Ms Liz Reynolds:

On HR, the committee will have heard a lot from section 39 agencies on the particular challenges in that sector. We have challenges ourselves. We are all recruiting for the same people. The sheer numbers we require are not there. We require increased places in university for specialist clinical staff. We are working with the national federation on a campaign to promote the disability sector as an attractive career path or place to work. That is a challenge. In some of our areas, there are behaviours of concern that pose a risk to staff. It can be challenging to get staff to work in areas where there are very complex behaviours. We have gone to the UK. We are continually recruiting. We are focusing on retention. We are barely keeping our head above water. Employees are moving around and moving to different organisations.

The Senator asked whether there was a requirement to step up and whether we had what we need. It is evident that we do not have what we need. What we need to maintain current sustainability is an uplift of almost 10% in the HSE allocation. We need significant investment in ICT and transport. I will let Ms Molloy talk about transport. On ICT, there has been underinvestment for years. Our systems and processes are very manual. Apart from that, we require a €2 million investment in ICT security and a spend of €1 million thereafter. The third thing we need is for new services to be funded in full. The actual cost of service delivery, including staffing, employer's PRSI, non-pay expenditure, clinical staff and transport, needs to be fully funded. We should not be expected to take on new services without that full funding. That is what St. Michael's House needs. As to whether there is a need to step up, we are a member of the national federation and, with the federation, we are calling for the disability action plan to be continued and fully funded over its lifetime.

Respite is a significant issue. The Senator will have seen that there are waiting lists for St. Michael's House. Years ago, there was respite with each service provider. Each service provider had a given number of respite houses. This would typically comprise residential respite and some alternative types of respite. However, in the CHO area we operate in and some other CHO areas, there has been a move away from respite per service provider and towards a more regional system whereby those most in need or of the highest priority get that respite. When there is funding available for a new respite facility, everybody is asked to tender. We have tendered in the past although we have not won those tenders. There was recently a tender for which we were not eligible because it was not focused on people with an intellectual disability. It was for disabilities in general. We would therefore be expected to operate a facility that, in theory, would not involve service users' families receiving respite from St. Michael's House. That is beyond St. Michael's House.

As to what happens when elderly parents die, it is reactive. Every month, we highlight those at home who are at risk. We do our best to plan for those occasions when people will really need a residential place or whatever it may be.

Sometimes it works when there is a vacancy, but other times it is an emergency situation and a crisis. This includes situations where individuals go into the acute sector. It is appalling for the service users, the staff and everybody involved. The acute sector obviously wants its bed back, and then we must typically cost a residential placement. If we do not have a suitable vacancy, which is often dependent on the appropriate environment, those individuals may sometimes be placed with private providers. There is no point in pretending otherwise to the committee. Sometimes we can accommodate a person, but I have been in the sector at an executive level for 20 years, and more and more, it is becoming an emergency response. We work very well with the HSE. I am not trying to throw it under a bus because everybody is doing their best, but that is the reality of the emergency placements.

The Senator asked about progressing disability services, PDS. He mentioned that the CEO of PDS stated that it has failed. As the CEO of St. Michael’s House, I have not received a notification that PDS has failed. We are continuing with it. We work locally with the HSE. We are involved in the governance and we are following the roadmap for PDS. That is all I am aware of.

The Senator asked if we are failing. When I speak with parents and when they ask me what will happen when they die, I must say to them that I do not know but that we will do our best when the time comes. Certainly, that feels like a failure. Yet, I can assure the Senator that we are doing our best.

I will ask Ms Molloy to respond to the question about transport.