Fergus O'Dowd (Louth, Fine Gael)

Shortly before Christmas I received a phone call from a friend. He was in great distress because he has a disabled son in St. Mary's, Drumcar. He had to have an operation, but could not arrange it until he was sure respite care was on offer for his son while he was in hospital. The problem was St. John of God's, Drumcar was told its funding had been cut. It could manage its own budget but would have to cut back on respite care. This man was in much distress. However, eventually St. Mary's, Drumcar was very helpful and arranged for respite care for the son while the father was having his operation. This was very important as it meant there was continuity of care from the home to the institution.

I attended another meeting in Drogheda during the week with 50 parents and about 50 carers. They were working with children at home who had disabilities and many of whom are now adults. All of them were concerned that the respite care facility, which had previously been available to them in Drumcar, would no longer be there. One lady claimed the cutback for St. Mary's, Drumcar was around €250,000, which is less than the money paid to Monica Leech Communications. The lady stated that if that money was spent in Drumcar, the carers and parents of children with disabilities would not have had to convene the meeting. The parents involved met with the Minister for Health and Children yesterday but I am not sure of the outcome. A big song and dance is made about improving services and about more money for disability, yet the Government is cutting back on existing services. It is not possible to plan new services for disability unless the existing services are sustained and improved.

There is a lack of concern at the heart of this Government. There is a challenge to meet the needs of disabled people in society and to listen to what groups are saying. I have a letter from the Disability Legislation Consultation Group from 13 January. It claims it sought a meeting with the Minister. It expressed a clear view that the next meeting with the Minister and her officials should be to hear the Government's comprehensive response to the ten key issues of concern on the Disability Bill, which were presented to her on 27 October 2004. Over 11 weeks have elapsed since that meeting and extensive consultation has taken place in the interim with those represented by the group. The group went on to state that it finds it unacceptable that an official response has not yet been issued. A full response in now required as a matter of urgency. The disability group is saying that it is not happy with the Government's response to its needs. Surely 11 weeks is long enough time for the Government to formulate its views and it should meet the group. The Government should be knocking on the door of the group's chairperson, Ms Angela Kearns, giving its response and what it proposes to do.

For many years, local authorities have had a less than excellent record in the area of disability. How many footpaths in our towns, cities and villages are broken or in disrepair? How many elderly people are not able to walk at night on these footpaths? Local authorities need to take a hard look at what they need to do to make all of our footpaths accessible to people in wheelchairs and to other disabled people, as well as young parents who are pushing prams. It is not possible in Drogheda to go from one end of the town to the other because not every footpath has a ramp. The Minister for the Environment, Heritage and Local Government should introduce a scheme where he would reward local authorities that excel in the area of provision for disability. That would help improve the profile of this particular need.

Many people come to politicians asking about the disabled person's grant. The problem with the grant is that different counties run it differently. Some counties are better than others in the provision of this money. There is an amount of money which each local authority must commit to disability and then matching funds come from the Government. Nevertheless, that is just not good enough. Proper provision ought to be made by the Government so that regardless of where one lives, it is only one's need that matters. If one meets the requirements of the application, there should be no need to have differences based on the geography of where one lives. The health boards work with local authorities in the provision of this grant. Louth County Council has been unable to process applications for occupational therapists due to the shortage of therapists in the health board. One is told the council will look at the application as soon as an occupational therapist becomes available. It is not good enough and there is a need for joined-up administration in that area. Occupational therapists make a report, which goes back to the health board and from there to the local authority. It is all just bureaucracy. We need a one-stop shop for the disabled person's grant, be it the health board or the local authority. Once a person applies, the application should be dealt with by one organisation only. The involvement of both health boards and local authorities leads to unnecessary delays and bureaucracy. Meanwhile, the disabled person is waiting, wondering and worried. In many cases, they are not able to look after themselves in their own homes. They have to get out of the acute hospital bed because their medical needs have been met. Yet the reality is that they cannot live in comfort in their own home until the disability is dealt with and until the structures are in place to meet their needs.

The reason we have so many people on trolleys in our hospitals is because there are no beds available. This is partly because existing patients, who are often well enough to go home, do not have the facilities to deal with their disability. The absence of these facilities leads to this continuing problem.

A primary medical certificate is issued to someone who is almost completely incapacitated. The test involved is very difficult. The health board will recognise that a lady has had a stroke, cannot use her right hand side, cannot use her left leg but can use her hand, so therefore does not meet the requirements of the primary medical certificate. One will then have to appeal and wait six months before anything can be done. People who apply for the primary medical certificate very rarely get it and it puts much pressure on families for the provision of transport for affected individuals. In the modern world, this is totally unacceptable.

The other question on disability concerns the care of the elderly. We have many elderly people in our society. The North Eastern Health Board rejected the budget because of the significant reduction of 80,000 home help hours, which the then Minister, Deputy Martin, approved. The community was not prepared to accept that such reduction would take place but it did.

If our health strategy is to be meaningful, it must have a community care strategy. There is much talk about acute hospitals but if the investment was made into community care and keeping people at home or allowing them to go home from hospital, we would get better value for money. It would also provide a higher quality of life for people. We should increase our contacts in the community, particularly with the elderly and the sick. The Government's policy in this regard is disgraceful and must be reconsidered and revamped.

More people in our society are living longer and, as they get older, the incidence of disability will increase. A proper strategy is required to deal with this but there is no such strategy at present. Consider people who have suffered a stroke. Often they are unable to communicate but they and their families will confirm that they need physiotherapy or speech therapy. However, they cannot get such therapy. When somebody has a stroke and is sent home, nothing further happens. There is a lack of continuity of care.

These people have a disability that is not being looked after. There is no provision of services for stroke victims. Many people die as a result of strokes but if there were a more proactive and interactive relationship between the health services and stroke victims in terms of care in the community, especially speech therapy and physiotherapy, it would make a significant difference.

A man who came to my clinic recently had bruises on both hands. I do not know what illness he had. He badly needs physiotherapy but he cannot get it. The waiting lists are phenomenal. We should encourage more young people to opt for those careers. Some years ago I researched the issue of speech therapy in Ireland. I discovered that Trinity College is the only college in the country that trains speech therapists. Students required seven or eight As in the leaving certificate to qualify for the course in the first place, which seems ridiculous, and the college could only take 30 or 40 students per annum.

The reason for the limit was that the students had to be given placements in the community with existing speech therapists and the system could only cater for that number at the time. I do not know if it has changed but a more dynamic approach is required to providing more speech therapists. There must be more speech therapy places and it should be easier for people who wish to do the course to qualify for it. However, that is another issue. Setting such a high barrier in academic standards, whereby practically nobody can qualify to do the course, does not make sense.

My main concern at present is that one of my constituents has been lying in a hospital bed in County Louth for three months awaiting a neurosurgery bed in Beaumont Hospital. Beaumont Hospital would be delighted to admit the person but the person has MRA so the hospital cannot do so unless it has a special room available. Unfortunately, that room is already occupied. My constituent is getting the best care the hospital can provide but she cannot see a neurologist. Her disability is, therefore, getting worse. Notwithstanding the efforts of the hospitals concerned, nothing is happening with her case. She must remain where she is until somebody in the special care unit either passes on or goes home. The lack of provision in the health service for people who suffer an illness and whose condition will worsen unless they can see a specialist is a damning indictment of the lack of resources provided by the Government for the health service.

Everybody welcomes this debate. Most Members of the House have spoken on this Bill and it is important that they do so. I hope the Minister will take on board the points we make. There is increased funding provision in the budget but more is required. The Government must listen more to the disability groups and not keep them waiting more than 11 weeks for a meeting.

How easy is it to come into this House if one has a disability? One must use the stairs to get into the House. If one has a disability, it is practically impossible. We are the legislators yet we do not provide an effective and easy access system into the Chamber. What will the Minister do about it? The issue must be addressed. There have been changes and improvements but that fundamental improvement has not been made. Let us get our act together as well as sorting out the other problems that exist.

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