Jillian van Turnhout (Independent) | Oireachtas source

I welcome everyone. With regard to the questions I tabled, I would like to follow up on question No. 9 about the HSE's national oversight group and day service or rehabilitative training places for young adults with a disability. The reality is every year between 650 and 700 young adults with an intellectual disability or autism leave school. They are viewed every year as new people in the system as if officials do not know they are coming into it. There is an annual issue over where the funding comes from to provide places for them. Similarly, 700 young people leave rehabilitative training every year and where they go and where the funding comes from is also an annual issue. As budgets have been cut back, the services providers affected have said no additional funding is available for school leavers and, therefore, they are falling into this limbo because they are considered to be new clients. No funding was made available in 2012 while €4 million was made available in 2013 and I am advised by service providers that this was not nearly enough.

I was disappointed with the reply I received. It mentions the membership of the national oversight group. Will the Minister outline the membership? Reference is made to a service user representative. I contacted several disability groups and they did not know that such a representative is on the group. They do not even know who is on the group. Will the Minister publish a list of the members of the oversight group? I am also disappointed that there is no mention of the New Directions policy, which is his policy for the provision of day services and supports to adults with a disability. This recommends a move away from centre-based segregated day services. Given post-school supports are day services, it is strange that the New Directions policy is not mentioned.

The second issue I wish to raise relates to question No. 10 about the pre-hospital emergency care council and allowing pronouncement of death by advanced paramedics. This came up in the committee's end-of-life care hearings. I welcome that the Minister is examining the issue through the Forum on the End-of-Life in Ireland but I remind him of the urgency of this issue. During the hearings, Professor Patrick Plunkett, a member of the council from St. James's Hospital, outlined to us that in cases where the patient has suffered a cardiac arrest, there is a natural reluctance on the part of the pre-hospital emergency care providers ambulance personnel to pronounce death in the home, which leads to ongoing resuscitation efforts and pronouncement of death in the accident and emergency department. This leaves the department's team to deal with the process of informing relatives and their grief, the logistical difficulties of identification and referral to the coroner. Dr. Geoff King also told the committee about how they cannot pronounce death and they must remain at the scene for ten minutes or an hour or until the next day, which is wasting time. I wonder if this contributes to our ambulance service issues because staff are waiting for a pronouncement of death at the scene. We were given vivid descriptions about staff who seemed to be resuscitating somebody they knew was dead. We need movement on this. I welcome the steps being taken but this issue was raised by several groups during our hearings.

The final issue I would like to raise relates to question No. 11 about the Children's Rights Alliance report card which gave the Government a worrying E grade on mental health services. The response I received states, "While noting the contents of the recent report card by the Children's Rights Alliance on mental health services, real and significant improvements have taken place". The Government went from a D grade to an E grade on mental health services. There was no urgency in this reply. I could have received this reply a year or two years ago. Will the Minster provide an update? At the previous quarterly meeting, I asked about a protocol between the Child and Family Agency and the child and adolescent mental health service and I was told that would be produced within days. Is it in operation? I have not heard any details since. I am advised by social workers that they are finding it hugely difficult to access child and adolescent mental health services.

In November 2012, the HSE issued an access protocol for 16 and 17 year olds to mental health services, which stated: "From 1 January 2013, CAMHS will accept referral of all new cases up to their 17th birthday and from 1 January 2014, where feasible, up to their 18th birthday". However, last year there was an increase in cases with 16% of cases involving 16 year olds. A protocol was put in place but the position is getting worse. More young people are entering adult services when they should be entering child services. Five children under the age of 16 were put into adult psychiatric wards between January and September last year when everybody agrees this should not happen. Service providers say places are available but they are not being accessed. Does legislation need to be introduced for this to happen?

We are all supportive of the Minister's initiatives on tobacco. What is the position on the smoking in cars with children Bill initiated by Senators Crown, Daly and myself? Will it be taken in the Seanad next week to complete its journey there?