29th October 2003
So, we now have the Prospectus, Brennan and Hanly Reports and all will be well with the Health Service. All that is needed is a bit of political will and a few hundred million euro. Frankly, I feel it will be easier to find the latter than the former. I'm not cynical but the political opposition to Hanly especially is fomenting already.
Professor Niamh Brennan is complaining about the fact that the Department of Health and Children has not begun to implement her report. If she sticks around she will see that the old hymn "A thousand ages in thy sight are like an evening gone" could be the theme song to accompany most reports and I have seen hundreds of them arrive with a bang and fade into obscurity. And here I will give you one example.
Some years ago my conscientious neurologist colleague Ray Murphy asked if I could do anything to encourage the updating of the medical criteria which applied to patients who could get tax concessions under the Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme. He sat with some other doctors on the Appeals Board for this scheme and felt that the medical criteria which had been in place some thirty years ago needed to be changed. He asked me to attend the interview by the Appeals Board of some patients and this, with the patients' permission, I did one morning.
To be brief, the medical criteria mainly apply to people in wheelchairs - people who are wholly or almost wholly without the use of both legs, people without one or both arms, people who are wholly or almost wholly without the use of both hands or arms and wholly or almost without the use of a leg, people with dwarfism. All very serious conditions and, of course, worthy of the tax concessions. But I saw other very disabled people that morning whose appeals had to be refused because the member of the Appeals Board cannot stray outside the strict medical criteria - examples of people I saw who could not get relief were the blind. Now while they cannot drive, they could be passengers. People with strokes who were desperately anxious to get back to work and so forth but if their paralysis did not fit with the medical criteria, they were out too.
Well, off I went and did a bit of letter writing to departments but these only yielded the "A Chara" letter, so I decided to seek an adjournment debate on the issue. These debates take place at the end of the Seanad day, one speaks for 8 minutes and the Minister replies. It is the Upper House equivalent to a Dail question.
On 23rd June 1999 I explained the problem to the then Minister of State Deputy Martin Cullen at the Department of Finance. I made particular reference to the parents who had written to me because their application for tax concessions had been refused. They lived in an isolated area and had their 23-year-old daughter with severe mental handicap and a form of epilepsy which caused her to suffer "drop" attacks frequently making it impossible to take her on public transport. The parents are not well off but while the girl is confined to a wheelchair and has to wear a protective helmet she is not "wholly without the use of both legs" so she does not qualify for tax relief for a disabled passenger.
To be positive, the tax concessions are very generous and do cost the Department of Finance many millions but from what I have written I hope readers will see how tightly controlled the grants are and the Appeal Board given no discretion.
In reply to my plea on 23rd June 1999 Minister Cullen said and I quote "A current review of the scheme is being undertaken by an inter-departmental group under the chairmanship of the Department of Justice, Equality and Law Reform with a view to determining what modifications if any might be proposed to the scheme".
Well, on and off if I met Ray Murphy I'd ask if there were any changes. The answer was invariably "No", and indeed after some years he resigned from the Appeals Board.
Years passed and a few weeks ago the father of the very disabled girl I described phoned me to say he was thinking of changing his car. He believed the inter-departmental review was now with the Department of Finance and did I know if there had been any change in the medical criteria.
Four years and four months after the first adjournment debate I put down another adjournment debate in which I could have spoken exactly the same words as I spoke on 23rd June 1999. On 15th October 2003 I was told - this time by Minister of State at the Department of Finance, Deputy Tom Parlon - "The Senator will appreciate that the Report of the review group is complex" and "It is envisaged that the Report will be published once the deliberative process is fully completed".
If a simple little review of a small but important tax concession scheme can take over five years what hope is there for the Minister for Health and Childrens' aspiration to have the Prospectus, Brennan and Hanly reports implemented in ten years? None, I'd say.
Senator Mary Henry, MD
