Thousands of older people and medical-card holders continued to be illegally charged for long-stay care in nursing homes and other institutions despite a "comprehensive review" of charges conducted by the Department of Health between 1991 and 1993.
The review highlighted "anomalies, grey areas and other difficulties" in the charges. However, no changes were made.
The details of the review are contained in correspondence seen by The Irish Times between then minister for health Dr John O'Connell, and the Irish Association of Social Workers.
Concern over the charges was expressed by the Commission on Health Funding in 1989, which examined the issue of long-stay charges and recommended that the law should be revised.
A Department of Health review was initiated in 1991 and was completed in 1993, the correspondence shows.
Patricia Doherty of the Irish Association of Social Workers, who raised the issue with the department over a three-year period, said yesterday she was "very disappointed" at the lack of action by the department and ministers for health over that period.
"We passed a motion at our agm in 1990 calling on the minister to urgently review the practice of these charges," she said.
"I had very vulnerable people, particularly people in psychiatric institutions, coming to me complaining.
"They were afraid to raise it publicly because of the potential consequences if they became ill again in the future.
"The general public was under the impression that people below a certain income were entitled to free healthcare if they had a medical card. But that wasn't the case for the vulnerable people in psychiatric care and nursing homes."
The ombudsman at the time, Michael Mills, also forced health boards to repay patients in these categories who were illegally charged.
He wrote in his 1991 annual report: "I am aware that the Department of Health is currently carrying out a comprehensive review of the regulations governing maintenance charges to ensure that the legislation, under which long-stay patients can be charged for maintenance, is interpreted uniformly throughout the country."
Mr Mills added: "Hopefully, the anomaly I have outlined can be appropriately addressed in the context of the department's review."
The Department of Health has declined to comment on the correspondence, except to say that the retired head of Forfás, John Travers, is carrying out a "thorough investigation" into the issue and is due to finalise his report shortly.
The complaints raised by the Irish Association of Social Workers related specifically to psychiatric patients with medical cards who were being charged for in-patient care after 30 days' care in any 12-month period.
After their admissions, the patients had their medical cards withdrawn, according to the association. They were subsequently charged and had their benefits withheld.
Psychiatric patients admitted to old "asylum" hospitals were charged. However, those admitted to a psychiatric units in acute general hospitals were not.
Ms Doherty yesterday said she believed it was "no coincidence" that two of the most vulnerable groups in society - older people and psychiatric patients - were charged, while the rest of the population was not.
Repayment helpline: details
A helpline for those who believe they may be eligible for repayments for public long-term care is to operate from today.
The Health Service Executive said the Government was still working out "all issues arising from the recent Supreme Court judgment" and would set out policy for how the repayments scheme would operate.
HSE National Steering Group chairman Pat Gaughan, said: "The scheme will help people or their families who believe they are due a repayment to register in advance."
Anyone phoning the helpline should have the following information to hand: name, address and date of birth of patient or client; name and address of long-stay centre or centres and date of admission to the centres.
Helpline operates from Monday to Friday, 9am to 5.30pm and can be reached on 1 800 77 77 37
