Richard Bruton (Dublin North Central, Fine Gael)

It has been repeated time and again in this House that there are no health cutbacks, and that what is being sought are efficiencies that will not hit the front line. Like me, a Chathaoirligh, you must have been appalled to hear the report this morning on St. Michael's House, which may now have to close down all services to new-born children with intellectual disabilities as a result of not receiving the commitment it was led to believe was forthcoming. That would mean that 16 parents every month would be turned away with no support, no counselling and no early intervention for children who suffer from a disability. That appals me.

There are currently 16 people who have been rendered homeless by the death of their carer, but since the State has not provided for them, St. Michael's House will have to use up six of its 30 respite beds immediately and a further seven over the year in order to accommodate them. That will have a tremendous knock-on effect. There are about 500 people who avail of respite care in St. Michael's House, but the respite capacity will effectively be halved. That means that parents who are caring for their disabled children on a full-time basis will have to give up their 20 day respite breaks. Those 20 day breaks will probably be reduced to 12 or even ten days.

All this occurs against a background in which the Government stated that there would be a five year plan that would commit to increasing funding for each year. The latest bombshell is that the HSE has informed St. Michael's House that it need not admit anybody into care services, even emergencies, without the written approval of an assistant national director at the HSE. The staff in St. Michael's House have been prevented entirely from extending any care to anyone, except in an emergency where they must still get written permission. That is the worst style of governance. We often talk about avoiding blunt cutbacks, but that is the most blunt front line impact one could come up with. It is a straight directive not to provide services to people, regardless of how serious their need.

To give the Taoiseach his due, he was committed to this area when he was Minister for Health and Children. He provided 70 residential places each year when he was in that role. This year, only ten places are being provided, down from 21 last year. In spite of this five year development plan, we have reduced the number of residential care beds to one seventh the amount provided by the Taoiseach when he was in charge of the Department all those years ago. We all know that there is an increasing demand on this service. People are living longer and their needs are becoming more complex, so it is more difficult to provide care. A third of the parents providing care are over 60 years of age, nearly half are over 70 and there are 55 carers over 80 years of age. We must get our heads around this.

Is it Government policy to tell St. Michael's House to cut everyone off at the knees unless there is written confirmation? These are the children who are most vulnerable in our community. It seems entirely in conflict with what Fianna Fáil espouses, which is to cherish people in need. Is this intentional or is it accidental? Is it some bureaucratic mix up? What has happened here? The House needs an explanation, but we can no longer get explanations by tabling parliamentary questions. Our only chance is to get a response on the Adjournment. However, the danger is that a defensive script has been prepared that will not answer the problems, so we will not be able to explain to parents what is happening. I cannot explain it, but I hope the Minister of State can explain it.

See this speech in context