Complaint from Ms Sarah Nolan
The decision to refuse DCA in respect of Patricia Nolan, was improperly discriminatory and contrary to fair or sound administration because the allowance had been awarded to her sister, Karen, on the basis of identical medical and other evidence.
Complaint from Ms Emer Kelly
The opinion of the Senior Area Medical Officer that Paul Kelly's diagnosed condition, ADHD, is not a disability is not in accordance with the DCA Guidelines issued by the Department of Health and Children, which provides that ... no condition is debarred ..." and that "eligibility is determined primarily by reference to the degree of additional care and attention required by the child rather than to the type of disability involved ...", and consequently the decision to refuse the application for DCA on these grounds was improperly discriminatory and contrary to fair or sound administration. Furthermore, the fact that DCA has been awarded in respect of other children with ADHD indicates that, in other Community Care areas, the SAMOs involved in the decision making processes do consider ADHD to be a disability.
Complaint from Ms Geraldine Smith
The decision to refuse DCA in respect of Matthew Smith was contrary to fair or sound administration on the basis that :-
(i) there is a conflict of medical evidence whereby a Consultant Paediatrician involved in his care and treatment for many years, said that he has a significant permanent disability, whereas the SAMO said that he was not severely disabled in the context of DCA. I had made suggestions as to how the case might be moved forward, however, these suggestions were not acted on by the HSE, and
(ii) there was overwhelming evidence, from many sources including his mother, medical consultants, Area Medical Officers, a Social Worker, Matthew's School Principal, Resource Teacher and Special Needs Assistant, that, as a result of his disability, he has required and continues to require a significantly higher level of care and attention than another child of his age
General
There is a lack of consistency in the administration of the DCA scheme throughout the HSE nationally which is demonstrated, for example, by the fact that AMOs in the Dublin West - HSE Dublin Mid-Leinster area, all of whom are qualified medical practitioners, do not formally record their opinion as to eligibility to DCA after they have medically assessed a child, whereas under the guidelines prepared by the former SHB, Area Medical Officers in that area were required, having completed a standard medical assessment form, to recommend or not to recommend DCA for the applicant.
Footnote to Findings
In advance of finalising my recommendations in respect of this investigation, I sent a draft of this report which included draft findings, to the HSE to afford it an opportunity to make any observations it wished to make on the contents.
When I received the HSE's reply, I was very pleased to note that it accepted the findings contained in the draft report and that it also acknowledged the needs to ensure consistency and understanding in the application of the Department of Health and Children's guidelines in the operation of the DCA scheme.