Kathleen Lynch (Cork North Central, Labour)

I support the sentiments of the Minister of State, Deputy Shortall, that it would be wonderful to be in this Department at a time of full and plenty with the country awash with money. God knows, there were times when the Government was hard-pressed to know what to do with it. We are in an entirely different space now and we are trying to ensure the front-line health services both within the acute hospitals and in the community are delivered in a more efficient and effective manner. That the country is virtually bankrupt is not and never was as a result of people needing a health service but of gross mismanagement by the previous Government, and Opposition Deputies should keep that in mind.

The Health Service Executive's national service plan for 2012 acknowledges that there will be an inevitable and unavoidable reduction in services this year because of the scale of the financial and staffing challenges facing the health service. However, it also outlines the various actions that will be taken to mitigate as far as possible the impact the budget and staff cuts would otherwise have on services. In framing the plan, the HSE was asked to avoid across-the-board cuts in budgets and to ensure that reductions in budgets should not lead to a corresponding reduction in services. This is in line with the objectives of the Government's health reform programme to prioritise our services in a way that supports those in greatest need.

I wish to address the areas of the health sector for which I have responsibility, namely disability, mental health and older people services. In excess of €1.4 billion will be spent on specialist disability services in 2012. The national service plan provides for a 3.7% reduction in budgets, but makes it clear that there is scope for achieving efficiencies of 2% or more through measures such as consolidation and rationalisation of back-office costs. That is not as easy as it sounds. Some organisations have already introduced all those efficiencies, as we are well aware. It is not something that can be said in a glib or off-hand manner. Organisations delivering disability services have done an exceptional job this year.

I wish to answer some of the points about school-leavers made by many contributors, including the last contributor. We started off with a figure of approximately 700 school-leavers - young men and women who happen to have a disability.

The number in this respect has not settled but we estimate that 180 people will be in need of a day place. I congratulate the disability services in the HSE and the organisations which have made room and managed to find space to provide for people who needed a service without it costing the Government any additional money. There will be no additional money in terms of provision having regard to demographics but we must ensure, and I am not certain that it can be done by way of threat, that people who are most vulnerable and in greatest need will have a service and we will continue to work on that on a daily basis.

Deputy Browne asked me the other day if I still had the €35 million allocation for mental health services. I would love to think that I had it personally but we have that funding. The posts which will be necessary to bring mental health services into the community and to strengthen the community mental health teams will be put in place this September. I congratulate the people in the Deputy's constituency of Wexford and the people of Waterford on the tremendous job they have done in driving that service forward and being courageous in doing that under some pressure. We have had the assistance of the Minister, Deputy Brendan Howlin, who insisted on the retention of the €35 million allocation, and there is also the promise in the programme for the Government's in regard to mental health.

We will publish a carer's strategy next week to provide not only for older people because carers comes in all shapes and sizes; sometimes they are very young and sometimes they are elderly. We will publish a dementia strategy in 2013. The review group and public consultation on that is being put together as we speak.

The allocation of €1.4 billion for the fair deal scheme is ring-fenced. I was amazed to hear there are difficulties in some areas because I inquired about the scheme only this morning and was told there was no waiting list. How we treat our elderly people cannot be only about nursing home or long-stay provision; it must be about far more than that. It must be about ensuring that we all live and die where we wish to be, namely, in our own communities.

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