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Dáil Debates & Questions
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November 11 2008 Dáil Debates Parliamentary Questions
DÁIL DEBATES Deputy Olwyn Enright (FG): asked the Minister for Social and Family Affairs if she will provide details of the increased controls designed to achieve savings which were initially intended to be realised by stopping the payment of the disability allowance to disabled teenagers; Deputy Mary Hanafin (Minister for Social and Family Affairs): In the social welfare budget, I announced that the age of eligibility for entitlement to disability allowance would be increased from 16 to 18 years for new claimants with effect from 1 January 2009. As an alleviating measure, the age for entitlement to the domiciliary care allowance would be increased from 16 to 18 years from the same date. These measures were estimated to save €5.6 million on my Department’s Vote while giving rise to a cost of €1.4 million on the HSE Vote. Accordingly, the net saving to the Exchequer in 2009 was expected to be of the order of €4.2 million. The changes announced in the budget were designed to address concerns raised about the appropriateness of paying young people a social welfare payment in their own right at the age of 16. It was feared that receiving the payment at an early age could undermine the incentive to pursue work, training or education options and cause them to become welfare dependent too early. Following the budget I met six different groups representing people with disabilities and disability service providers. At these meetings, the underlying principle of the budget measure, namely, that it is inappropriate to pay a social welfare payment to a 16 year old in his or her own right, was not seriously contested. The key concern expressed by the groups related to the loss of expected income at short notice to families of young people with disabilities. Following these meetings, I recommended to the Government that the disability allowance continue to be paid to 16 and 17 year olds pending a full review of the scheme. The review is considering a wide range of issues as identified by groups representing people with disabilities, their families and service providers, and will take account of a forthcoming report on disability and illness benefits by the OECD. It will also draw on new data published by the Central Statistics Office last week from the national disability survey 2006. An amount of €1.4 million which will not now be required for the domiciliary care allowance measure will be transferred from the HSE Vote to my Department. Accordingly, the net impact on social welfare expenditure of not proceeding with the budget proposal is €4.2 million. This represents just 0.02% of projected overall social welfare expenditure in 2009 and will be accommodated by ongoing efficiencies across the whole range of the Department’s activities next year. It will not be necessary to introduce further measures affecting entitlements or payments. Deputy Olwyn Enright: Given the Minister’s answer, she clearly did not learn anything from the announcement made in the budget. She is still trying to claim that the families were looking for this measure when she refers to the six different voluntary bodies which did not seriously contest what she did. The families involved seriously contested the decision the Minister made. The decision was wrong and the fact the Minister still seems to be considering it in a different context is wrong. In any case, that was not the question I asked. If the Minister reads the question, she will see the last line of her answer is all that refers to the question asked. I asked the Minister from where in her budget she will save the €4.2 million that was ring-fenced when she was going to make this change. Both the Minister and the Taoiseach said in the media that she was going to find these savings elsewhere in her Department. The specific question I asked was from where those savings will come. The Minister was able to say she would get them so she should account for them to the House. Deputy Mary Hanafin: I met the six groups to which the Deputy referred and, as I noted in my reply, those whom I met have not contested the principle of this, either then or subsequently. If anybody in the House would look at this, they would realise it is a valid principle not to make a social welfare payment to a person at 16 years of age. Deputy Olwyn Enright: The Minister should deal with the question. She has a requirement to do so. Deputy Mary Hanafin: That issue is not contested. Acting Chairman: It is not Deputy Enright’s job to intervene. Her job is to hear the answer. Deputy Olwyn Enright: The Minister is not giving the answer to the question asked. Acting Chairman: Let the Minister speak. Let me do the job I am put here to do and let the Deputy do the job she is supposed to do, if she does not mind. Deputy Olwyn Enright: Do it, please. Deputy Mary Hanafin: The overall budget is €19.6 billion. We believe that with increased control savings, some of which I referred to in the first answer, we will be able to save another €4.2 million. A figure of €19.6 million is an enormous sum in this context. Judging by the success of some of the activities we have undertaken this year in our controls, particularly in regard to the jobseeker’s and child benefit, as well as other initiatives we hope to take in this regard, I envisage there should be no difficulty in saving €4 million next year. Deputy Olwyn Enright: Every time there is a problem, the Minister tells us she will make increased savings. She told us in July or August she would get €25 million in savings, which was the subject matter of the first question. However, she was unable to explain how that €25 million has been obtained. Now, she is telling us she will save another €4.2 million in respect of this through increased savings. From where is that €4.2 million to come? If it is so easy to make savings by increased controls, as she seems to think, why has the Department, the Minister and her predecessors not been doing this every year for the past number of years? I again ask the Minister to outline how exactly the saving of €4.2 million will be accounted for in the Department’s budget. Deputy Mary Hanafin: This is only early November, which is why we have not yet reached the target of €25 million, but we would envisage doing so by the end of December. Deputy Olwyn Enright: It does not look like it. Deputy Mary Hanafin: To the end of September, total savings of €331 million were made by the Department in all kinds of savings and control. Deputy Olwyn Enright: They were already budgeted for. Deputy Mary Hanafin: I will be reviewing those that have been the most successful, and I have already highlighted some. Out of a budget of €19.6 billion, it is my intention to save the further €4 million that would have been required under this disability allowance initiative. Deputy Olwyn Enright: The Minister cannot answer the question. PARLIAMENTARY QUESTIONS Deputy Joe Costello (L): asked the Minister for Social and Family Affairs when she will provide for a personal advocacy service in respect of people with disabilities; the specific target date she is working to; Minister for Social and Family Affairs (Deputy Mary Hanafin): The statutory basis for the introduction of a personal advocacy service under the Citizens Information Board (CIB) was provided for in the Citizens Information Act, 2007. However, having regard to the current budgetary circumstances, it will not be possible to proceed with this next year. The provision of an advocacy service remains a priority for this Government. In this regard, significant resources have been provided since 2005, and will continue to be made available under the auspices of the Citizens Information Board for the development and provision of advocacy services for people with disabilities. Funding of €1.8 million was provided in 2008 for service developments which include advocacy services. This brings the total funding for advocacy services to €6.1m for the period 2005 to 2008. The Citizens Information Board has developed a Community and Voluntary Sector Advocacy Programme and has funded 46 separate advocacy projects. The overall focus of the programme is on representative advocacy for people with a disability. Projects either operate within a specific geographic area or are focused on a particular disability type. Each of the projects poses different challenges, some requiring more intensive work with smaller caseloads while others have larger caseloads with shorter periods of client contact. Up to the end of June 2008, 3,241 members of the public have availed of the services provided by the projects. The breakdown per year is as follows:
The Citizens Information Board is monitoring the programme to ensure that the projects are operating in accordance with the Board’s advocacy guidelines. It is planned to undertake a full evaluation of the Community and Voluntary Sector Advocacy programme in 2010. The Citizens Information Board also provides advocacy through the Citizens Information Services focusing on access to services, welfare entitlements and employment rights. This type of mainstream advocacy is also open to people with disabilities and the Community and Voluntary Sector Advocacy programme is creating close links with the Citizens Information Services to ensure that people with disabilities are encouraged and supported to use the mainstream services where possible. The advocacy capacity within the Citizens Information Services is being strengthened through the provision of Advocacy Resource Officers who work to build the capacity of information providers to advocate on behalf of clients. There are nine Advocacy Resource Officers in operation across the Citizens Information Services network. I am satisfied with the developments undertaken to provide advocacy services for people with disabilities through the Citizens Information Board. The Department will continue to work with them to further enhance advocacy services for all citizens including those with disabilities.
Deputy Bernard Allen (FG): asked the Minister for Social and Family Affairs when the National Carer’s Strategy will be published; Minister for Social and Family Affairs (Deputy Mary Hanafin): The development of a National Carers’ Strategy is a key Government commitment in both the national partnership agreement Towards 2016 and the Programme for Government. A working group, chaired by the Department of An Taoiseach, is working on developing the strategy. My Department provides the secretariat to the working group which also includes representatives of the Departments of Finance, Health and Children and Enterprise, Trade and Employment as well as FAS and the Health Service Executive. Developing the strategy involves consultation with other government departments and bodies not represented on the working group. The Department has met with a wide range of organisations including the Equality Authority, Combat Poverty Agency, Citizen’s Information Board, the National Council on Ageing and Older People, the Office of the Revenue Commissioners, the Department of Environment, Heritage and Local Government and the National Disability Authority to discuss this issue. A request for submissions from the public was published in regional newspapers in early March. The closing date for submissions was Friday 18 April 2008. There was a good response from individuals and organisations and the submissions received are being examined. Towards 2016 commits the Department to hosting an annual consultation meeting of carer representative groups and relevant departments and agencies. Such a meeting was held on 23 January 2008. Representatives of 12 groups and 9 government departments and bodies attended. The theme was the National Carers’ Strategy and groups were given an opportunity to comment on the draft terms of reference and to raise other issues considered relevant in the context of the strategy. I was very pleased to launch the report “Listening to Carers, Report on a Nationwide Carer Consultation” produced by the Carers Association in partnership with Caring for Carers Ireland and Care Alliance on 30th of June this year. The issues raised in this report are currently being considered as part of the development of the strategy. The commitment to the development of a National Carers’ Strategy also includes a commitment to appropriate consultation with the social partners. An update in relation to the strategy was provided to the social partners plenary session in February. The first of two consultation meetings with the social partners was held on 8 May 2008. Key issues raised were recognition for carers and their work, access to suitable health services, income support, training, gender issues and balancing employment and care. We are currently working on bringing the carers strategy to completion. Deputy Kathleen Lynch (L): asked the Minister for Social and Family Affairs her future intentions in relation to the age thresholds for disability allowance. Minister for Social and Family Affairs (Deputy Mary Hanafin): The question of the age thresholds which apply to Disability Allowance is one of a wide range of issues now being addressed in the context of a comprehensive review of the scheme which is being undertaken by the Department. This review is assessing the effectiveness and efficiency of the Disability Allowance scheme. It draws on new data being made available by the Central Statistics Office from the National Disability Survey 2006. Account will also be taken of a forthcoming report on disability and illness benefits which is being published later this month by the OECD. And, of course, the review is also taking account of the wide range of issues identified by groups representing people with disabilities and by service providers in the disability sector. I look forward to seeing the outcome of this review which it is expected will be completed in the first half of 2009.
Deputy Seán Barrett (FG): asked the Minister for Health and Children the rationale for the 1% cut in disability funding in both 2008 and 2009, along with the withdrawal of €53 million and €17 million in 2007 and 2008 respectively from the multi-annual disability funding voted in Dáil Éireann; if she will restore these cuts to disability and mental health; Minister of State at the Department of Health and Children (Deputy John Moloney): Almost €1 billion is provided each year to non-statutory providers of disability services. In line with the efficiency measures being taken elsewhere in the health system, an efficiency reduction of 1% will be applied by the HSE to the allocations of non-statutory disability agencies for 2009. It is envisaged that efficiencies will be achieved in non-frontline areas such as advertising, PR, travel and subsistence and management/administrative payroll costs. The Office for Disability and Mental Health will be conducting a review in 2009 of nonstatutory agencies which provide services for persons with disabilities, which will consider issues of structure, overheads, and coherence of and synergies within the sector with a view to assessing the scope for further efficiencies. This exercise will be undertaken with our focus at all times on the needs of those that we serve. Under the Multi Annual Investment Programme additional funding of €75m was allocated in both 2006 and 2007. In the 2008 Budget, €50m was provided to the Health Service Executive (HSE) to fund a range of additional services under the Multi Annual Investment Programme for Disability. Although the commencement of the planned developments in disability services this year had been delayed due to a financial review, I am pleased to inform you that the Executive has informed the Department of Health and Children that it is now in the process of rolling out the planned developments. The HSE has indicated that due to the delayed start to some of these developments, it expects to spend €33m of the €50m by the end of 2008. The resulting €17m time related savings were included in this Department’s budgetary consolidation measures announced to the House in July 2008. As the issues raised by the Deputy are matters for the HSE under the Health Act 2004, I have requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.
Deputy Andrew Doyle (FG): asked the Minister for Health and Children the number of occupational therapists employed in County Wicklow; the action being taken to employ occupational therapists to provide an occupational therapy service in County Wicklow; and the terms of employment and the means used to advertise vacancies. Minister for Health and Children (Deputy Mary Harney): Almost 130,000 people work fulltime or part-time in our public health services. In recent years, the Government’s ongoing high level of investment in health has achieved and maintained significant increases in the numbers of doctors, nurses and other healthcare professionals employed in the public health services. The Government has also invested heavily in the education and training of such personnel in order to secure a good supply of graduates to provide for the healthcare needs of the population into the future. In view of this significant investment, the Government is committed to ensuring continued adequate recruitment of professional staff across a range of community settings to ensure the continued development of community services. Additional funding of €20 million has been provided in 2009 for health and education services for children with special educational needs. This funding will provide a total of 125 additional therapy posts in the HSE targeted at children of school-going age. 90 of these will be in the disability services, including speech and language therapists, occupational therapists, and physiotherapists. 35 additional posts will be provided for child and adolescent mental health services, including clinical psychologists, occupational therapists, and speech and language therapists for new and existing multidisciplinary teams. In addition, certain key health and social care professional posts, including speech and language therapists, physiotherapists, occupational therapists, clinical psychologists, counsellors and social workers, are to be protected by setting employment floors for these grades within the Health Service Executive (HSE) in 2009. These posts are essential to the development of a number of services areas such as disability (including speech and language therapy), child adolescent mental health services and child protection services. In order to protect these posts, my Department will be writing to the HSE setting out the minimum employment levels to be maintained within each of these occupations in the health sector in 2009. The recruitment and retention of these key front line professional posts is vital to ensure continued progress in the development of community settings. Subject to overall parameters set by Government, the Health Service Executive has the responsibility for determining the composition of its staffing complement. In that regard, it is a matter for the Executive to manage and deploy its human resources to best meet the requirements of its Annual Service Plan for the delivery of health and personal social services to the public. The Executive is the appropriate body to consider the matters raised by the Deputy. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the matters investigated and to have a reply issued directly to the Deputy.
Deputy Róisín Shortall (L): asked the Minister for Health and Children the amount she will allocate the mental health services in accordance with the provisions as set out in A Vision for Change; the mechanisms put in place to ensure accountability in spending of these funds; the steps she has taken to implement recommendation 19.11 of A Vision for Change; and the action to date taken by her on the recommendations issued by the sub-committee on the adverse side effects of pharmaceuticals. Minister of State at the Department of Health and Children (Deputy John Moloney): Substantial resources have been invested in mental health services. Overall spending on mental health services in 2007 amounted to €1 billion and this level of funding continued into 2008. It is also important to bear in mind that some 90% of mental health problems are dealt with in primary care. The estimated additional cost of the implementation of ‘A Vision for Change’ the Report of the Expert Group on Mental Health Policy is €150m over 7 — 10 years. A total of €51.2 million has been allocated since 2006 which represents over a third of the overall requirement. Under the Health Act 2004, the Health Service Executive is obliged to operate within its overall vote. In this regard, it took steps to ensure that it met this objective in 2007 by delaying some of its planned developments, including developments in mental health. I am advised that of the €51 million provided in 2006 and 2007 for the implementation of ‘A Vision for Change’, about €30 million has now been invested. In addition, the recruitment of 8 additional child and adolescent teams and the commissioning of 14 additional beds for children and adolescents is underway. I wish to assure the Deputies that this Government is firmly committed to the development of mental health services in line with ‘A Vision for Change’. Implementation of the recommendations of the Report is a key priority for the Office for Disability and Mental Health. By working in partnership with the HSE to achieve the agreed targets, the Office is bringing a new impetus to implementation. Funding will be provided in 2009 for the recruitment of 35 therapy posts for the child and adolescent mental health service. In addition, once-off funding of €1.75m is being provided for suicide prevention initiatives and for mental health projects supporting service users and carers. I also wish to point out that implementation of ‘A Vision for Change’ is dependent to a much greater extent on the remodelling of existing resources than on new additional funds. Implementation of many of the recommendations in 19.11 of ‘A Vision for Change’ is the responsibility of the HSE. In relation to research the Department of Health and Children provides funding to the Mental Health Research Unit (MHRU) as part of the Health Research Board’s overall allocation. The Unit manages and reports on national information systems in the mental health area e.g. the National Psychiatric In–Patient Reporting System (NPIRS). Support has been provided to develop WISDOM — a system which will capture information on inpatient and community care service activity. Research is also an integral part of the work of the Health Service Executive and the Mental Health Commission. In relation to the Report on the Adverse Side Effects of Pharmaceuticals, April 2007, I am advised that the Irish Medicines Board (IMB) initiated a process to carefully examine the various items raised. This assessment was completed in November 2007. The outcomes of this assessment have been communicated to my Department and I am advised that proposals concerning conduct of clinical trials and post authorisation studies are already provided for in legislation and are the subject of a range of initiatives. Regarding the handling of Adverse Drug Reaction (ADR) reporting, a number of items highlighted in the Oireachtas report reflected submissions made by the IMB and the consultant’s assessment drew attention to the following opportunities which are currently being progressed by the IMB:
I am also advised that the IMB has developed a website which has the capacity to take on-line reporting of adverse reaction reports. This system is fully operational and reports are being taken from both health care professionals and patients. The website can be accessed at; http://www.imb.ie/EN/Safety--Quality/Online-Forms/Human-Medicine-Adverse-Drug-Reaction.aspx The position in relation to the establishment of a Patient Safety Agency is that a Commission on Patient Safety and Quality Assurance was established to develop clear and practical recommendations to ensure that quality and safety of care for patients is paramount within the healthcare system. The Commission’s Report — ‘Building a Culture of Patient Safety’ was published on 7th August 2008. It contains 134 recommendations spanning across almost every area of the health service including a number relating to the reporting, managing and learning from adverse events in the health system generally as well as some recommendations in the area of medication safety relating chiefly to the Irish Medicines Board and other bodies with a stake in the medication sector. The implementation plan endorsed by the Commission recommends the immediate establishment of an Implementation Steering Group (ISG) and five expert subgroups relating to specific subjects. The advantages of this model are that it immediately builds on the structures already in place and can deliver results quickly. On this basis, the establishment of a new patient safety agency is not proposed.
Deputy Richard Bruton (FG): asked the Minister for Education and Science if he will provide an estimate of the cost of legal services which his Department paid for in 2007 and to date in 2008; and if he is satisfied that effective measures are in place to minimise this cost. Minister for Education and Science (Deputy Batt O’Keeffe): My Department incurred costs of €1,319,817.79 in 2007 and €2,039,199.34 in 2008 in relation to certain litigation costs, i.e. for cases before the Courts which involved the Department as a Defendant or Respondent. These would have included litigation relating to Primary and Post-Primary Schools, Community and Comprehensive Schools, Special Educational Needs, school non-attendance, school transport, employment law matters, (including salaries and pensions), litigation arising from industrial relations actions and/or appeals to the Courts from decisions of the Equality Tribunal, contractual disputes and a diverse range of matters. It should be noted that these figures include legal costs relating to Community and Comprehensive Schools, as the State provides a general indemnity to the authorities of these schools in respect actions or claims made against them by visitors, parents or other members of the public in respect of accidents etc. occurring on school premises. Also included is the cost of actions pursued by the State Claims Agency. Since 1st September 2005, all personal injury claims against the Minister for Education and Science have been delegated by the Government to the State Claims Agency. A consequence of this is that the State Claims Agency has sole responsibility for deciding the approach to be adopted in litigation and for determining how individual cases are conducted. Payment of all State costs in these actions is made directly by the Department. The cost of legal services detailed above would also include advisory work on PPP projects, drafting work in relation to various contractual matters and so forth. Legal costs incurred by the State, in defending those cases which are brought to court, are not met directly by my Department. In accordance with financial procedures in cases involving damages or compensation against the State, costs are generally charged to the Chief State Solicitor’s Office Vote as sanctioned by the Attorney General. The Department is not complacent in dealing with these cases and attempts, wherever possible, to reduce the potential for litigation and the levels of legal costs where they arise. It may also be noted that the question of minimising legal costs incurred by the State is being addressed by the Department of Justice, Equality and Law Reform in its proposed “Legal Costs Bill” which is included in the “C List” in the current Government Legislative Programme. The Residential Institutions Redress Board and the Commission to Inquire into Child Abuse expended €41,050,139.00 in 2007 and €37,165,454.10 for the current year to date for their legal services’ costs and for those 3rd party costs for which they are required to meet. Section 27 of the Residential Institutions Redress Act 2002 provides that all reasonable legal costs and other costs associated with the preparation and presentation of an application to the Redress Board will be met by the Board. In the event that agreement cannot be reached between the Board and the applicant’s legal representative, the matter is referred to the Taxing Master of the High Court for determination. The Residential Institutions Redress Board publishes an Annual Report each year. Included in this Report is a breakdown of monies paid by the Board to individual legal firms together with details of the number of clients they have represented in that particular period. These annual reports are made available to download on from their website at www.rirb.ie.
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