Public Body

Health Service Executive

An Investigation under Section 4 of the Ombudsman Act 1980
Office of the Ombudsman

February 2014

This report examines why an application for a Home Care Grant (HCG), on behalf of an elderly, dependent woman, was refused by the HSE, even though it was submitted several weeks before the grant was abolished. The Ombudsman's investigation looked at how the HSE dealt with the application, how it communicated with the applicant, and how the decision to abolish the grant was communicated to key stakeholders. The Ombudsman found that the decision to abolish the grant was not communicated to all of the key stakeholders in a timely way, that no arrangements were in place to track applications received before the cut-off date, and that no appeals process was offered to the applicant. 

The HCG (a cash grant paid to assist older people to buy in extra care which could not be provided by the HSE) had been a feature of the Home Care Package Scheme (HCPS) until December 2010. At that point, new national guidelines for the HCPS were published and the payment of cash grants was to be phased out. The HSE told the Ombudsman that training and briefing sessions for HSE staff about changes to the Scheme were held across each region and at local level with all of the key stakeholders. However, these briefing sessions did not take place until mid November 2010 which meant that the Public Health Nurse (PHN) was unaware that the grant was being abolished when she advised the woman to apply for it.

In this case, the woman applied for the cash grant in October 2010 and her application was being considered on financial and medical grounds. While she had been deemed eligible on means grounds, her application had to be signed off by the PHN and the woman’s General Practitioner (GP) who had to verify that she was medically eligible as well.  The form was signed by both PHN and GP on 10 November 2010 but, unfortunately, her application was not approved because the form was not returned by the GP until January 2011. At that stage, the grant had been abolished.

While the woman was offered some additional home help hours, which were provided by the HSE, her family considered that the cash grant should have been paid given that the delay in processing her application was not of her making.

The Ombudsman is pleased that the HSE accepted the findings and recommendations and apologised to the family. An ex gratia payment of €8,500 was made to them in settlement of their complaint. Sadly, the woman passed away in 2013.