The all-party Oireachtas Joint Committee on Health and Children has said that it was impossible to come to a shared agreement on how responsibility for the illegal nursing home charges controversy should be apportioned between ministers and civil servants.
In a report agreed in a private session yesterday, the committee said there was an urgent need to clarify the responsibilities of ministers and the extent to which they can reasonably be held accountable for the actions of the departments and agencies under their control.
The committee has been hearing evidence for the last two months on the background to the controversy over the illegal charges levied on patients in public nursing homes over the last 28 years which could ultimately cost the taxpayer around €1 billion.
In evidence to the committee, the former secretary general of the Department of Health, Michael Kelly, said that he briefed the former minister, Micheál Martin, on two occasions on the potential problem with the nursing home charges.
Mr Martin denied he had received any proper briefing and said that he believed that he bore no responsibility for the issue.
It also emerged that neither the minister, his minister of State at the time, Ivor Callely, nor his two special advisers had read briefing material prepared for them in advance of a meeting with health board chiefs at which the nursing home charge issue was discussed.
In its report, which will be published next week, the committee will say that while the public sector modernisation programme had clarified the role and responsibilities of secretaries general of departments to match the growing complexities of policy formation and implementation, "the vital political dimension has received nothing like the same attention".
The joint committee said that it noted the "confusions and disagreements" about how the roles of ministers of State and special advisers worked in practice in the Department of Health.
The report recommended that attention should be paid to how these could be more effectively structured and it urged that the merits of adopting a "cabinet"-style system should be investigated. "The 'cabinet' system has been deployed to good effect in many EU member-states as well as the EU Commission," it stated.
In its report, the joint committee said that it had sought three separate pieces of legal advice provided to the Department of Health on the nursing home charges issue in recent years but that this had been refused. It said it had appealed the issue to the Department of the Taoiseach but did not receive a reply in time for this final report.
It was "surprised" at the lack of legal resources available to the Department of Health "and to find a departmental culture that paid insufficient attention to the legal dimension of policy implementation".
