Róisín Shortall (Dublin North West, Labour)

I thank Deputy Byrne for raising this matter. Under the Health Act 2004, the Health Service Executive, HSE, is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including disability services. The HSE's service plan for 2012 states that the allocation for disability services will reduce by 3.7% as a consequence of the impact of the efficiency, procurement and targeted pay reduction savings. However, the aim of the HSE will be to tailor such reductions in a way which minimises the impact on service users and their families, as much as possible. The Government is very much aware of the importance of respite service provision for the families of both children and adults with disabilities including those with autism. Disability service providers have been requested by the HSE to advise and discuss with it the challenges they are experiencing, prior to any reductions or changes to service provision being implemented. While there may be some changes to front line services, in many cases these changes will not necessarily result in service reduction, but in a different model of service delivery being applied. For example, respite provision is not always centre based and can be provided in a number of ways, such as, out of home, in home, home to home, home support or family support. Assessments are completed locally to determine and prioritise needs.

In 2010, a working group was established by the HSE to carry out a national overview of models of respite and residential care with host families in community settings and to determine the viability of these models of service delivery for future development for people with an intellectual disability. The report of the working group will be published shortly and one of its recommendations will be that each HSE area review and reconfigure respite and residential service provision to include the host family support model of service provision as an element of the overall respite or residential package available.

The cumulative impact of staff reductions from this year and previous years through the moratorium on recruitment of public servants and retirements represents a significant challenge for the health system in delivering services. The priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. The reduction in staffing increases the need for reform. The HSE national service plan includes a commitment to addressing these issues within the context of the Croke Park agreement. It also commits the HSE to minimising the impact on services by fast-tracking new, innovative and more efficient ways of using reduced resources, including greater flexibilities in. work practices and rosters.

Service provision continues to be a challenge for all of us in the current environment. However, the HSE is currently involved in detailed discussions and collaborative working under the auspices of the National Consultative Forum, which includes umbrella groups such as the National Federation of Voluntary Bodies. Through these discussions, the HSE is developing an innovative approach to service provision to maximise how resources are used to protect front line services. There has been a continued expansion in the availability of respite support services and these services have grown significantly in recent years. More than 4,600 people availed of respite services funded by the HSE in 2011. This service has supported people to continue living with their families and in their communities. The Government is very much aware of the importance of respite service provision for the families of both children and adults with disabilities and will seek to ensure that front line services are protected as far as possible within the current difficult circumstances.

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