THE TOP CIVIL servant in the Department of Health has said that the policy of charging fees to nursing home residents who were entitled to free care was “never challenged” politically in the decades it was in place.
Many medical card holders who were in long-term care during the period from 1976 to 2005 had to pay when it should have been free for them.
Speaking at the Oireachtas Health Committee today, Secretary General at the Department of Health Robert Watt said it was accepted that this system was “unfair.”
A report in the Irish Mail on Sunday contained claims that successive governments have allegedly pursued a secret strategy aimed at limiting refunds from the State to individuals who were incorrectly charged for public nursing home care.
It is claimed that this involved denying compensation to “anyone who did not have the resources to fight legal cases”, while the remainder of the cases “were all quietly settled by the State”.
Watt said today of this legal strategy: “Whether it’s unjust or not, you could debate that.
“If you look back on the debates historically over this, this policy was never really challenged from a political perspective … the issue has arisen because there wasn’t a lawful basis for the policy, that’s a different thing.”
“The times are very different in so many respects, in terms of the nature of the state, the role of the state, the obligations of the state, the capacity of the state.
Some 16,000 people availed of nursing-home care in 1985, a number that has grown to 23,000 in 2022.
In 1968, 80% of nursing home beds in Ireland were public. Currently, around 20% of beds are public.
Sinn Féin’s health spokesperson David Cullinane asked Watt whether he accepted that “we need to establish whether or not there were people who would have qualified [for redress] had they applied under the scheme, or had appealed, that their appeal would have been upheld, but because they didn’t they simply accepted the judgement of the HSE?”
Watt responded that a “trawl” was being carried out to establish whether there were more people in “similar situations.”
If there are, he said, “we’ll have to bring that to the minister … I’m a bit reluctant to get involved in the business of conjecture.”
Social Democrats co-leader Róisín Shortall said that only about half of the estimated €1 billion allocated for repayments was paid out under the 2004 scheme.
She said either the number of people who were estimated to be entitled to repayment was wrong, “or there wasn’t sufficient awareness among people who were invited to claim.”
Watt said there was a “large public campaign at the time”, including newspaper adverts
The Mail on Sunday also reported that it is alleged that the “legal strategy”, which was upheld by successive governments, sought to prolong cases and ensure that settlements were not publicly reported.
Shortall also said that the Oireachtas Special Committee on Covid-19 had recommended a review of the privatisation of nursing homes, a recommendation Watt said he was not familiar with.
Referring to the “creeping privatisation” of healthcare in Ireland, Shortall asked: “Isn’t this at the root of why we find ourselves now in this situation? Where, if the state doesn’t provide adequate public facilities, then people had no choice but to try and get private facilities?”
She asked Watt whether there was any work being done in the Department of Health on legislating for a legal entitlement to healthcare. Watt said there was not.
Watt later said of the controversy: “I don’t think anyone disputes that it was unfair … that’s different to legal entitlement.”
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