Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)

I welcome the opportunity to discuss the very important area of disability. I do not doubt the Minister of State's commitment to deal fairly with people with disabilities and to provide the resources and supports necessary for them. We are all human beings and we all want to see people treated humanely and in a dignified way. However, it is easy to talk about consulting and reviewing legislation. There is often a big gap between aspiration, even in legislation, and the reality on the ground.

I do not claim to be an expert in this area, but when one becomes a TD, one quickly meets people who are experts because they are dealing with situations of disability. Overwhelmingly, I meet people in desperate straits who are continuously frustrated and often driven to despair by the lack of resources and funding and the bureaucracy through which they must wade to get the support they need. I experience this on a constant basis in my office and in my clinics, and it is difficult not to conclude that all the pious aspirations in the world really mean nothing against a background of brutal cuts being imposed in health, social protection and other areas which are making the situation worse for people with disabilities. That is what we must address.

The facts which confirm this view are manifold. As was mentioned already, the implementation of recommendations in the document, A Vision for Change, has not taken place. This document was commissioned in 2006 and it is a very good document that sets out to develop a framework for delivering mental health services in a holistic way. It is precisely what is needed. However, there has been no implementation of that policy. The new Government committed, at the beginning of the year, to delivering on A Vision for Change, but has come up short. A Vision for Change promised community care, minimising hospitalisation, more occupational therapists, more social workers and more advocates. However, due to the public sector recruitment embargo and the public sector retirement scheme, the reality is that we do not have enough of these staff and we are actually losing them. How many such staff will we lose as a result of the public sector retirement scheme? How many have we lost due to the embargo?

While A Vision for Change promises precisely the right things, in reality, mental health is still being dealt with in terms of hospitalisation, medicalisation and a lack of autonomy for the patients. This was highlighted yet again before Christmas with the Louise Bayliss affair at St. Brendan's Hospital. This shows the woeful failure to implement A Vision for Change.

The Government has promised that €35 million will be ring fenced for mental health, but Amnesty International has pointed out that unless that money is ring fenced for community mental health services, it is simply plugging the gaps left as a result of the general cuts in funding across the health service, as well as the recruitment embargo and the loss of staff across the HSE and the mental health services.

I have a friend whose 80 year old aunt had severe mental health problems. She was coping relatively well at home with a community mental health nurse who came to visit her at least once - sometimes twice - a week. As a result of the embargo, those visits were reduced to every fortnight or less and consequently she had to go into hospital for a year. That is just one example of the failure to move in any serious way in the direction of delivering A Vision for Change. It can be delivered only if we have the adequate staff and resources, but all of the cuts and reductions in funding are moving us in precisely the opposite direction.

I would also like to make particular reference to the domiciliary care allowance. This is a monthly payment to the carer of a child with a disability. The criteria for the allowance are so severe that the child requires care and attention and supervision substantially in excess of another child of the same age. The allowance was administered by the HSE until 2009 and since then it has been administered by the Department of Social Protection. The problems really began from that point, coinciding with the economic crash here. I have a constant stream of people complaining about this to me. Even though they get diagnoses from medical professionals clearly stating that their children meet the criteria and require care and attention or supervision substantially in excess of another child of the same age, they are refused the domiciliary care allowance. I am getting a constant stream of complaints in this regard. It is difficult not to conclude that this is an austerity measure, a tightening of the austerity screw and that a directive has been issued that people should be refused if any excuse can be found, even if they meet the criteria laid down. If they appeal the decision and can wade their way through the bureaucracy, bang their heads of the wall for long enough, some of the applications may be granted on appeal. The families in question are suffering as a result. It amounts to unfair treatment of the most vulnerable sectors of society. It seems to be nothing more than a cost-cutting exercise, presumably following the logic that if people are refused over a period of many months, they will eventually give up and decide not to appeal or if they do and succeed in their appeal, the State will have saved itself a number of months of payments while the appeal was being processed.

I have some examples to illustrate and reinforce the point. John from Ballybrack is in the Visitors Gallery. Last August his son, Harry, aged nine years, was diagnosed with autism spectrum disorder. He was refused domiciliary care allowance in October, even though he had psychiatric and GP assessments stating clearly that he needed care and supervision substantially in excess of that required by another child of the same age. He needs constant care and attention by his parents. His mother has had to take time off work and is suffering from depression as a result. He needs help eating and dressing and can only be brought to school or collected by one or other of his parents. Recently he has had to attend a special school for children with autism because his condition prevents him from continuing in mainstream school.

I refer to the opinion of the medical professionals on Harry's qualification for domiciliary care allowance. The medical certificate states he has been diagnosed with autistic spectrum disorder by Dr. Anne O'Donovan, consultant child psychiatrist at the Lucena Clinic. It states he has a severe disability and needs full-time care and attention far beyond what is normally required by a child of his age. The response of the Department of Social Protection to this medical opinion states:

It is clear from your application that your child requires additional support. However, while the diagnosis of your child's disability is not in question, the medical evidence provided does not indicate that the extra care and attention required is substantially in excess of that required for a child of the same age.

The medical professional's opinion is that he requires full-time care and attention far beyond what a normal child would require. The word "far" is stronger than "substantially". However, the application for the allowance has been refused at the stroke of a pen. I ask the Minister for an explanation. This is but one instance; I have had a great number of cases coming to my clinic and know that other Deputies have encountered the same problem. How is it that officials are making these decisions when the medical evidence and all of the circumstances surrounding the applications make it clear that such cases should be entitled to domiciliary care allowance, but they are still being refused? It is difficult not to conclude that the simple reason is austerity, that there is a directive that people should be refused if at all possible in the first instance in the hope they will go away, or else the hope is to make some savings if applicants are frustrated for a few months. The result is extreme suffering for vulnerable children and their families who need this money. For example, Harry cannot do what children want to do, including playing football, going to a local club or attending swimming classes. Such activities cost approximately €150 a year, but in his case the one activity he likes to do - playing in a centre which caters particularly for children with autism which is located in County Kildare - costs €60 for each trip. His parents need the money they are being denied to care for a child who, self-evidently and based on the clinical evidence available, needs this support, but the State or the Government or both are refusing to give it to him. This situation has to change, otherwise all the pious aspirations mean nothing.

I refer to another example involving a woman with a five year old son who has autism and speech difficulties, is not toilet-trained, cannot feed himself and attends a special needs school. She received domiciliary care allowance for two years but suddenly last November the Department of Social Protection informed her that the allowance was being reviewed. A GP had certified that the young boy needed care and attention in excess of that required by a child of the same age. In a letter dated 12 January the Department indicated that the allowance was being withdrawn from 31 December. One must question what the Government has got against children with special needs. This is unacceptable treatment.

I appeal to the Minister. I have no doubt about her sincerity, but the policies of austerity being pursued by the Government and the budgetary decisions hitting the most vulnerable and disadvantaged in society mean human suffering for persons who need more support than most of us. It is simply obscene to deny families and vulnerable children that support.

As the Minister well knows, there are many other instances and examples of problems in the disability sector. I refer to the situation in St. Michael's House, the budget cuts, the number of families in crisis, the number of new families looking for services every month, services not having adequate resources or staff, the number of people on waiting lists for occupational therapy and speech and language assessments. The list goes on. The most vulnerable persons, about whom we are always talking about protecting, are the victims of the austerity measures, a Government policy to prioritise the paying-off of bankers and bondholders, instead of looking after the vulnerable sections of society. I appeal to the entire Government, not just the Minister, to change its priorities in order that people like Harry among the tens of thousands of young vulnerable children who are being treated abominably will be given the support and help they need.

See this speech in context