September 24 2009

Dáil Debates

• Order of Business: EPSEN Act and Capacity Legislation

Parliamentary Questions

• Decisions on domiciliary care allowance

DÁIL DEBATES

• Order of Business: EPSEN Act and Capacity Legislation

Deputy Kathleen Lynch (L): When will the provisions of the Education for Persons with Special Educational Needs (EPSEN) Act, which was suspended in the most recent budget, be reactivated? When will the mental capacity Bill — the title of which, I hope, will be changed to the legal capacity Bill — be introduced? When will the review that is taking place in respect of personal alarms for the elderly be completed, when will it be published and when will the Government act on it? The one item of security the elderly had at their disposal were these personal alarms and the Government has taken them away. When will the review be completed?

An Leas-Cheann Comhairle: The Deputy’s first two questions are in order. Her third should be tabled to the relevant Minister in the form of a parliamentary question.

The Tánaiste: A decision has not been taken in respect of reactivating the education legislation to which the Deputy refers. It is hoped the mental capacity legislation will be introduced by the end of this year or the beginning of next year. The review on personal alarms will be completed next month.

PARLIAMENTARY QUESTIONS

• Decisions on domiciliary care allowance

Deputy David Stanton (FG): asked the Minister for Social and Family Affairs her views on the comments contained in pages 81, 82 and 83 of the Ombudsman Annual Report 2008 regarding the lack of consistency in relation to making decisions on the domiciliary care allowance scheme; if she has specific guidelines in relation to the granting of the domiciliary care allowance to children with attention deficit hyperactivity disorder; if there are disabilities or medical conditions which automatically entitle children to domiciliary care allowance;

Minister for Social and Family Affairs (Deputy Mary Hanafin):  The transfer of the Domiciliary Care Allowance scheme from the Health Service Executive to this Department arises from a Government decision on 28th February 2006 to reallocate certain functions between Departments and Agencies as part of the health service reform programme. The Department of Social and Family Affairs took over responsibility for new claims in April 2009, with existing recipients of the allowance transferring to the Department from the HSE in September 2009. The Domiciliary Care Allowance scheme is now a statutory scheme with the primary legislation provided for in the Social Welfare and Pensions Act 2008. As there were no agreed national medical guidelines for the scheme while it was administered in the Health Service Executive, an Expert Medical Group was established in advance of the transfer of functions. This Group was chaired by the Department’s Chief Medical Advisor and comprised of senior medical personnel from the HSE as well as eminent professionals in the areas of physical disabilities which affect children, and child psychiatry/psychology. This report was reviewed independently by external medical experts. The primary purpose of this Group was to agree a set of consistent and objective guidelines for use in determining eligibility of children for Domiciliary Care Allowance. To qualify for Domiciliary Care Allowance a child must have a disability so severe that he or she requires care and attention and / or supervision substantially in excess of another child of the same age. The level of care and attention required to allow the child to deal with the activities of daily living must essentially require the fulltime attention of the applicant. The child must be likely to require this level of care and attention for at least 12 months. The Group considered that the most appropriate way for the Department to conduct assessments for medical eligibility was by assessing evidence submitted by the claimant rather than by way of individual examination by the Department’s Medical Assessors as they are not involved in advice or treatment of the child. The process in operation in the department involves the submission of a detailed statement by the parent or guardian of the child; a detailed statement by the child’s General practitioner; and any other relevant evidence from qualified experts who have examined the child. The evidence is assessed by designated departmental Medical Assessors who have received special training in Human Disability Evaluation. Eligibility for Domiciliary Care Allowance is not based primarily on the disability or medical condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. Each application is assessed on an individual basis taking account of the evidence submitted. As such it is not possible to predict in any general sense whether children with attention deficit hyperactivity disorder or any other disability would qualify for a payment under the scheme. In the case of an application which is refused on medical grounds, the applicant may submit additional information and/or ask for the case to be reviewed by a different Medical Assessor specially designated for this task. Where a person is not satisfied with the decision of a Deciding Officer they may appeal the decision to the Social Welfare Appeals Office. The cases mentioned in the Ombudsman report relate to a period when the scheme was administered by the HSE, and it would not therefore, be appropriate for me to comment. I am satisfied that the current arrangements in place for the processing of Domiciliary Care Allowance cases provide for a high level of consistency in the decision process.

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