Nursing home charges and State legal strategy
Deputy Mary Lou McDonald accuses the Taoiseach of backing a callous legal strategy on nursing home charges and similar redress cases, saying vulnerable people were denied refunds and access to court. The Taoiseach rejects the claim, says the cases are different from DPMA, and argues the Government has repeatedly created redress schemes even without legal liability.
Hello to everyone from Ballymun in the Visitors Gallery.
Yesterday the Taoiseach admitted to the Dáil that he was, in fact, briefed on Government legal strategy on nursing home charges. This was 24 hours after he stated that he was not involved in the strategy and sought to put distance between himself and it. Not only did he admit he was briefed and that his predecessors and successors in government were also briefed, but he also stated that he stands foursquare behind this plan, this strategy. His expressed view is that this was, and is, a good Government strategy - a heartless plan designed by Government to hardball elderly, vulnerable people and their families forced to pay nursing home charges they should not have been paying; a strategy to stop them getting their money back, to prevent them from vindicating their rights and to keep things quiet.
Last night, we learned on RTÉ's "Prime Time" that another cold and heartless Government strategy was in place to remove allowances - the disability maintenance payment - from people with disabilities in residential care. This was a Government decision that was deemed to be unlawful. The documentation from 2009 shows that the Government of the day knew that these citizens were entitled to their allowance but used their vulnerability to prevent them from getting their payment.
This was another political strategy put in place to stop ordinary people wronged by Government from taking their case to court. Why was this? The view of the Attorney General at the time was that the State would be unable to defend these cases successfully and so we have another strategy to conceal, to deny, to cover up and to protect the Government instead of protecting vulnerable citizens. In fact, this secret document set out that a comprehensive trawl of all of those who had been illegally stripped of their disability maintenance payment should not be done because, it said, “such an exercise would be unlikely to escape media attention or speculation and could generate further claims which otherwise would not have been made”. Worse still, the Minister for Health of the day and, indeed, the entire Cabinet, endorsed this strategy. Of course, it was endorsed again by the 2011 Government, of which the Taoiseach was part, because it was reflected in the memo I discussed with him yesterday.
The story of these Government strategies is a sordid tale of successive Governments involving Fianna Fáil, Fine Gael, the Labour Party and the late Progressive Democrats actively working against the interests of some of our most vulnerable citizens. Families were forced to use private nursing homes because of the failure of Government to provide places within the public system. These families were ripped off, with many forced to work into their 70s to just get by, in some cases on less than €30 a week. Now, we see a mirror image of this political strategy adopted by Government after Government against citizens with disabilities who are dependent on the State to look after them, to vindicate their rights and to protect them. These were citizens, many of whom lived in sheltered environments and who may not have had the capacity to initiate their claim. All of this has caused real hurt, real trauma and real hardship for many people; people who needed the Government to stand up for them instead of Governments facing them down and fighting them tooth and nail, at every turn, to deny them things they were entitled to. The human cost has been heavy and deep.
Does the Taoiseach believe that this Government strategy set out in a memo from 2009, and used against people with disabilities, was a legitimate strategy for Government? Is that a legitimate Government strategy? Does the Taoiseach stand by that? Does he call this also a good plan and a good strategy from Government?
Comment on this
I still cannot fathom why the Deputy always feels the need to misrepresent what I say in this House and what the Government says. Obviously, I stand over what I said yesterday in regard to me being briefed and I am still trying to get the documents around that. What I can say is that regarding a document that appeared in the newspapers yesterday in relation to 2016, we have confirmed from the Department of Health that I was not circulated on that document, and on the agreement between the Minister and the Attorney General's office I was not the Minister who made that agreement; it was a 2014 agreement. As the Deputy may know, when civil servants talk about “Ministers”, they often talk about "the Minister" in the context of the corporation sole, not necessarily the person who was the Minister on the day.
However, that does not matter; that is just a sideshow. What matters are the issues the Deputy is raising now. In regard to the historic nursing home charges issue, I want to emphasise once again that it does not relate to anyone in nursing homes today or, indeed, in recent years. That is an important point of clarity that people in nursing homes today and their families will want to know. It relates to charges prior to the 2005-06 period and those matters were resolved prospectively when the nursing homes support scheme, the fair deal, was introduced by the Minister, Ms Harney, back in 2009. That created a universal system that sets out how people are entitled to nursing home care and what contributions they need to make.
The State - the taxpayer - has compensated those who had paid charges in public nursing homes to the tune of €480 million. That was the right thing to do, and it was done. In regard to private nursing homes, the situation is different; it is more complex, and that was explained at the time back in 2006. We do not accept that medical card patients ever had an unqualified entitlement to free private nursing home care. The advice from successive Attorneys General is clear that that is not an accepted position.
Even to this day, medical card patients either choose or are forced to go privately, and we do not reimburse them for their costs. Where we do pay for medical card patients to go privately, there is a system in place of prior approval. That is the position.
It was never the intention of the Government or the Oireachtas to confer a right to free private nursing home care on medical card patients. That is clear from the debates in the Dáil if the Deputy wants to look back at them. That does matter. What the Oireachtas intended and what Government policy was do matter.
Some cases have been settled with a financial settlement, but others have been settled without a financial settlement, and some cases were not settled at all, because they had been managed on a case-by-case basis pending a test case, which has never happened. There will be a report from the Attorney General on this to the Cabinet next week and I know the Department of Health is keen to report on it as well.
In relation to the other matter the Deputy raised, which is the disabled person's maintenance allowance, DPMA, this was paid between 1973 and 1996 under the Health Act 1970 by the former health boards. I am advised that the allowance, which could be and was used for food, heating, electricity, rent and so forth, was paid to people who could not provide for themselves. The policy position at the time - this is going back to the 1970s, 1980s and 1990s - rightly or wrongly, was that this money was no longer required as the individuals were living in State-funded residential care and those needs were being met. People with a disability who were resident in long-term care facilities did not receive this allowance after the first weeks in residential care.
In 1996, the allowance was renamed the disability allowance and responsibility for it was transferred to the Department of Social, Community and Family Affairs, as it was called at the time. Since 2007, it has been paid in full to people with disabilities living in long-term care, so this matter was resolved 15 years ago. However, the question that arose in 2009 was whether there should have been retrospection and back pay. It is an historical issue, a legacy issue, but to me it does appear different from the nursing homes charges issue. It appears different in substance because the legal advice is different and the legal advice and position became clearer after the High Court ruling. It is something we are going to look into over the next week or two and respond to further.
Comment on this
Yesterday, the Taoiseach expressed incredulity at what was suggested. Here are his words so that I am not accused of misrepresenting or misquoting him.
The allegation here is very clear. It is that four or five Governments, four or five Attorneys General, any number of Ministers and former Ministers, some of whom are now in the Government and some in the Opposition, and dozens of officials all conspired to deny people refunds they were entitled to. That is as far-fetched as it sounds. It is not what happened.
However, it is exactly what happened.
Comment on this
That is exactly what happened. It happened in respect of preventing those who had been illegally charged in nursing homes from going to court, having the matter adjudicated and getting their money back. It also happened in respect of these citizens who, by the way, were entitled to that allowance. It was illegal. It was judged to have been ultra vires, illegal, for the State to deny those people that money. Again, the same strategy was used to keep it quiet, say nothing and not to raise the hare. The worst aspect of it is that government after government, knowing that the State had wronged and denied people things to which they were entitled, colluded and conspired in a strategy to ensure that people could not have their rights vindicated. Where is the compassion in that?
Comment on this
Where is the care for people? Where is there evidence of a government standing up for people rather than facing them down-----
Comment on this
-----many of them in the most vulnerable circumstances imaginable in society?
Comment on this
I think Deputy McDonald is conflating two different issues, and they are different, namely, the historical nursing home charges and the issue of the DPMA. The legal advice is different. The legal advice on the DPMA was that the State did not have a leg to stand on. The legal advice on the nursing home charges is that those charges were not illegal.
Comment on this
Deputy McDonald is making an assertion that has not been established. She also made an assertion that people were prevented from going to court. Nobody is prevented from going to court. One cannot prevent somebody from going to court in Ireland. That is an entirely false statement.
Comment on this
The State settles before the case goes to trial.
Comment on this
There were cases that were settled and there are cases that have not been settled and they may yet go to court. That assertion is also false.
I have been a member of three governments. More so than ever, and more so than other governments have done or governments around the world have done, we have put a huge amount of time, care and resources into putting right some of the wrongs of the past, whether it is Magdalen laundries, mother and baby institutions, mica and pyrite, or the apartment block defects. The Government does have a responsibility to do what is right and just, but it also has a responsibility to protect the taxpayer and the common good. That means balancing the future and the past.
Comment on this
We cannot protect the past by attacking the vulnerable.