Tom Clonan (Independent)
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I thank the witnesses very much for coming in this evening. I have a number of questions for them. In the evidence, a number of significant challenges were set out for St. Michael's House. It was stated that the number of individuals in residential settings is 450. If I heard correctly, in the coming years an increase of 137% is expected. I do not know over what time period the 137% increase is expected, but my pass leaving certificate maths from the early 1980s suggests to me that there could be as many as 900 people in total. There are already 80 people on urgent waiting lists. Could the witnesses quantify the forecast for the coming years? For example, in five years' time do they expect there would be another 450-plus people requiring urgent accommodation on top of the 84 who are already waiting?

What is the forecast? What is the capacity of St. Michael's House to meet it? Has the organisation sought a funding programme which is matched to this predicted forecast?

How many facilities and accommodation centres are planned to be built in the next five years? For example, there are 170 ageing carers. I could be wrong but I imagine this somehow matches the 84 people who require urgent accommodation. This means accommodating a lot of people with ageing parents. I know from having lost my parents that events can move very quickly, especially when people are caring for an adult child with complex needs. People die all the time. If this is urgent, what is being built? Does it match the requirement plus the predicted 137% increase?

With regard to this predicted increase, our population has increased by 1 million since 2004. That population expansion will continue. We are getting new citizens from all over the world who have complex needs. I have a large volume of correspondence from people who have no resources whatsoever in this regard, many of whom are homeless. With regard to the capital programme, Ms Reynolds touched briefly on recruitment and retention. Is there a realistic HR recruitment programme in place to upscale and recruit the correct number of staff to deal with this massive increase of people in the population who require support and services?

Is there something the committee can help St. Michael's House with? Is there a requirement for the Government to step up and exponentially increase the investment in St. Michael's House? The organisation is asked by the State to provide these services. Reading between the lines in the presentation I sense it does not have sufficient investment or resources to meet what is required. Is there a number or headline figure the witnesses would put out to state that in an ideal world this is how much it would need on an annual basis to adequately resource and support these families?

I receive a lot of correspondence about respite and it has been reported in the mainstream press recently. Respite is not readily available to families. My situation is different from that of those towards whom the services St. Michael's House are oriented. In 20 years I have never had respite. I have had not one day or not one hour. How does the organisation plan to expand the respite that is available?

I apologise for the number of questions I have. There is no implied criticism in them of anyone in the room. Transport is an issue that comes up over and over again. I have a nephew with Down's syndrome in south County Dublin. He has no transport to his day service. As a consequence he does not have a day service. We are all forced to work. There should not be the idea that there is somebody at home who can bring somebody to a day service. In his case, that day service would involve a daily commute of three hours. If service users do not have transport, they do not have a service. If we are speaking about a rights-based approach, transport has to be provided. I invited a guest, who could not attend, who has no transport for their child.

The opening statement mentions that in addition to Article 7 of the UNCRPD St. Michael's House's policy and approach to the delivery of services to children and young people is governed by the progressing disability services policy of the HSE. The HSE has come before the committee and stated on the record that the policy has failed. Therefore, there cannot be policy predicated on something that has failed. We have had on the record from the CEO of the HSE that progressing disability services is in failure. In recent weeks we have also had evidence presented to the committee from researchers that shows there is no evidence base for progressing disability services. It was never signed off by a clinician or risk assessed. It is having incredibly negative outcomes for children and adults throughout the State. Who is accountable for this? I do not know.

In this context I have a difficult question to ask. St. Michael's House states it has school leavers who are being failed, with one from 2020, three from 2023 and four from 2024. There are 84 people on the list of those who do not have an appropriate day service. There are 84 people on the residential priority list. There are 50 adults and 27 children on the respite waitlist . There are 45 people on the transport waitlist. For St. Michael's House trying to provide this service in good faith, and I trust in its complete integrity and utmost good faith, if the HSE tells us that progressing disability services is a failure, would the witnesses described the situation that confronts St. Michael's House as a worst-case scenario? Is it also failing? Is it in crisis or acute crisis? Is there a requirement for intervention? Do the witnesses think everything is as they would expect in any other jurisdiction? Are we outliers in this regard?

What happens when these elderly parents die? What happens to those adults with complex needs? Where do they end up? Are they involuntarily detained under the Mental Health Act? Do they end up in the emergency department? Are they placed in nursing homes? Where do they go? What happens to them?