Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank all the Deputies for their contributions to this debate. On behalf of my colleagues, the Minister, Deputy Stephen Donnelly, and the Ministers of State, Deputies Rabbitte and Butler, I assure Members that this Government is acutely aware of the importance of respite care for service users and their families and remains firmly committed to ensuring increased capacity is built into respite services provided by or on behalf of the HSE.

The Government is committed to providing services and supports for people with disabilities, which will empower them to live their lives and provide greater independence in accessing the services they choose. In addition, overarching 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 Government recognises the important role that family carers play in the provision of care in Ireland. I would like to restate what my colleague, the Minister of State, Deputy Butler, said about family carers and how they are the backbone of care provision in our country and have cared for the most vulnerable in society during the Covid-19 pandemic. The need for increased respite provision for persons with a disability and older persons is acknowledged by the Government and is reflected in the HSE's national service plans for 2021 and 2022.

The Government's commitment to improving services and supports for people with disabilities and their families, was demonstrated in budget 2022, with a total budgetary allocation of more than €2.3 billion, which included funding to reflect the importance of respite breaks as part of the overall suite of services available for people with disabilities and their families. Building on the 2020 funding for respite services of circa €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 alternative respite projects including Saturday clubs, breakaway schemes and summer schemes. The number of overnights, with or without day respite, accessed by people with disabilities in 2021 is advised as 94,606. The number of day-only respite sessions accessed by people with disabilities in 2021 is advised as 16,306.

Budget 2022 provides €9 million to build the capacity of our respite services with the Government committed to the establishment of three additional specialist centre-based services - one to provide specialist care for people with Prader-Willi syndrome and the other two to provide high-support respite for children and young adults with complex support needs. These centres are expected to provide 4,032 nights to 90 children and young adults with complex support needs. In addition, funding for further respite services is provided for in budget 2022, which will provide 9,408 nights to 245 children and adults in a full year.

The Government also provided an unprecedented level of investment in the 2021 budget to improve access to primary care services and older people's services, including €150 million of 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. The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the HSE supports access to quality long-term residential care where this is appropriate.

Access to respite care is based on both the needs of the older person and their carer and can take place within their own home or in a residential care unit managed by the HSE, voluntary agencies or by private providers. Respite can occur in a variety of settings for various lengths of time, depending on the needs of the individual service user and their family or carer. Respite is not always centre-based and can be provided in a number of ways, for example, centre-based, in home; home to home, family support, etc. 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. However, the provision of residential respite services has come under increasing pressure in the recent years due to a number of impacting factors, including: an increase in the number of children and adults who are seeking access to respite as a reflection of general population increase; increasing levels of complexity across the sector due to better and improved health care; an increase in the age of people with a disability resulting in people presenting with changing needs; and the impacts of regulatory standards and national policy on capacity.

As was set out by the Minister of State, Deputy Butler, the Covid-19 pandemic has resulted in the closure of some residential disability services in line with public health advice. I do acknowledge that this has been difficult for many people with disabilities and their families. Respite services operated at reduced capacity throughout the pandemic. This was as a direct impact of prevailing public health advice at that time, to keep some of our most vulnerable safe during the pandemic. During this time, some respite centres remained open, while others were temporarily repurposed as isolation facilities. The use of targeted one-to-one home support hours were offered in lieu of respite in certain circumstances, subject to appropriate risk assessment. Throughout the pandemic, staff and resources associated with closed or curtailed services were redeployed where possible to support residential provision and to provide for targeted in-home, community and online supports for service users and families based on prioritised needs. For those with disabilities and their families and for older persons, the impact of the pandemic on those services has presented challenges and the human cost for those affected by the reduction in respite services as a result of Covid-19 cannot be underestimated.

The Disability Capacity Review to 2032 - A Review of Disability Social Care Demand and Capacity Requirements to 2032, published in July 2021, set out the additional respite capacity that will be required in light of Ireland's anticipated demographic change, and what is required to address unmet need. Following the commitment in the 2020 programme for Government to work towards implementing the findings, a disability action plan framework was also published in July 2021 alongside the terms of reference for an interdepartmental working group to develop this action plan, for submission to the Cabinet sub-committee on social affairs and equality. The action plan, which is in the process of being finalised, will help to guide the Government to ensure that we can plan ahead to meet changing needs and demographics and ensure that people with disabilities can get the right services, in the right place, at the right time. It is also intended to work towards providing equitable access to respite services irrespective of where people reside. While challenges remain, the need for increased respite provision is acknowledged and reflected in the HSE's national service plan for 2022.

It is important to note that the programme for Government aims to prioritise policy actions that protect the most vulnerable, including those both in caring roles and those they care for, as our economy returns to growth in the aftermath of the pandemic. The Department of Health is committed to working with other Departments to ensure that we are providing the most appropriate supports to sustain carers in their caring role. Officials from the Department of Health recently partook in the annual carers forum hosted by the Department of Social Protection. This annual forum is there to allow family carers and representative organisations to voice their views on caring in Ireland and their priorities to support them in their caring role. The national carers strategy aims to recognise and respect family carers as key care partners where carers are supported to maintain their own health and well-being and to care with confidence.

I assure the House that the Government is as determined as ever to provide timely access to high-quality health and social care services, including respite services for all children and adults who require them. As Ministers of State with responsibility for disability and mental health and older people, Deputies Rabbitte and Butler, are acutely aware of the respite service for service users and their families. Respite remains a key priority. This is reflected in the funding commitment achieved for the development of new respite centres, alternative respite and the expansion of existing services.

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