Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputy Connolly and the other co-sponsors of this motion. I welcome the debate. As the Deputy said, this does shine a spotlight on things.

When I saw on the Order of Business last Thursday that there was to be a debate on respite, I was delighted because I believe it is a matter that we need to be debating.

I am responding to the motion on behalf of the Minister for Health and the Minister of State with special responsibility for disability, Deputy Rabbitte. I am also responding to it on my own behalf as the Minister of State with responsibility for mental health and older people. Furthermore, I am responding on behalf of the Government as a whole. I confirm that we are not opposing this motion. My answer will be in two parts. First, I will be speaking on behalf of the Minister of State, Deputy Rabbitte, about disability and respite, and then I will speak about my area of responsibility, namely, older people.

The one line that really stood out for me in Deputy Connolly's opening contribution is that the provision of regular respite care has been shown to delay or prevent the admission of service users to long-term residential care. It does work. From my constituency office and as Minister of State, I am acutely aware of the challenges for older people. I acknowledge Deputy Connolly's bona fides on this and the way she has addressed the matter today. For the past two years, she has been raising with me the issues of respite and older people in the Galway area.

We all recognise how important respite can be for relieving pressures and increasing the quality of life for families. We are committed to providing services and supports for people with disabilities that will empower them to live their lives and provide greater independence in accessing the services they choose. In addition, the Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible.

The need for increased respite provision is acknowledged and reflected in the national service plans for 2021 and 2022. It has been reflected in the significant funding secured for the development of new respite centres, alternative respite and the expansion of existing services by the Government. I stress that the Government recognises the important role that family carers play in the provision of care. They are the backbone of care provision and have cared for the most vulnerable in our society during the Covid-19 pandemic. Whether caring for a child or parent with a disability or illness or an elderly family member, carers, through their selfless hard work, knowledge and compassion, enhance the quality of life of the most vulnerable in our society daily.

I am sure many here today know that respite can occur in a variety of settings for various lengths of time, depending on the needs of the individual service user and his or her family or carer. Respite is not always centre-based and can be provided in several alternative ways, such as, for example, in the home, from home to home and through family support and day care centres. I met representatives of the Alzheimer Society of Ireland on Monday morning and learned that €1.75 million was provided this year to support respite in the home. One of the key points the representatives made was that this was done because of Covid. They asked that the arrangement be continued because it suits some people.

As a vital part of the continuum of services for families, respite potentially helps prevent out-of-home full-time residential placements, preserves the family unit and supports family stability. All in government acknowledge there is a need for increased respite provision both for persons with a disability and older persons. Budget 2022 demonstrated the Government's commitment to improving services and supports for people with disabilities and their families, with a total budget allocation of over €2.3 billion. In 2020, funding allocated to disability respite services amounted to approximately €70 million. In 2021, funding of €5 million was provided for nine additional centre-based respite services to provide 10,400 additional respite nights along with a range of alternatives, including Saturday clubs, breakaway schemes and summer schemes. This year, in the 2022 national service plan, we committed to the establishment of three additional specialist centre-based services: one to provide specialist care for people with Prader-Willi syndrome and a further two to provide high-support respite for children and young adults with complex support needs. This is expected to provide 4,000 nights to 90 children and young adults who have complex support needs. Additional funding has been allocated for further respite services, which will provide 9,400 nights to 245 children and adults in a full year.

The Government also provided for an unprecedented level of investment in the 2021 budget to improve access to primary care services and older people's services, including €150 million in additional funding for home support to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home support services. This funding has been maintained into 2022, providing for 5 million more hours of home support, notwithstanding the staffing issues I am currently trying to resolve.

For older persons, respite care is an important element in the support of caring for service users within their own homes and communities. The provision of regular respite care, which is so important, has been shown to delay or prevent the admission of service users to long-term residential care facilities. It also supports hospital avoidance.

Respite care is provided in our public residential centres and also contracted by the HSE in private nursing homes. At the end of May 2022, there were 1,516 short-stay beds open across all CHO areas, 243 of which were designated as respite beds. Those are the figures for the whole country. There were a further 20 dementia respite beds, which are also exceedingly important.

The motion highlights that some carers have provided increased levels of care with less respite support during the Covid pandemic. I truly appreciate the human cost for those affected by the reduction in respite services as a result of Covid-19. While it is acknowledged that respite services operated at a reduced capacity throughout the pandemic, it is important to note that this was as a result of prevailing public health advice at the time and was singularly focused on keeping some of the most vulnerable safe during the pandemic. During this time, some respite centres remained open while others were temporarily repurposed as isolation facilities. Targeted one-on-one home support hours were offered in lieu of respite in certain circumstances, subject to the appropriate risk assessment. It did work in some cases.

As a Government, we are very much aware of the extraordinary work carried out by carers. Since everybody has my script and I am a little caught for time, I will skip the information in this regard. It is really important for carers and service users to ensure the demand for respite services and the unmet need of service users are addressed.

I am open to what Deputy Connolly suggested about an audit. I can give a commitment only in regard to an audit of respite beds for older people. I will talk to the other Minister of State, Deputy Rabbitte, about this. She is away on ministerial business at the moment, so she is not available today. I cannot give a commitment on her behalf but I would like to see the audit happen. We are currently auditing mental health beds throughout the country. An audit of respite beds per CHO is certainly something I would like, and I will get working on it.

It is important to refer to the Disability Capacity Review to 2032, published in July 2021 and which sets out the additional capacity required in specialist disability social care services in light of anticipated democratic change, and to address the gap between available services and the level of need. A disability action plan framework was published in July 2021, alongside the terms of reference for an interdepartmental working group to develop the action plan. The group has now completed its work and is now in the process of finalising the detailed, costed draft disability services action plan, with targeted respite residential capacity and alternative respite options as part of its range of actions.

I want to speak about the Government's commitment to meeting our duty under the UN Convention on the Rights of Persons with Disabilities, UNCRPD. Ireland ratified this on 20 March 2018. This marked an important milestone in a process to strengthen the rights of people with disabilities in Ireland that has gathered momentum since Ireland became a signatory to the convention in 2007. Ireland's approach to meeting the obligations of the UNCRPD is one of progressive realisation, each year moving forward on key reforms, with the obligations arising from the convention being met over time. Priority has been given to meeting legislative commitments and requirements initially. The Government recognises the importance of the optional protocol to the UNCRPD. The optional protocol is an international treaty that establishes procedures aimed at strengthening the implementation and monitoring of the convention.

Due to delays at UN level, Ireland's appearance before the committee will be delayed, possibly for some time. In light of this, the Minister for Children, Equality, Disability, Integration and Youth and the Minister of State, Deputy Rabbitte, have indicated they are open to earlier ratification, contingent on the State being in a position to meet its obligations. This is reflective of the State's long-standing approach to entering binding international obligations in good faith.

I do not have time to read the rest of my script but the Deputies all have it. I could have spent my ten minutes speaking about respite for older people. I am sorry I did not have more time but I will give a commitment on the audit of beds for older people. I will talk to the Minister of State, Deputy Rabbitte, about an audit on the disability side.

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