Hundreds of vulnerable people with intellectual disabilities are being charged far more than they should be for residential care, campaigners have warned.
Inclusion Ireland, the national organisation for people with disabilities, says there is widespread inequality in the new payments system for long-stay care in health institutions.
The group's chief executive, Deirdre Carroll, told a conference at the weekend that people receiving a similar level of care can pay anything between a token amount and €120 a week.
Up to 6,000 people with intellectual disabilities are resident in long-stay institutions or residential centres.
There is a tiered set of charges for people in long-stay care which increases depending on the level of nursing care in the institution. Residents in a residential centre with part-time nursing care are charged about €60 a week, while those in centres with full-time nursing care are charged up to €120 a week.
"You could have one person in a house which happens to have a full-time nurse rostered paying the maximum fee. Yet, another person of similar need in the same service could be in a house provided under social housing with health staff and isn't charged at all," she said.
She said the charges amounted to half the disability allowance that a person may receive from the State every week. Inclusion Ireland believes a charge of about €60 would be more appropriate.
"We are not against charges per se, but the level of charges involved penalise people who are already penalised enough in life. How can you ask people to participate fully in the community if you take away half their income?"
The Health Service Executive has delegated responsibility for levying charges to agencies that provide services on behalf of the HSE. This responsibility includes carrying out assessments to determine the amount an individual should be charged.
Inclusion Ireland said only health authorities should have the right to assess people's means in relation to charges and not voluntary service providers.
The conference heard from solicitor Máirín McCartney that Ireland's position in relation to capacity and people with an intellectual disability dates back to the Lunacy Act of 1871.
Ms McCartney said the Irish system of wardship took the full legal capacity away from the individual, in contrast to human rights instruments which stress the importance of supporting the right to self-determination.
"Any new legislation should underpin and support the right to self-determination, the right to participate and the right to make choices," she said. "In the light of the contents of the UN Convention of the Rights of Persons with Disabilities, the emphasis in new legislation should be on the presumption of legal capacity and supported decision-making."
