Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputies for bringing forward this important motion on specialist community-based disability respite services providing us with a welcome opportunity to discuss the matter. The Government is not opposing this motion on the grounds that we all share a desire to see increased respite services for people with disabilities and those loved ones who care for them.

Respite - a short break - can make a significant difference to the lives of people with disabilities and their families. It can be a very positive experience for the person with a disability providing an opportunity to meet others and have new experiences. It also provides a break to those who are providing care. Respite covers a range of services and 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.

It is important to recognise that respite is not always centre-based and can be provided in a number of ways. It can take the form of home support, after-school provision and weekend activities or family support. Last week, there were a number of reports in the media that related to families seeking respite services. I think we all recognise that there is unmet need in respect of respite and I can assure the House that this Government and the HSE are doing everything possible to increase provision and to ensure that provision is allocated on an equitable basis. I know the Minister of State, Deputy Rabbitte, has a deep understanding of the importance of respite for service users and their families. She and the Minister for Children, Equality, Disability, Integration and Youth, along with the rest of the Government, remain committed to ensure increased respite services are supported.

Significant additional resources have been provided to expand respite services in recent years. The past three years in particular has seen sustained new development funding secured. The Minister of State, Deputy Rabbitte, has worked hard to ensure that all forms of respite are expanded across all community healthcare organisation, CHO, areas and that additional accommodation is made available for centre-based residential respite. In 2023, €6.7 million in new development funding is being made available to further expand respite services. In 2023, the HSE plans to establish five additional respite services and increase one service from part time to full time opening to provide 7,872 additional nights to 278 people in a full year, provide 27 additional in-home respite packages to children and young adults in a full year and provide 265 day-only respite packages to 180 people in a full year.

We must also acknowledge the respite care grant, which is now called the carer support grant, that is made available by the Department of Social Protection and provides a grant of €1,850 to eligible individuals once a year for each person they care for. While the grant was never formally linked to the purchase of respite services and recipients are free to use the grant as they choose, it is nevertheless some support to carers.

While additional resources are welcome, we have to acknowledge that there are a number of challenges associated with the provision of respite services. One of the key challenges is that of staffing and the Minister of State, Deputy Rabbitte, will later this evening outline some of the measures being taken to address this.

It is important to acknowledge that the provision of residential respite services in particular have come under increasing pressure in the past number of years due to a range of impacting factors such as 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 and an increase in the age of people with a disability resulting in people presenting with changing needs. A number of respite beds have been utilised for long-term residential placements due to the presenting complexity of the individual with a disability and also due to circumstances at home. The placement may be temporary until a residential service becomes available. In some instances, the provision of centre-based respite to high-support individuals with complex needs means that capacity is necessarily reduced due to health and safety and-or safeguarding. The HSE advises that while these scenarios can result in respite services being affected for a significant period of time, it is important to note that the aim is to ensure that services are not closed for respite permanently.

Regulation is important in ensuring that the services provided are safe and of a high standard and can meet the needs of individuals in the most appropriate way. HIQA regulation applying to respite centres is the same as that applying to full-time residential care. This brings with it requirements concerning capacity, reporting obligations, fire regulation etc. In the case of the latter, it is understood that in a number of existing facilities, only one wheelchair user can be accommodated at a time. So while regulation is welcome and necessary, it has to be acknowledged that it places certain obligations on service providers and can have implications for how services are managed. I also need to reference the availability of accommodation in respect of centre-based respite. Procuring appropriate housing is a challenge, however, this issue is not unique to respite services. It has implications across a range of specialist community-based disability services impacting on measures relating to decongregation, the transitioning of people aged under 65 from nursing homes and the provision of disability residential supports in the community.

While I have outlined some of the challenges associated with the provision of respite, every effort is being made to support the provision of respite on an equitable basis and to expand provision in all its forms. The Government’s commitment to specialist community-based disability services and to respite is demonstrated by the provision of ever increasing budget allocations. I want to impress upon colleagues that we are continuing our efforts to make a real, meaningful difference to the lives of people with disabilities. I again thank the Deputies for providing me with the opportunity to discuss these important issues and I look forward to their contributions.

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