Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Gabhaim buíochas don Cheann Comhairle as an deis chun na ceiste seo a phlé. In an adjournment debate on 29 January 2003 I called upon the Minister for Health and Children to act as a matter of urgency to address the severe staffing shortage at St. Mary's residential care facility at Drumcar, County Louth, and to ensure that the residents at the centre had all the personnel and other resources they needed to live with dignity and safety.

Thousands of people, including the families of more than 250 people with physical and intellectual disabilities then resident at Drumcar, were sick with worry about the welfare and safety of their loved ones. A consultant's report had just been published which highlighted the unacceptable conditions for many residents in Drumcar as a direct result of understaffing. Understaffing led to inadequate supervision, inappropriate mixing of residents with very different abilities and disabilities, including very aggressive individuals with passive and introverted individuals, the overuse of restraints in some cases, the leaving of some residents locked up and unattended at night and increased risk of mortality from fire.

The report identified the need for 94 additional staff to cater for all the needs of the residents. Following this report there was a concerted campaign for increased funding for more staff. I played a part in that lobby and I welcomed the outcome when agreement was reached with the Department of Health and Children for the appointment of 30 extra staff at St. Mary's. The extra staff commenced work in April 2003 and were specifically hired to ensure there were sufficient numbers on night duty. This was to address fire and other safety risks for residents at night. A key part of the agreement with the Department of Health and Children and the North Eastern Health Board was that the other issues would be addressed, including the provision of the remaining 64 staff required.

I will cite a note by the management of St. Mary's, which is under the auspices of the Hospitaller Order of St. John of God:

We remained hopeful that the funding for the remaining 64 staff would be approved over the following two years.

During the past two years, because of the serious risk to the safety of the clients and staff on day duty, we were left with no alternative but to take on extra staff without funding which resulted in overspends in the nursing pay area. This excess in expenditure was funded through stringent cutbacks in other areas, and vacancies in areas such as speech therapy, social work, medical registrar and administration. The planned programme of building maintenance and painting had to be suspended and this has impacted negatively on the quality of the environment for the clients, and will ultimately cost a lot more to restore in the future.

In 2004, both ourselves and the NEHB experienced substantial shortfalls in the funding to meet the extra cost of the various pay awards, and like other health agencies we had substantial value for money and other cutbacks imposed on our allocation. We have now reached the stage where we have exhausted all options internally to meet the shortfall.

The very grave situation facing the North East Services was discussed with the North Eastern Health Board on the 10 November 2004 and the Board requested us to conduct a review of the situation, and advise them of the options which we would have to consider to deal with the situation. We did this over the following weeks and informed the Board in December of the various options. The Board passed our concerns on to the Department of Health and Children and a meeting was arranged with the Health Service Executive on 1 February 2005.

Following that meeting on 1 February between the HSE Northeast and St. John of God Northeast Services it was agreed to use the existing joint partnership forum to develop a strategy on how best to continue the implementation of the Sale and Oreschnick Report to address the outstanding priority concerns regarding health and safety issues and critical staffing levels at St. Mary's Residential Services.

It is expected to complete this process within the next three weeks. In the meantime St. John of God Northeast Services has undertaken to defer the decision around the suspension of respite service provision in St. Mary's until February 28 2005.

Aware that my time has marched on, I will conclude by appealing to the Minister for Health and Children to ensure that the outcome of this process is the approval of the full staff complement, namely, the 64 staff identified more than two years ago, funding for same and the restoration of all services lost through the unacceptable delay in fulfilling commitments already given.

As the sibling of someone with Down's syndrome who has spent many years in Drumcar, I believe that it is a wonderful facility only because of the great dedication of the hospitaller order and staff at the site. It requires and deserves a wholehearted and fulsome response from the Department. The loss of respite would be a devastating blow to countless families and I do so appeal.

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