed workers may establish eligibility to assistance-based payments such as jobseeker's allowance. They can apply for the means-tested jobseeker's allowance if their business ceases or if they are on a low income as a result of a downturn in demand for their services. In general, their means will take into account the level of earnings in the previous 12 months in determining their expected income for the following year and, in the current climate, account is taken of the downward trend in the economy. As in the case of a non-self-employed unemployed claimant of jobseeker's allowance, the means of a husband, wife, civil partner or cohabitant will be taken into account in deciding on entitlement to a payment.

I thank the Senator for raising this important issue. I know how concerned he is about it. I await the views of the advisory group on social welfare on this matter.

Senator Denis Landy

I thank the Minister for what I consider to be a positive response. I accept that self-employed people are allowed to apply for means-tested jobseeker's allowance. However, as the Minister is aware this is a cumbersome process that can take up to six or eight months and in the meantime people have nothing to live on. In the context of trying to kick-start the economy the Minister will be aware that for every job we can create, we take one person off the live register and save approximately €20,000 per person per year. Through county enterprise boards and the Leader programme etc. I have been involved in helping people to start up businesses. The main issue is the concern that if the business is not successful, then they have no fallback position and this is a deterrent for people to start a business. I call on the Minister to keep this issue live. I look forward to the response from the group she has set up and from the actuarial review as well. I hope we can revisit this in the coming months.

Deputy Joan Burton

This time last year we were in the run-up to voting day of the general election. One of the most memorable features of the election campaign for Members on all sides and one of the saddest things was the number of people in construction who were involved in good firms which gave good employment and who found that everything had disappeared. Many of these are the people to which Senator Landy has referred. Senator Landy also raised the possibility that people might be allowed to make a voluntary contribution, amounting to the current total of the employer and employee's contributions. That merits examination because the distress level of self-employed people can be very high. Also, many of these people ran good businesses and worked hard, particularly those with a construction background, during the boom. It is important we help them as much as possible to get back on their feet. I will return to the Senator with information when I have the actuarial evaluation and the report of the advisory group. I am grateful the Senator has acknowledged that in the current climate there are cost issues of which I must take account.

Social Welfare Appeals

Senator Martin Conway

I welcome the Minister to the House. I submitted this matter to highlight the fact that a young man of 18 years of age in County Clare has been refused disability benefit, although he has been diagnosed with ADHD. This young man will not work for the rest of his life, because he is incapable of working. His comprehension ability, delayed reaction and a myriad of other conditions feed into his overall inability to work. He is hyperactive at times and completely inactive at others. Anybody who met this young man would know he would never be capable of holding down a job, yet despite medical support he has been turned down for disability benefit.

I realise, better than anybody, that granting somebody disability benefit is a big step for any government or Minister, because once somebody receives disability benefit, he or she tends to hold it for a long time, unless their circumstances change significantly. However, there comes a time when common sense must prevail. Families already under pressure from looking after a person of this age need a break and should not be in a position where they have to fight the system and the Department. If this family did not provide the care it does to the young man in question, he would be in care and would cost the State significantly more. We should empower these families rather than be confrontational with them. While I understand that people have a responsibility to do a job, there comes a time when it is as clear as the day is long that a disability payment is required.

Deputy Joan Burton

I thank the Senator for raising this issue. Disability allowance is a means-tested payment for people with a specified disability whose income falls below certain limits and who are aged 16 and are under 66 and who are deemed to be habitually resident in the State. The qualifying conditions for disability allowance are provided for under Part 3 Chapter 10 of the Social Welfare Consolidation Act 2005 as amended. In order to qualify for disability allowance a person must be suffering from an injury, disease, congenital deformity or physical or mental illness or defect which has continued or may reasonably be expected to continue for a period of at least a year and where, as a result of the condition, the person is substantially restricted in undertaking work which would otherwise be suitable having regard to the person's age, experience and qualifications.

The person concerned applied for disability allowance on 10 May 2011. The medical evidence supplied in support of his claim was referred to one of the Department's medical assessors, who was of the opinion, based on the information supplied, that the person was not medically suitable for disability allowance. The deciding officer accepted this opinion and the claim was refused and the person was notified in writing of this decision. Further medical evidence subsequently received from the person was referred to another of the Department's medical assessors, who was also of the opinion based on the information supplied that, while the person suffers from a degree of disability, he is not medically suitable for disability allowance. The deciding officer accepted this opinion and the original decision to refuse the claim remained unchanged. The medical opinions on suitability for disability allowance, based upon the medical evidence supplied, were reviewed and confirmed by the chief medical assessor of my Department. The person was notified in writing of this outcome on 7 February 2012 and of his right of appeal to the independent social welfare appeals office.

As set out in the guidance given to the person in the decision letter, if he wishes to appeal this decision to the social welfare appeals office, he should do so in writing stating the grounds of his appeal.

Senator Martin Conway

I accept there has been a medical review carried out, but knowing the young man, I would have a different view. Will the Minister instruct her officials to facilitate this family with an oral appeal allowing it make the case in person, rather than a written appeal which is turned down by letter? I would be most grateful if the Minister would facilitate an oral appeal.

Deputy Joan Burton

I will ask the officials if it is possible to arrange that. I would like to stress again that with regard to disability, the decisions are made on medical grounds and made by medical people. This case has been considered a number of times and it is not the social welfare general staff who have made the decision. The decision has been made on medical grounds. However, I will certainly advise the officials that the Deputy has requested an oral appeal in this case.

Mental Health Services

Senator Deirdre Clune

I thank the Minister for being here to respond on this matter. I raise this issue because this week is national awareness week for eating disorders. I have always had an interest in this area because individuals and families who have been faced with this issue have come to me over the years because they have not known where to turn. The more one gets involved in this area, the more one realises the lack of services, although there have been some improvements, particularly with the provision of beds for children and adolescents with mental health issues. Nonetheless, we need greater awareness of this issue and of the need for services at GP and primary care level in the community.

I pay tribute to BodyWhys, an organisation which carries extensive advocacy work in this area. By coincidence, it had a briefing for Oireachtas Members today at which it informed us it had in excess of 300,000 calls last year. This week, BodyWhys has made available a resource for the schools' SPHE programme, entitled, Responding to Eating Disorders and Body Image Issues. This provides information on what an eating disorder is and how it can be recognised. It explains how teachers can recognise them and respond in the school environment and how best to work with the parents of those affected. This will be a valuable resource. The more information we have available, the more individuals, particularly young people, can be helped.

The statistics involved with eating disorders are frightening. The average age for the onset of anorexia is 14 years of age and for bulimia it is 17. However, children as young as nine have been affected by the disorder. Early intervention and treatment are recognised as the most successful method of dealing with eating disorders. It is not only girls who are affected, although 1.2% of Irish girls are at risk of developing anorexia nervosa and 2% at risk of developing bulimia. Males are at risk also, although a smaller percentage of them.

Some €35 million has been ring-fenced for the provision of mental health services in our community. This is part of the programme for Government and the promise was repeated in the HSE service plan. I would like to know how much of this €35 million will be dedicated to services for those with eating disorders and their families.

Deputy Joan Burton

I thank the Senator for raising this important issue, which affects a large number of young girls, in particular, and families. I am responding on behalf of the Minister of State, Deputy Kathleen Lynch, who is responsible for these matters. I am pleased to have an opportunity to confirm to the House that it is planned that some of the additional funding that was allocated to the mental health area in budget 2012 will be used to support the treatment of eating disorders. It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes, which are currently being developed. The three specific areas that will be prioritised in 2012 are the treatment and care of patients with eating disorders, early intervention in psychosis and suicide prevention.

A fundamental principle of early intervention for any health condition is that identification, diagnosis and treatment should occur as early as possible to maximise the likelihood that interventions will successfully minimise the burden of suffering. By strengthening our community mental health teams and enhancing the capacity of primary care to deal with people with mental health issues, it is hoped we will go a long way towards achieving that goal. Therefore, the €35 million in funding will primarily be used to strengthen community mental health teams in adult and children's mental health services. It will ensure at least one person from each mental health professional discipline is represented on every team. Over 400 additional staff will be recruited to support initiatives under this €35 million package.

It is important to recognise that the primary care sector has a significant role to play in the management and treatment of eating disorders. Individuals with eating disorders frequently present to primary care practitioners with complications of their conditions. Early intervention at this level greatly improves outcomes. There is a need to enhance the capacity of primary care to recognise, assess and treat a range of mental illnesses within the primary care setting. To this end, the HSE and Dublin City University have developed a mental health in primary care accredited training programme for primary care practitioners. The programme aims to give primary health care staff the necessary knowledge and skills to respond to the mental health care issues that arise in primary care. I understand it has been very well received.

Services for people with eating orders are also provided in the voluntary sector. The HSE provides funding to BodyWhys, which is a national voluntary organisation that supports people with eating disorders. BodyWhys provides a range of support services for people affected by eating disorders, including specific services for families and friends. BodyWhys also offers a range of supports to health promotion departments throughout the HSE. This interface provides welcome expertise from the service user perspective.

I am confident that the additional €35 million that has been provided for mental health in 2012 will ensure that improved services are provided to people with eating disorders. I accept that the expenditure reductions in 2012 will challenge all areas of the health system to provide continuity of services that are appropriate and safe for patients. As in other care areas, efficiency and other savings will be required from the mental health service nationally. This will necessarily involve some rationalisation and reorganisation of services at local and regional level. We are fortunate that the additional resource which has been made available in mental health gives us an opportunity to prioritise areas for development. I am conscious that development funding for mental health was diverted in the past. I assure the House that the Department of Health will work closely with the HSE to ensure the €35 million that has been provided in this case will be used to fund the commitment in the programme for Government to develop the necessary community-based mental health services and the other essential initiatives I have described.

Senator Deirdre Clune

I am glad the Minister has said, on behalf of the Minister of State, Deputy Lynch, that eating disorders are recognised and that the funding to be provided in the community mental health area will be used to help those with eating disorders. As this week is eating disorders awareness week, it is important that we are debating this issue and making a public commitment to it in this House. I thank the Minister for that.

Deputy Joan Burton

I concur with what the Senator said about BodyWhys. I know of families that have been affected by eating disorders. It is an incredibly painful issue not only for the individual, but also for the members of his or her family, who feel helpless they watch as an active and lovely young child growing into somebody with a difficult eating disorder. I thank the Senator for raising the issue.

The Seanad adjourned at 6.45 p.m. until 10.30 a.m. on Thursday, 23 February 2012.