• You are here:
• Home /
• Archived /
• Social Welfare/Health Boards/Health Case Summaries(Annual Report 1996)

Social Welfare/Health Boards/Health Case Summaries(Annual Report 1996)

Social Welfare/Health Boards/Health Case Summaries(Annual Report 1996)

DEPARTMENT OF SOCIAL WELFARE

5 June 1997 In 1996 the Ombudsman received 653 complaints within jurisdiction against the Department of Social Welfare which amounted to 53% of the total number of complaints against government Departments. In 1995 a total of 574 complaints within jurisdiction was received so the 1996 figure represents an increase of 13.5% in complaints against the Department of Social Welfare. The total number of complaints against the Department on hand in 1996 was 807 as 154 complaints had been carried over from 1995. During 1996 an examination of 608 of these was completed. The total number of complaints withdrawn or discontinued was 167. Of the remaining 441 cases, 265 were not upheld, 57 were resolved and in 119 cases assistance was provided.

These are some of the cases involving the Department of Social Welfare which the Ombudsman reports on in his 1996 report.

• Disability Benefit Arrears for MS Patient

A woman suffering from advanced multiple sclerosis made a number of Disability Benefit claims since 1987 but all had been rejected by the Department of Social Welfare because she had no recent history of social insurance, whether paid or credited. This woman had been out of work since 1975 due to health problems but it was many years later before multiple sclerosis was diagnosed. Because of the unknown nature of her illness, she did not claim either Disability Benefit or Unemployment Benefit, nor did she seek social insurance credits, following her leaving work. Whereas by 1987, when she made her Disability Benefit claim, she was clearly seriously disabled, her social insurance record had lapsed because she had neither received a payment, nor been awarded credits, since leaving work in 1975. The Ombudsman's examination of the matter showed that this woman had, in reality, been incapable of work since 1975. Following a review of the case the Department awarded Disability Benefit together with arrears of almost �20,000. (Annual Report 1996 - Page 15) .

• Widow's Pension Arrears

A woman, who was widowed in 1965, approached the Department at that time and was advised that she had no entitlement to Contributory Widow's Pension. In 1983 she applied for the pension on the advice of a friend and was found to be eligible. She was paid three months arrears of pension but was refused arrears back to the date of widowhood in 1965. The Department's position at that time was that, in cases of late pension claims, arrears could be paid only for a period of three months prior to the actual application. This woman had been living in the United Kingdom at the time of her husband's death and qualified for a reduced UK Widow's Pension prior to her returning to Ireland. The Ombudsman suggested to the Department that the provisions of the 1966 Agreement on Social Security between the United Kingdom and Ireland might apply in that a claim for a social insurance payment in one country may be treated as a claim in the other country. The Department agreed and she was deemed to have claimed the Irish Widow's Pension from October 1966 when the Agreement came into effect. On this basis arrears of pension amounting to �14,200 were paid. (Annual Report 1996 - Page 31)

• Companion Free Travel Pass for Blind Person

This case involved a complaint against the Department on behalf of an elderly lady who had serious visual impairment for the previous thirty years and could not get around unaided. She qualified for Free Travel on her Non-Contributory Old Age Pension but was refused the Companion Free Travel Pass on the basis that she was not in receipt of Blind Pension and was not registered as blind. The Companion Pass is provided to certain incapacitated people who are medically unfit to travel alone and, in this case, would allow the holder to have a person over age 16 accompany her free of charge when travelling. The complainant would have satisfied the eligibility requirements if she had a Blind Pension.

She never claimed the Blind Pension or registered as a blind person because of her desire to be independent and her wish not to be classified as a blind person. Her problem, therefore, was that despite the fact that she had free travel, she could not use it without a companion.

The Companion Free Travel Pass scheme is non-statutory, with the Department of Social Welfare having discretion in relation to the scheme. The Ombudsman felt that, if the Department accepted that she would qualify for the Blind Pension were she to apply, it seemed unreasonable to refuse the Companion Pass simply because she did not wish to have that pension as she was being paid the same amount on her Non-Contributory Old Age Pension.

The Department accepted that it was possible she would qualify for a Blind Pension but for the fact that she was in receipt of the Non-Contributory Old Age Pension. It was, therefore, prepared to review the case in the light of the medical evidence. The lady was subsequently issued with a Companion Free Travel Pass. (Annual Report 1996 - Page 20)

HEALTH BOARDS

In 1996 the Ombudsman received 411 complaints within jurisdiction against the Health Boards. In 1995 a total of 345 complaints within jurisdiction was received so the 1996 figure represents an increase of 19% in complaints against Health Boards. The total number of complaints against the Health Boards on hand in 1996 was 577 as 166 complaints had been carried over from 1995. During 1996 an examination of 431 of these was completed. The total number of complaints withdrawn or discontinued was 130. Of the remaining 301 cases, 103 were not upheld, 85 were resolved and in 113 cases assistance was provided.

The following is one of the cases involving Health Boards which the Ombudsman reports on in his 1996 report.

• Domiciliary Care Allowance for Deaf Child

A woman, whose son was profoundly deaf, had been receiving Domiciliary Care Allowance (DCA) for him from the Eastern Health Board until he was 16 years old. At that stage he was assessed for Disabled Person's Maintenance Allowance (DPMA) but was refused. He was assessed again over a year later when he was aged 17� and was awarded DPMA. She could not understand why he had been refused 1� years earlier. The Ombudsman examined the Health Board file which appeared to suggest that the reason why DPMA was not recommended was that he was still at school and that he would be able to work in the future. However, attendance at school is not a relevant consideration and the Ombudsman also pointed out to the Board that the DPMA Regulations do not provide for the assessment of a person's future work capability but are based on capacity for work at the time of application for the allowance. The evidence on file also suggested that there had not been any significant change in the extent of the handicap over the period in question. The Board reviewed the case and awarded DPMA, with effect from his 16th birthday together with arrears of �3,593. (Annual Report 1996 - Page 27)

• Provision of Facilities for Home Births

The Ombudsman received a number of complaints about the failure of four health boards to provide midwifery facilities for women who chose to have a home birth. The women complained that their health board could not provide them with a midwife and, when they themselves contracted private midwives, the boards would not pay realistic fees for their services. A further complication was that the fees offered by the different health boards were varied, resulting in complainants receiving differing amounts of assistance depending on where they lived.

Having examined the relevant legislation and a court decision on the matter the Ombudsman was satisfied that the health boards had a statutory duty to provide home midwifery services. He was aware however that the number of available domiciliary midwives had declined over the years.

The Ombudsman acknowledged the practical difficulties faced by the health boards in the provision of these facilities, on a consistent basis, throughout the country. He was also conscious that the Department of Health is endeavouring to address these issues, within the context of the Women's Health Plan, by introducing pilot schemes in some health board areas. However, the inconsistency in the provision of the service resulted in unfair discrimination given that every applicant has an equal statutory right to the service.

The Department of Health was requested that, as an interim measure, it approach the health boards and seek agreement on a standard fee to be paid to women who engaged private midwives for a home birth. As a result, the Department obtained the agreement of the health boards to pay two thirds of the cost of a home birth, up to a maximum of �400. In addition, the Department will keep the Ombudsman's Office informed about progress on the pilot schemes which are being arranged to explore longer term solutions to the home births issue. (Annual Report 1996 - Page 28)

DEPARTMENT OF HEALTH The scale of complaints against the Department of Health is such that it does not warrant the compilation of separate statistics.

The following are some of the cases involving the Department of Health on which the Ombudsman reports in his 1996 Annual Report.

• Refusal to Release Report

The parents of two autistic children complained that the Department of Health had refused to provide them with a copy of a report by the Department's Advisor on Mental Handicap Services. The report related to a visit made by the advisor to an education and treatment centre for autistic children in the United States which their two children were attending. The parents' health board was contributing about 20% of the very substantial fees involved. A copy of the report had been given to the health board and the parents felt it was in the interests of their children that they should have a copy of the report also.

The Department of Health wrote to the parents to say, among other things, that a copy of the report had been forwarded to the health board. The Department did not make a copy of the report available to the parents. The matter was among a number of issues raised in a Dáil question in January 1996. That part of the Dáil reply which dealt with access to the report said that "there is no formal report published" but went on to acknowledge that the Department's Advisor had visited the particular facility. The parents contacted the Ombudsman in March 1996 arising from their failure to obtain a copy of the report.

The Department informed the Ombudsman that there was "no formal report published" in relation to the visit to the facility. The Ombudsman pointed out to the Department that the complaint clearly related to the report sent from the Department to the particular health board. He asked the Department to say clearly whether or not it intended to make the report available to the parents and, if not, to give the precise reasons for the decision to withhold the report. Eventually the Department agreed to make the report available to the parents, subject to the deletion of certain references which might tend to identify other families. The Ombudsman expressed his concern at the Department's failure to confirm the existence of the report and the delays in clarifying the actual position. (Annual Report 1996 - Page 30)

• Disabled Person's Maintenance Allowance (DPMA)

This case involved the Department of Health and the South Eastern Health Board. A High Court judgment delivered in the case of O'Connell v Minister for Health on 31 July 1995 found that, from 1991, certain provisions of the Disabled Person's Maintenance Allowance (DPMA) Regulations were ultra vires the Health Act, 1970. The provisions in question purported to provide health boards with the power to pay a reduced rate of DPMA in the case of spouses, where both of them were entitled to be paid a maintenance allowance. The Department of Health lodged an appeal to the Supreme Court soon after this judgment was delivered.

In September 1995 the Ombudsman received a complaint that the South Eastern Health Board was failing to apply the terms of the High Court judgment in an individual case. The Board's response was that it had been advised that payment should not be made on foot of the High Court judgment until the Supreme Court handed down its decision on the appeal.

The Ombudsman wrote to the Department of Health expressing his concern that the South Eastern Health Board, in refusing to pay full personal rates of DPMA in this case, was relying on a provision of the DPMA Regulations which had been ruled ultra vires by the High Court.

After a delay of some months, which the Department attributed to the necessity to seek legal advice on the matter, it confirmed that the Minister for Health had decided not to proceed with the appeal to the Supreme Court and that health boards were being instructed to pay the full rate of DPMA where both partners in a couple were in receipt of DPMA. The revised rate was to apply from the date of the High Court judgment. (Annual Report 1996 - Page 14)