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Select Committee on Justice, Defence and Equality díospóireacht -
Wednesday, 4 Feb 2015

Redress for Women Resident in Certain Institutions Bill 2014: Committee Stage

This meeting has been convened to consider the Redress for Women Resident in Certain Institutions Bill 2014. I welcome the Minister for Justice and Equality and her officials to the meeting. All mobile telephones should be switched off or set to flight mode.

Section 1 agreed to.

Amendments Nos. 1 to 9, inclusive, have been ruled out of order.

Amendments Nos. 1 to 9, inclusive, not moved.
Section 2 agreed to.

Amendment No. 10 has been ruled out of order.

Amendment No. 10 not moved.
Sections 3 and 4 agreed to.

Amendment No. 11 is in the name of Deputy Finian McGrath but he is not here so the amendment cannot be moved.

Amendment No. 11 not moved.
Sections 5 and 6 agreed to.
TITLE
Question proposed: "That the Title be the Title to the Bill."

I would like to move some amendments on Report Stage and will indicate the areas they cover. They arise from some points brought up in the course of discussion in the Dáil. Several Deputies were concerned that the Bill was trying to restrict the health benefits recommended by Mr. Justice Quirke, in particular concerns were expressed that we were trying to restrict the choice of general practitioner, GP, for the women concerned. That has never been my intention and I have discussed the matter with my colleague, the Minister for Health, and we have agreed that to remove any doubt an amendment to section 2(1)(a) will be brought forward on Report Stage to ensure that the women will have the option of choosing a private GP or one who has a contract with the Health Service Executive, HSE. I am aware that many of the women have a medical card and may wish to stay with a GP. This change will enable the women to stay with their private GP if their GP is one of the few GPs practising in the country who do not have a contract with the HSE.

Time did not allow an amendment to be prepared and submitted for today's debate. The amendment to be brought forward will confirm that we were acting in good faith in implementing the Quirke recommendations. Mr. Justice Quirke pointed out that the scheme introduced under the Health (Amendment) Act 1996 was aimed specifically at those who contracted hepatitis C as a result of contaminated blood transfusions and that some of the benefits were not directly applicable and that the scheme would require suitable adaptation. The scheme proposed for the Magdalen women does have such adaptations. People suffering from hepatitis C required some products outside the normal range of drugs available and that does not apply to the Magdalen women.

To ensure that the women get the best health care, provision is made in the scheme for several health services to be provided for referral by a medical practitioner or nurse. This is not intended to in any way restrict access as the focus is firmly on the health needs of the women. Referral will ensure that the health care will be coordinated and will enhance continuity of care through the GP who is the primary contact for the women. In this way a referral will ensure that all the care provided will be most appropriate to the needs of each participant.

Mr. Justice Quirke made a very clear distinction between what is put in legislation, which is appendix E of his report, and the broader administration of the scheme. For example, there is no reference in the Health (Amendment) Act 1996 or in the draft scheme put forward by Mr. Justice Quirke to liaison officers or the issue of special cards. These are details dealt with under the operation of the scheme and we are following the model recommended by Mr. Justice Quirke. To avoid any doubt, however, we have included two additional services in our Bill, chiropody and physiotherapy, that were not included in the 1996 Act. I did not say this on Second Stage but it is important to point it out. Several people commented on the complementary therapies issue. All the services that Mr. Justice Quirke set out in the report are being provided under the Bill. He did not comment one way or another on complementary therapies.

I have had some discussions with the Minister for Health, who has serious reservations about such therapies being provided and funded through the medical card. For that reason, they were not included in the Bill. I will examine the possibility of providing some funding to the women so that they may avail of such complementary therapies. To respond to some of the issues that have been raised, I will come up with proposals for a separate, carefully laid out scheme - an administrative rather than a statutory scheme - specifying what would available on a limited basis.

On the question of advocacy, Mr. Justice Quirke made it very clear that his comments on advocacy were on particular issues. We have implemented his recommendations in full. He recommended arrangements similar to those provided for in section 21 of the nursing home support scheme, which allow the court to appoint a care representative to look after the interests of a person lacking full mental capacity. The Magdalen women are fully covered under that scheme. The model recommended by Mr. Justice Quirke was the best available at the time, but following his report we published the Assisted Decision-Making (Capacity) Bill 2013, which provides a better model. The women will be covered under that Bill. They will have access to advocates and people to help them with decision making. We were careful to ensure that we would have that arrangement in place for the Magdalen women. We have identified 40 such women to date and we are waiting until proper safeguards are in place before we make the decisions on those women. We have provided funding to the advocacy groups in the UK, and that is working very well. We will examine how to provide advocacy support for them in Ireland.

In a separate recommendation Mr. Justice Quirke recommended the establishment of a dedicated unit which would have a variety of functions including assisting women in obtaining their entitlements and advocating on their behalf. That does not require legislation. We have a unit in the Department working on payments to the women. I will look at how we can assess and develop that role, but I do not envisage the Department carrying it out. That is separate from the women who have difficulty with decision making and would need assistance. We will examine how the more general advocacy service might be applied.

I hope I have dealt with the issues that were raised in the course of the Second Stage debate. I will table an amendment to address the concerns about access to some aspects of the health service. To recap, we have incorporated all of the recommendations that Mr. Justice Quirke made in the Bill.

Question put and agreed to.
Bill reported without amendment.
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