Today the report by Mr John Travers into the management and administration of charges for people in public long-stay places is being published.
I asked Mr Travers to carry out this report on 16th December last. It was evident that a full, professional and disinterested evaluation was required to understand the issue and learn the lessons of past mistakes.
Mr Travers has produced this evaluation now. I wish to record my thanks to him, and to the people in the Department of Health and Children and elsewhere who co-operated to enable him to produce a speedy and comprehensive report.
Illegal charging unacceptable
Over 300,000 people were charged illegally during 28 years. This was entirely wrong. They were old, they were poor, they suffered from mental illness, they had intellectual disabilities, they were physically disabled. As vulnerable people, they were especially entitled to the protection of the law and to legal clarity about their situation. The charges should never have been made illegally, even though the principle of charging for shelter and maintenance had broad public and political acceptance.
We are a society ruled by law. No one and no organisation can dispense with or alter a law.
The problem is that this is what happened over 28 years. It has given rise now to a major financial, legal and administrative problem that was entirely avoidable.
Department of Health
and Children
The Travers report recognises the achievements and public service commitment of the Department of Health and Children. It states, 'The many considerable achievements of the Department over that period of intense work pressure need to be acknowledged in the context of this examination which is the subject matter of this report.'
I agree with this from my own experience. Since September, I have met many professional and dedicated people throughout the Department. I recognise and value the long hours people put in, the pressures they absorb, and the service they give.
It is incontestable, however, that there are grave issues here for my Department.
I have asked the management team to begin work on implementing Mr Travers' recommendations. I will work with my Department for change, so that the people of the Department of Health and Children can move beyond these difficult days and take pride in new public service achievements.
The terms of reference of the report focused on the Department of Health and Children only. The report has wider relevance for all involved in the administration of health services and for the civil service. I have written today to the chairman of the Health Service Executive, Mr Liam Downey, to ask that the HSE too will reflect on the report and take appropriate actions for its administration.
We can all acknowledge that we make mistakes, politicians and myself included. We can all ask, what standard are we held to? What is the tolerance for error?
There can be tolerance for error if we learn from mistakes. And no one wants to set impossibly high standards. The public service is committed to meeting the highest standards of professionalism in public administration. In this case, however, some minimum standards were not met.
This is particularly acute in relation to what Mr Travers describes as "issues of singular importance", like the legal basis for charges. These cannot be folded into an ongoing process. They should be identified and dealt with in clear language and with a clear purpose and remedy.
Statements to Dáil Éireann
The issue about these charges was first brought to my attention in the Dáil last October. On foot of this, I sought the advice of the Attorney General.
In his report Mr Travers invites me to review the speech and information I gave to the Dáil last December. I had begun that process and can now complete it with the full facts.
Three weeks ago, the House debated the decision of the Supreme Court on the Health (Amendment) (No.2) Bill, 2004. I stated then, based on new information brought to me and on the assessment of the court, that I could no longer stand over statements I made or gave to the House that the charges had been made "in good faith".
Briefings and a report on this basis had been given to me, to the Taoiseach and to the Government, and then forwarded by me to the Dáil.
This information can now be seen to have been inaccurate and incomplete in certain key respects. I will not set out each instance.
The Government's decisions in December were made relying on this information. Inaccurate statements were made to Dáil Éireann by myself and by the Taoiseach relying on it. I regret this very much, because the Dáil subsequently debated the Health (Amendment) (No.2) Bill, 2004 in that light. Our democratic system of government cannot work in this way.
Conclusions
I asked for this report because I wanted all the information about this problem to be made available to the public. It is now time to put solutions in place.
Repayments will be made quickly, fairly and efficiently to those who were illegally charged. We will do this in a way that is responsible and that ensures that the repayment system we put in place is robust in identifying all genuine cases.
Last December, I asked for a full audit of the legal basis for charges and other practices in health.
There is a considerable amount of work ahead at the Department of Health and Children to take on board the lessons and recommendations of this report.
An interdepartmental team has begun work already on putting long-term care for older people on a clear, sustainable, financially and legally sound basis. It is fair that there should be clarity about services, clarity about finance and charges, and clarity about shared responsibilities.
We have a challenging agenda of progress for long-term care and many other areas of health policy. I will be relying on and working with professional civil service support to deliver this.
We are in a period of radical reform in health administration involving much clearer roles for Department and the Health Service Executive, with a shared top priority of improving services for patients.
There is much to be proud of already, and there will be much more to take pride in for the future, once we absorb the lessons set out in this report.