Dáil debates

Thursday, 14 April 2005

Adjournment Debate.

Services for People with Disabilities.

4:00 pm

Photo of Jack WallJack Wall (Kildare South, Labour)
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I thank the Ceann Comhairle for allowing this Adjournment debate and thank the Minister of State, Deputy Brian Lenihan, for attending. This matter arises from my frustration over trying to resolve the problems of the unfortunate person in question. He was involved in a separation and got his own local authority house in my home town of Athy. Unfortunately, he suffered from a stroke and is therefore not able to relate to family members or friends who visit. One can imagine the frustration this causes him.

The man has his own home and looks after it. He was really appreciative when the local authority provided the house. However, due to his health condition, he suffers from all the problems that result from a lack of communication with the outside world. I have tried through every means available to me to obtain for him some type of speech and language therapy, but without success. As the Minister of State will note from the further information with which I supplied him, the Health Service Executive, south-eastern area does not provide community speech and language therapy services for adults. The outpatient services which were available previously from Naas Hospital have ceased and only a minimal number of speech therapy sessions are available for inpatients. One could argue that the only course of action available to the man in question is to try to get readmitted to the hospital to obtain inpatient services. Given that only a minimal number of sessions are available, it would not be of much benefit to him.

There is no funding available for the man in question. He is a medical card holder and has retained the card through representations. He attended the National Rehabilitation Centre in Dún Laoghaire as part of his rehabilitation after his stroke. He has met a stone wall because the Health Service Executive is not in a position to provide the communication link between him and the outside world, including his friends and family. I hope the Minister of State will try to do something for this man.

It seems futile for a person to overcome so much and be thwarted in this way. He holds a medical card. Does this reply from the Health Service Executive imply that no one in the executive's south-western area will provide speech and language therapy for an adult? Will everyone who suffers a stroke be in the position that he or she must get private tuition, funded personally or by family members, or some other mechanism, or must these people suffer in a limbo of non-communication?

One can see this man's frustration. He cannot speak on the phone although he can call for help if he needs it. He is totally isolated. I hope the Minister of State's reply will offer him some solace and that the Health Service Executive, which receives so much funding from the Exchequer, will provide a service for him. This man contributed to the Exchequer, having worked all his life until he fell ill. He paid tax and social insurance contributions. I hope there will be some light at the end of the tunnel for him and that he will be able to communicate with the outside world.

Photo of Brian Lenihan JnrBrian Lenihan Jnr (Dublin West, Fianna Fail)
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I am pleased to take this opportunity to clarify the matter relating to the provision of speech and language therapy for the person on whose behalf Deputy Wall has raised this matter. The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services.

This includes responsibility for speech and language therapy services. However, my Department has inquired into this matter. The Health Service Executive, south-western area, confirms that this person was referred to it for speech and language therapy services following his discharge from a hospital in another area of the Health Service Executive. The Deputy had been previously informed by the Health Service Executive that a minimal number of speech therapy sessions are available at Naas Hospital which requires the provision of speech and language therapy services to adults to be limited to inpatients of that hospital. The executive also informed the Deputy that community speech and language therapy is not provided for adults.

A medical card issued by a Health Service Executive area enables the bearer to receive certain health services free of charge. However, where community-type services such as speech therapy are concerned, there is no statutory obligation that automatically entitles a person to such services although some Health Service Executive areas provide a level of these services. Demand for speech and language therapists was recognised in the Bacon report in 2002 which recommended that training places for speech and language therapists increase from 25 places per year to 105 places per year.

To address this shortfall in supply, three new schools of speech and language therapy were opened in 2003, in the National University of Ireland in Galway and Cork and in the University of Limerick. In addition, the number of training places in Trinity College Dublin was enhanced. The end of this academic year will see the first graduates of these new courses, those students who undertook an accelerated two year masters programme in University of Limerick and in 2007 graduates from the traditional degree programme from the universities in Cork and Galway.

To meet the demand for speech and language therapists we rely heavily on the return of students who have studied abroad and on an EU and non-EU workforce. It is estimated that 20% of the speech and language therapy workforce comes from abroad. In 2002 an additional grade of clinical specialist was introduced to speech and language therapy. This grade had many objectives including to ensure best practice and research in the profession. It is intended to review and develop this extremely beneficial grade soon. The Irish Association of Speech and Language Therapists has embraced the Sustaining Progress agenda and produced a position paper for the introduction of programme assistants to the profession. This skill mix will ensure the best use of scarce and valuable resources. The grade will be established and a training programme for such programme assistants initiated soon.

Despite the significant developments in speech and language therapy to date, it is widely accepted that there is further need to enhance the numbers employed in the health and education sectors. Long waiting lists for services must become a feature of the past. The recently announced investment in the disability sector is a first step in advancing to a service where those in need of this essential service receive it.