John Dolan (Independent) | Oireachtas source

The Minister said he did not regard health as a party-political issue and he also spoke about the increased incidence of chronic conditions. I hope health does not become a party-political issue. It is important for us to say what health is, as distinct from what it might not or should not become. For me, it is a societal issue. I come immediately to the 600,000 people with disabilities or chronic illnesses and the 200,000 carers. Everybody will find themselves in this space. This is about how we see the trajectory and the planning regarding services into the future.

In my first question I talked about knitting the commitment to ratify and implement the UN convention into the statement of strategy, specifically that it would state that it is a matter for ongoing consideration at a senior management level in the Department. Although the reply was helpful, it was a little shy of that. Everybody comes into the disability or chronic illness space at some stage.

Given the increased incidence of chronic illness, planning is extremely important. As I said earlier this week, I am very concerned that if there is any increase in costs of paying people who provide the services, it will come from the level of service the Minister is struggling hard to try to provide. Employment is a major element of what is a personal service. I am not saying whether there should or should not be any movement in it.

We talk about the winter initiative. There is a disability issue morning, noon and night, winter and summer, but probably more in the winter time. Many people are on a knife edge and are already getting less than they need. This is another worry and concern on top of it. The Minister understands the load he and his officials bear when they go into negotiations and try to be fair to everybody. We have a huge distance to travel regarding the UN convention.

The director general's opening remarks were the opening remarks for this meeting. They were examining many issues that are here and now. We should have a decent idea of the trajectory of chronic conditions. This is not a criticism of the Minister but must be dealt with. Some of the causal factors are behavioural, and some are due to the parents people had which we cannot do anything about. However, we can do more about amelioration, early intervention and good self-management, and there are many organisations in that space. In parallel with dealing with the hot issues at the moment, it is important that we see the template regarding what Ireland is facing. For example, at a presentation here a few weeks ago, Dr. Joe Harbison said that in 20 years we will have twice the number of people who have suffered strokes. Let us start to put those things together and figure out what can be done in a range of ways about them.

I have written to every Department about disability and the statements of strategy. Disabled people are simply members of the public to be served. Health has taken up more of a load than it ever should have regarding people with disabilities. In many Departments, there is a knee-jerk reaction to send any disability issues over to the Department of Health. There is plenty for the Department of Health to get on with, and there is plenty for other Departments to do.

The success and value for money from health spend around disability and chronic illnesses is what people can do outside health. Can they get jobs and be part of their communities? It is a major issue.

What has to happen outside health to get the good bang from the investment that health is struggling to put in? A strong statement on this should be in the statement of strategy and that might encourage others to do the same.

What will be the quantum of the additional delivery of services to people using personal assistants, PAs, next year? The Minister helpfully said increases in PA services are needed. His service plan will not be published for a week or two. What improvement will there be in the hours and services available for people in the year ahead? If he cannot reply now, that is fair enough but that is the question.

My third question relates to the provision of neurological community and hospital-based services in 2017 over and above the current level of service. I am in the same time warp in this regard. Hopefully, the reply will be one I would like to hear. Specific condition support organisations and other disability organisations, the Department and the HSE could do better work on early intervention and supporting people. The Minister mentioned that the fair deal scheme is statutorily underpinned whereas community services are not. Provision has been shaved away over the years. Putting supports into the community will take pressure off acute services and make sure people who should never be in the acute system do not end up there.

Mental health reform groups were buoyed up when they heard €35 million would be provided next year but now they are hearing the figure will be approximately €15 million, increasing to €35 million the following year. They are concerned that this amount will not be available next year because it is needed.