Health Services.
88. Ms C. Murphy asked the Minister for Health and Children if, in consultation with service providers, she will carry out an evaluation of the impact the levying of charges on those in residential care has had on persons with intellectual and physical disabilities whose care is partially funded through their social welfare payments; and if she will make a statement on the matter. [6340/07]
Minister of State at the Department of Health and Children (Mr. T. O’Malley): The Health (Charges for In-Patient Services) Regulations 2005 have provided for two different classes of persons on whom charges may be levied. These regulations were signed by the Minister for Finance and the Minister for Health and Children on 14 January 2005.
Class 1 refers to people in receipt of inpatient services on premises where nursing care is provided on a 24-hour basis on those premises. In this case, a weekly charge of €120, or the weekly income of that person less €35, whichever is the lesser, can be levied.
Class 2 refers to people in receipt of inpatient services on premises where nursing care is not provided on a 24-hour basis on those premises. In this case, a weekly charge of €90, or the weekly income of that person less €55 or 60% of the weekly income of that person, whichever is the lesser, can be levied.
These regulations provide for the maximum charge to be levied on either class of person. The HSE issued revised guidelines for the implementation of the charges in July 2006. No further distinctions are made in terms of the classes of persons to which charges apply and I do not have plans to introduce any.
The HSE has the power to reduce or waive a charge on the grounds of “undue hardship”. Under section 1(b) of the Health (Amendment) Act 2005, the HSE can examine a person’s overall financial circumstances in view of his or her reasonable expenditure regarding himself or herself or his or her dependants, if any.
I welcome the recent decision by my colleague, the Minister for Social and Family Affairs, to grant the full disability allowance to all persons in institutional residential care who, prior to this decision, were not eligible for this allowance. The net impact of granting the full disability allowance, in the context of long-stay charges, is that the individuals will continue to receive the same level of service as before but will have increased income which they will be able to retain for their personal use.
Ms C. Murphy: I heard many of the Minister of State’s points during the reply to an Adjournment debate and am aware of the charge that is levied. I was essentially seeking an evaluation of the impact of the charge on patients. Having read the explanatory memorandum to the Health (Amendment) Act 2005, I note it focuses very much on old age pensioners. Was it envisaged, when the legislation was being drawn up, that those with physical and intellectual disabilities would be subject to the charges? What consideration was given to differentiating between those living in capital-assisted houses with a house parent and the others? Those in the former category are not subject to the charges. Many individuals living in residential institutions, who aspire to live in capital-assisted houses but have not had the opportunity, are doing the same sheltered work as those living in capital-assisted houses, yet there is a very significant difference in the income they are allowed to retain.
Was the legal opinion proffered during the drafting of the Bill that one could not apply the charges to elderly people if they were not applied equally to everybody else in residential institutions? The difficulty is that there is a class of persons whom nobody expected would have to pay a price for the introduction of the legislation.
Much fundraising is done by parents and friends to keep residential institutions functioning and many of these people are elderly. I have met pensioners who are making contributions from their pensions towards the cost of keeping their children in institutions.
I call for an evaluation of the impact of the charges on people in institutions for whom small treats such as being able to choose their own clothes and shoes or going to the pictures are being put in jeopardy. The charges are also impacting on family members with limited means who may wish to take their relatives out of institutions. I do not think the charges are in the interest of patients.
Mr. T. O’Malley: While there is no intention at present to re-evaluate the policy, the charges will be kept under review for any anomalies that may arise. The decision by the Minister for Social and Family Affairs to pay the full disability allowance, which means that residents of institutions have more money to spend, should be welcomed by everybody.
Ms C. Murphy: Given the amounts charged in administrative fees, the institutions are going to end up with more money but is there any benefit to the residents of institutions from these charges? It seems they were simply seen as a soft target. The Government is legally compliant in that it imposes a charge irrespective of whether a patient is elderly or has an intellectual or physical disability but many of the people to whom I refer are not in a position to fight back and their parents and families often do not fight because they do not want to upset the institutions. This is a mean charge on a vulnerable group of people.
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20th February 2007 Parliamentary Question re Residential Care Charges |