Thursday, 21st March 2013
I, too, thank Senator Marie Moloney for initiating this debate and the Leader for allowing time for it. However, I note the fact that no Minister or official has attended the House for the debate, which is very disappointing. I am happy that the working group on the mobility allowance will be meeting shortly. Under the chairmanship of Ms Sylda Langford, I have no doubt that it will take into account what we have to say. As I had the pleasure of working a lot with Ms Langford in her role when director general of the Office of the Minister for Children and Youth Affairs, I have faith in her.
The two relevant schemes in question are the mobility allowance and the motorised transport grant schemes. Up to 4,700 people with disabilities receive the mobility allowance, while 300 are in receipt of the motorised transport grant. The schemes were closed on 26 February and a new legally compliant scheme will be devised in the next three months. The €10.6 million allocated for the schemes has been ring-fenced for the new alternatives.
The mobility allowance is a means-tested, monthly payment made by the Health Service Executive. At the highest rate, it comes to €208.50 per month; at the lowest, it comes to €104.25. The allowance is for people with severe physical disabilities who are unable to walk or use public transport and would benefit from a change in surroundings. It is to meet transport costs which are currently unvouched and the occasional taxi journey. The Department of Health anticipated that revising the scheme to bring it into compliance, that is, to remove the upper age limit, would translate into an additional cost of €100 million per annum in the case of the mobility allowance and €200 million over a three year period in the case of the motorised transport grant.
To remove the upper age limit would translate into a cost of €100 million per annum for the mobility allowance and €200 million over a three year period for the motorised transport grant, not to mention the large administrative costs to, and burden on, the HSE. These estimations are outlandish. The eligibility criteria are very strict. How many disabled people over the age of 66 are unable to walk, even with the use of artificial limbs or any other suitable aids or whose health is such that the exertion required to walk would be dangerous? That is not to mention the other requirements for qualification. I did a calculation on the estimation from the Department. It is based on the expectation that there would be an extra 39,968 applicants if the upper age limit was removed. Can we just note that in 2012, 43 people over the age of 66 applied and were rejected, which is nothing near the 39,968 figure? I seriously question the figures provided.
As I have said already, the eligibility criteria are very strict and I wish to put those criteria on the record. An applicant must be unable to walk, even with the use of artificial limbs or any other suitable aids; his or her health must be such that the exertion required to walk would be dangerous; the inability to walk must be likely to last for at least a year; he or she must not be medically forbidden to move; he or she must be in a position to benefit from a change in surroundings; he or she must be living at home or in a long-term institution; and he or she must pass a means test. The decision on whether or not an applicant meets the medical criteria is made by the HSE’s senior medical officer in the relevant area. In that context, one must question the figures from the Department of Health.
The estimate for the motorised transport grant is €200 million over three years. The Department of Health estimates that 19,000 older people over 66 would apply for that grant if the age limit was removed. This grant is aimed at assisting people in accessing employment, so how did the Department arrive at that figure? Perhaps the Department knows something I do not know.
There are many outstanding questions and so much insecurity and uncertainty for those who are in receipt of the allowance or grant, who have been told that their payments will cease on 26 June. What if the alternative scheme is not ready to be rolled out by then? In devising the alternative scheme, will the Department consult with the disability sector and the recipients of the allowance or grant to ensure personal choice and autonomy, in terms of the applicable transport service, is preserved? We talk about personal budgets, money following the patient, maximising independence and so forth but I am concerned that the new scheme will, in effect, remove or diminish personal choice. What is safe and appropriate for one person is not safe and appropriate for all. A community transport service is not safe and appropriate for a person with severe autism, for example. Furthermore, community transport schemes are not always the most cost effective choice. Two of the providers in Dublin, for example, Vantastic on the northside and ACTS servicing the southside, charge a higher price and mileage rate, equivalent to a private taxi, and only operate between 7 a.m. and 10 p.m., with a limited number of choices. Senator Moloney has already referred to the challenges in rural areas for community transport schemes.
Will the working group examine the possibility of adding a mobility component to the disability allowance and the supplementary welfare allowance? Given the means test associated with these benefits, I suggest that such a move would keep the expenditure within budget. I have serious doubts about the figures given by the Department of Health and seek clarity on them. I also want to know why the decision to scrap the schemes happened overnight. Anybody who has attended a management or leadership training course will know that one does not raise a problem if one does not have a solution. A solution should have been devised because the problem did not arise overnight. We have known for a long time that the schemes were problematic. It is unacceptable. This is a spreadsheet decision when really, it should be about people.