Findings

Arising from this investigation the Ombudsman makes the following findings (See Note 1 below)

1. That Ms Kelly was adversely affected by the refusal of her applications for a Long Term Illness card in July 2009 and in September 2010 and that the decisions to refuse her applications were based on erroneous or incomplete information, on irrelevant grounds and were improperly discriminatory.
2. That the decision to refuse to recompense Ms Kelly for her son’s medication for the period of her application prior to March 2012 was taken on irrelevant grounds, erroneous or incomplete information and improperly discriminatory.
3. That the administration of the Long Term Illness card scheme by the HSE, treating children differently depending on their geographical location, is improperly discriminatory, an undesirable administrative practice and contrary to fair or sound administration.
4. That the HSE failed in its responsibility to ensure a uniform approach to the administration of the LTI card scheme and failed also to provide the HSE administrators of the scheme with adequate and clear guidance in relation to the scheme and that these failures were contrary to fair or sound administration.
5. That, in the light of the fact that the scheme is under review and the outcome of that review is not yet known, the HSE proposal to alter the approach of its Medical Officers who heretofore had accepted ASD and ADHD as conditions which conferred eligibility under the scheme, is contrary to fair or sound administration.

Note 1 :

These findings reflect the language of section 4(2) (b) of the Ombudsman Act 1980 which identifies eight categories of maladministration. These apply where an action was or may have been ;

• taken without proper authority,
• taken on irrelevant grounds,
• the result of negligence or carelessness,
• based on erroneous or incomplete information,
• improperly discriminatory,
• based on an undesirable administrative practice,
• a failure to comply with section 4A or
• otherwise contrary to fair or sound administration.