Dáil debates

Thursday, 12 October 2006

Adjournment Debate

Services for People with Disabilities.

5:00 pm

Photo of Catherine MurphyCatherine Murphy (Kildare North, Independent)
Link to this: Individually | In context

In the past, we were told it was possible to predict the life chances of babies by looking at their addresses in the maternity ward. The addresses to which this statement alluded tended to be in areas of significant poverty and disadvantage. If the same review of maternity wards were to take place today, the address of a baby would still play a part. However, if a child has a special need or disability, where the child lives will dictate the level of support services available and, as a result, his or her life chances. The reason is inequality in current service provision.

Although the Health Service Executive is a single entity, it appears that eight former health boards continue to function behind this organisation. To highlight what I mean I will refer to three children. Conor, who is aged three years and has a problem with his speech, requires speech and language therapy and has been placed on a list for assessment. I received from the HSE a reply to a query informing me that it currently takes 23 to 24 months to complete an assessment and it is working off the 2004 list. The reason for this waiting period, according to the HSE, is low staffing levels relative to the number of referrals. On checking further, it emerged that more than 1,500 children are on the County Kildare waiting list, a threefold increase since 2002. As Conor's mother cannot afford to go privately, her child will have to wait, with the result that he may commence school before receiving an assessment, not to mention treatment.

In replies from the Health Service Executive, I have been informed that under the "staff employment ceiling" it is not possible to approve all necessary posts. Rapidly expanding counties such as Kildare are disproportionately affected by this embargo on further recruitment. The State is perfectly willing to allow a child to attend school with a known disadvantage in a county with the highest class sizes in the country, yet it wonders why he might underperform.

The second child to whom I draw attention is Tim who was born 18 months ago with Down's syndrome. He lives in my constituency and featured in an article in the most recent issue of The Sunday Tribune. The article compared the services available to Tim with those available to another child with the same diagnosis who was born on the same day and lives three miles away in Lucan. Both children reside in the old Eastern Regional Health Authority region, albeit in different sections of it. While the parent in County Kildare had to fight for every service the child secured, the other parent in the Dublin area received a seamless service.

Services for children with Down's syndrome in south Kildare are substantially better than those available in north Kildare. Tim, like all children with Down's syndrome, requires early intervention which would make him much more receptive to learning at an early stage, an obvious advantage. He cannot wait until the State gets around to providing services.

The third case relates to a child of seven years who also lives in my constituency. He was diagnosed with autism spectrum disorder when he was three years old but despite his disability, he is doing well in school. Initially placed in a special class, he has since progressed to mainstream. Until now he has had support from Beechpark services which focuses on early services for children with autism. The child in question requires occupational therapy and speech and language therapy to ensure he does not regress. In response to a query, his parents received the following incredible statement from the HSE:

Unfortunately we must inform you that we do not have resources to treat children with autism as we are not an autism specific service and our staffing levels are particularly low at present. We regret to inform you that we do not have an occupational therapist nor a psychologist on our team presently. We realise that this is an unsatisfactory situation, however it is outside the control of this team. We can only apologise and regret our lack of resources at present. Should you be in a position to source the above therapists in a private capacity, we can forward you some information.

This is shocking. While it is understandable that the major focus of the HSE has been on hospital beds and accident and emergency departments, the life chances of children are being badly affected by the unequal service the organisation provides. As I indicated, the little boy to whom I refer is doing well in school. However, his parents have been told following a professional assessment that if he does not receive the necessary occupational therapy, he will regress. Providing support to this child now is an investment in ensuring he leads an independent life.

There is no problem in finding the parents of the children in question when the State seeks taxation. We need to ensure they receive equal levels of service from the taxes they pay.

Photo of Noel AhernNoel Ahern (Minister of State, Department of Environment, Heritage and Local Government; Minister of State, Department of Community, Rural and Gaeltacht Affairs; Dublin North West, Fianna Fail)
Link to this: Individually | In context

I take this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I am pleased to have an opportunity to address the general issues raised by the Deputy.

I emphasise the Government's commitment to providing high quality services to all people with a disability. This commitment is illustrated by the substantial investment we have made in services in recent years and the multiannual investment programme provided by the Government for the period 2006 to 2009. The Government's six sectoral plans on disability, including the plans for the health sector, set out in some detail how we plan to improve the experience of people with a disability.

The recent claims in a newspaper article that "for children it has never been so bad" cannot be supported by the facts.

Photo of Catherine MurphyCatherine Murphy (Kildare North, Independent)
Link to this: Individually | In context

They are supported by the facts.

Photo of Noel AhernNoel Ahern (Minister of State, Department of Environment, Heritage and Local Government; Minister of State, Department of Community, Rural and Gaeltacht Affairs; Dublin North West, Fianna Fail)
Link to this: Individually | In context

I accept some of the points raised by the Deputy and will not defend the HSE regarding some of the unacceptable responses all Members receive. If the Deputy is correct, services should not relate to where one lives. However, considerable improvements have taken place in services for people with a disability. For example, between 1997 and 2005 additional revenue and capital funding of €464 million was provided for persons with intellectual disability and autism. This is not acknowledged in the article the Deputy cited.

The Government provided additional revenue funding of €74 million in 2006 for services for people with physical, sensory and intellectual disability and those with autism. The priority this year is to enhance the assessment and support services for children with disabilities. In particular, these moneys are to meet the costs associated with the commitments in the multiannual investment programme for specific high priority disability services. This will also help to build the additional capacity in multidisciplinary and other support services required under the Disability Act 2005 and the Education for Persons with Special Educational Needs Act 2004.

With regard to the specific services raised by the Deputy, I understand from the HSE that the relevant services in County Kildare are provided in the north of the county by a partnership arrangement between the HSE and the St. John of God services at St. Raphael's Celbridge and in the south of the county in a partnership arrangement between the HSE, Kare and Moore Abbey.

I also understand that the service in west Dublin and south Kildare has developed extensively in recent months but it has proved difficult for logistical reasons to achieve similar progress in north Kildare. The HSE has assured me it will work closely with the St. John of God service to develop early learning services in order that it can attain the type of provision available in south Kildare. The HSE and St. John of God are committed to developing a holistic service that meets children's needs in the area.

The development of high quality services, available on an equitable and equally accessible basis, throughout the country is an important objective of the Minister and HSE. I am confident that, over time, the varying levels of service provision will be standardised and that the HSE, as a single national organisation, will achieve this objective.

I draw the Deputy's attention to the Disability Act, Part 2 of which will be commenced on 1 June next for children under five years. This Part entitles people with a disability to an assessment of need and to a formal statement of services to be provided. It will offer greater certainty and consistency in the level and type of services available for children in the circumstances outlined by the Deputy. I will draw the Minister's attention to the cases raised by the Deputy.