Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank the Labour Party for tabling the motion. I acknowledge Deputies' support of me in my role as Minister of State with responsibility for disability, and the Minister, Deputy O'Gorman, who has been present for the entire duration of this debate to support me.

On reflection, I went over my diary to see how I spent the past month to colour and put in context what I am doing behind the scenes. I met with FUSS Ireland, AsIAm, Mr. Bernard Gloster, nine disability managers - that was nine separate meetings - and all the leads of CHO 4. I met eight times with departmental officials, Mr. Bernard O'Regan and Ms Yvonne O'Neill, also in the past month, with the Taoiseach and the Minister, to set our priorities for the upcoming budget, and individually with numerous Deputies regarding the issues they bring before me. As they will now be aware, I have focused a lot of energy over recent months on increased investment into disability capital budgets which, outside de-congregation, have been lacking. Deputy Kelly was instrumental in ensuring that St. Otteran's Hospital was in the capital plan when he was on this side of the House. It remains there, believe it or not, but is still at appraisal stage and not moving.

We know many of our services are near capacity so increased investment in supports and services that will ease pressure on families is crucial. I have learned over recent years that the pace of development of such services has been frustratingly slow. Through my monthly meetings with the nine disability managers throughout the country, the areas in need of investment have become very clear. I have also met with wonderful organisations right around the country that have shown me how they can add capacity to the system to help deliver for families and ease the pressure the HSE is under. These are shovel-ready projects that can add capacity, but I find the current system too clunky to allow for fast delivery. I am working with Mr. Gloster and his team to help deliver on these as soon as possible. I remain optimistic that we will see delivery in this area under his leadership.

When I talk about shovel-ready projects, it is important that I share some of my ideas with Deputies. I mean equine therapy in Kanturk, Sensational Kids in County Kildare, Neurodiversity Ireland in Sandymount and Rainbow Club Cork. They are already supporting kids. Rainbow Club Cork is already supporting 1,150 kids through giving interventions on a weekly basis. It needs more support. I need the HSE to move away from its model of what it believes is working to a more inclusive model of participation in the community. As part of this work, I will hold round-table meetings with providers before the end of this Dáil term to discuss the issues of investment in respite and residential care and how we can deliver more capital projects to boost capacity, as well as what the providers see as the roadblocks to delivery.

Every one of the disability managers tells me that they need and have made applications to the national office for more respite and residential houses. They also talk about the impact of Covid. In CHO 2 alone, there is a need for six residential houses for children under 18 years of age. It is important to say that I make those comments in the context of three large budgets have provided funding for a major upscaling in respite nights available to children. In 2021, there was €5 million in funding for 10,400 additional respite nights either through new services coming on stream or expansion of current assets. In 2022, €9 million saw the establishment of three additional specialised centres, one for Prader-Willi respite care and two others to provide high-support respite for children and young adults with complex support needs. These are expected to provide 4,000 nights. The other seven services will provide 9,408 respite nights in a year. This year, five additional respite services will come on stream, while we will also increase one service from part time to full time to provide 7,800 nights. In all, in the past three budgets, I have delivered 31,000 nights that have been added to the system.

Needless to say, when I listened to Paschal Sheehy's report on RTÉ last Sunday, I was frustrated to hear that ten beds are not in operation. My understanding is there should be no idle bed when we have families in crisis. I have written to the HSE and made an interim suggestion to ensure that we can provide support. I talked to those in the Carrigaline space, in particular, where children do not fall under any particular patronage. I had this conversation with all the leads, to be fair, in CHO 4. I have suggested that CHO 4 needs to immediately stand up agency nursing to staff the ten beds until such time as the providers are allowed the funding to stand up those beds. Whatever rate needs to be paid, those nurses need to be stood up at that rate in order that no family is left in the situations presented here today. The lead agency stated to me that it needed 74 staff immediately. The HSE knows the ask and needs to deliver on that.

Deputy Duncan Smith referenced the list for assessments of need that I believed had been cleared. I did clear it, but it has grown back. The Minister and I have made a proposal to the HSE, where I want a minimum of six regional assessment units stood up. The reason for that is when every child is assessed, there will be round-table liaison that will work together, with somebody from child and adolescent mental health services, primary care and education. We will then be able to find the proper pathways back into where the child needs those services. Those regional assessments will be a combination of public-private to ensure we get a correct delivery of assessment, that the assessment will be liaised on correctly so that the child returns to the proper team, and that we allow the teams that are in place to build up the capacity to make a direct intervention.

If that is not done by 1 August, I will take to budget what the Labour Party has suggested today, that we will fund the families. I am giving the time to the HSE to act on the ask and I am supported by the senior Minister in that.

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