Press Release

Government Agrees Bills for Repayment of Long Stay Charges and Public Consultation Process for the HIQA

The Tánaiste and Minister for Health and Children, Mary Harney T.D., and the Minister of State for Older People, Sean Power T.D., today announced that the Government has agreed the texts for the Health (Repayment Scheme) Bill 2006 and Heads of the Health Information and Quality Authority Bill 2006.

Repayments legislation

The Repayment Scheme Bill, to be published next week, will provide for the repayment of public nursing home charges to all those who were wrongly charged and are alive, and the estates of all those who were wrongly charged and died since 9 December 1998.

The Tánaiste said,

“The repayment scheme will be simple to use and has been designed following consultation with and input from the Oversight Committee whom I appointed to provide an independent input into the process.

“The scheme will ensure that repayments can be made swiftly to those eligible for repayment, following the completion of an uncomplicated application process.

“It is my intention that priority in making repayments will be given to those applicants who are still alive.”

HIQA and Social Services Inspectorate

The General Scheme of the Health Information and Quality Authority Bill will be published within the next few weeks as part of a public consultation process.

The draft Heads provide for

  • the establishment of HIQA
  • the establishment within HIQA of the Office of the Chief Inspector of Social Services
  • and the establishment of a registration system for residential services for children in need of care, for persons with disabilities and for older people.

The Tánaiste said,

“The establishment of HIQA and the Office of the Chief Social Service Inspector demonstrates the Government’s commitment to quality patient care as a key driver of the health reform programme.”

“Part of the work of the Chief Social Services Inspector will be to inspect, for the first time, public nursing homes as well as private nursing homes, which are presently inspected by the HSE. There will be clear and uniform standards for all nursing homes in the country and inspections will be based on compliance with these standards.”

Note for Editors

The Health (Repayment Scheme) Bill will enable full repayments of public nursing charges to be made to all those who were wrongly charged and are alive, and the estates of all those who were wrongly charged and died since 9th December 1998. The scheme will not allow for repayments to the estates of those who died more than six years ago. It is the intention that legislation will be approved and signed into law before the end of May, with repayments commencing shortly thereafter following the appointment of an outside company by the HSE.

The repayments will include both the actual charge paid and an amount to take account of inflation. All repayments to living persons will be exempt from income tax and repayments will not be taken into account in assessing means for health and social welfare benefits. The normal tax and means assessment arrangements will apply to those who benefit from repayments to estates. The scheme includes a provision to allow those eligible for a repayment to waive their right to a repayment and have the money assigned to fund one-off service improvements for older persons and persons with a disability.

The application process will be as simple and as user friendly as possible while also providing appropriate safeguards against fraud and preventing the exploitation of those not in a position to manage the repayments which they will receive. The scheme has been designed and will be managed with the aim of ensuring that those who are eligible for repayments receive them as soon as possible. Priority will be given to those who are still alive, and the HSE has begun pro-actively identifying and working up details of repayments due to living persons to enable prompt repayments to be made.

The application process for estates has been streamlined with the assistance of the Probate Office and there will not be a requirement for applicants to obtain a Grant of Representation in order to receive repayments.

It is estimated that up to approximately 20,000 people who are still alive and a further 40,000 to 50,000 estates will benefit. The scheme will cost approximately €1billion and an appropriate allocation for 2006 will be made when the legislation is passed by the Houses of the Oireachtas. There will be an independent and transparent appeals process

The legislation will also provide for the regulation and administration of patient private property accounts to ensure the money in these accounts is used for the benefit of the patient and that the money held in these accounts can be invested on behalf of the patient. The Minister may appoint an independent overseer in relation to the administration of these accounts.

The governance of the scheme will allow the Minister to receive reports on, the operation of the scheme, the appeals process and the fund established to receive donations. These reports shall be laid before each House of the Oireachtas. Legislation also provides that all accounts and funds related to the scheme may be audited by the Comptroller and Auditor General.

The Oversight Committee appointed by the Tánaiste to provide an independent input into the design and monitoring of the scheme has been fully briefed on all aspects of the scheme and has provided valuable input into the legislation to date. The Committee has approved the contents of the Bill.

The establishment of the Health Information and Quality Authority (HIQA) on a statutory basis was one of the recommendations of the Health Service Reform Programme announced in June 2004. It was also proposed in the Health Strategy – Quality and Fairness: A Health System for you.

The General Scheme provides for the establishment of the Office of the Chief Inspector of Social Services as a statutory office within HIQA. This meets the commitments made in the ‘Agreed Programme for Government (2002)’, the Health Strategy and Sustaining Progress to establish the Social Services Inspectorate on a statutory basis.

The Health Information and Quality Authority will set standards for services provided by or on behalf of the HSE except those within the remit of the Mental Health Commission and the Inspector of Mental Health Services.

It will also monitor those standards except those set in relation to the personal social services which will be monitored or inspected by the Chief Inspector of Social Services. It is being given the powers to investigate, at the request of the Minister or the Executive, the safety, quality and standards of any service (except those registered and inspected by the Chief Inspector of Social Services and the Mental Health Commission) provided by or on behalf of the Executive and to make any recommendations it deems necessary.

It will also have the role of accrediting services and will be able to provide an accreditation service for the private sector. HIQA will also advise the Minister and the Health Service Executive on the effectiveness of health technology. In addition, HIQA will have a role in setting standards in relation to information and data on services provided by the Health Service Executive and on its behalf, and the health and welfare of the population as well as identifying deficiencies in such information.

The Office of the Chief Inspector of Social Services will be a statutory office within HIQA. It will replace the Social Services Inspectorate which has been operating on an administrative basis since 1999. The Chief Inspector will continue the Social Services Inspectorate’s work of inspecting the child welfare and protection services. It will also be assigned responsibility for the inspection of residential services for persons with a disability and for residential services for older people, including private nursing homes.

It will be the registration authority for these services and will inspect them against regulations provided for in the Draft Heads and against the standards set by HIQA. The registration system is being provided for residential services in order to give greater protection to those persons considered to be in a vulnerable position. The Chief Inspector will have powers to cancel registration of a service, or to add conditions to a registration. He or she will also have the power to seek urgent cancellation of registration by application to the District Court in situations where it is considered the health and well-being of a person is at risk.