Richard Bruton (Dublin North Central, Fine Gael)
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It has been repeated time and again in this House that there are no health cutbacks, and that what is being sought are efficiencies that will not hit the front line. Like me, a Chathaoirligh, you must have been appalled to hear the report this morning on St. Michael's House, which may now have to close down all services to new-born children with intellectual disabilities as a result of not receiving the commitment it was led to believe was forthcoming. That would mean that 16 parents every month would be turned away with no support, no counselling and no early intervention for children who suffer from a disability. That appals me.

There are currently 16 people who have been rendered homeless by the death of their carer, but since the State has not provided for them, St. Michael's House will have to use up six of its 30 respite beds immediately and a further seven over the year in order to accommodate them. That will have a tremendous knock-on effect. There are about 500 people who avail of respite care in St. Michael's House, but the respite capacity will effectively be halved. That means that parents who are caring for their disabled children on a full-time basis will have to give up their 20 day respite breaks. Those 20 day breaks will probably be reduced to 12 or even ten days.

All this occurs against a background in which the Government stated that there would be a five year plan that would commit to increasing funding for each year. The latest bombshell is that the HSE has informed St. Michael's House that it need not admit anybody into care services, even emergencies, without the written approval of an assistant national director at the HSE. The staff in St. Michael's House have been prevented entirely from extending any care to anyone, except in an emergency where they must still get written permission. That is the worst style of governance. We often talk about avoiding blunt cutbacks, but that is the most blunt front line impact one could come up with. It is a straight directive not to provide services to people, regardless of how serious their need.

To give the Taoiseach his due, he was committed to this area when he was Minister for Health and Children. He provided 70 residential places each year when he was in that role. This year, only ten places are being provided, down from 21 last year. In spite of this five year development plan, we have reduced the number of residential care beds to one seventh the amount provided by the Taoiseach when he was in charge of the Department all those years ago. We all know that there is an increasing demand on this service. People are living longer and their needs are becoming more complex, so it is more difficult to provide care. A third of the parents providing care are over 60 years of age, nearly half are over 70 and there are 55 carers over 80 years of age. We must get our heads around this.

Is it Government policy to tell St. Michael's House to cut everyone off at the knees unless there is written confirmation? These are the children who are most vulnerable in our community. It seems entirely in conflict with what Fianna Fáil espouses, which is to cherish people in need. Is this intentional or is it accidental? Is it some bureaucratic mix up? What has happened here? The House needs an explanation, but we can no longer get explanations by tabling parliamentary questions. Our only chance is to get a response on the Adjournment. However, the danger is that a defensive script has been prepared that will not answer the problems, so we will not be able to explain to parents what is happening. I cannot explain it, but I hope the Minister of State can explain it.

Máire Hoctor (Tipperary North, Fianna Fail)
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I will speak on this matter on behalf of the Minister for Health and Children. The Government is committed to providing a high quality service to all people with a disability. This commitment is illustrated by the substantial investment we have been making in disability services over the last number of years. The national disability strategy, launched in September 2004, reinforces equal participation in society of people with disabilities and provides for a framework of new supports for people with disabilities. This strategy, together with the other support services, is a key factor in building the additional capacity required to ensure that services best meet identified needs.

The strategy builds on a strong equality framework, which is reflected in several equality Acts. It puts the policy of mainstreaming public services for people with disabilities on a clear legal footing. The main elements of the strategy are the Disability Act 2005, the Education for Persons with Special Educational Needs Act 2004, the sectoral plans published in 2006 by six Departments, the Citizens Information Act 2007 and the multi-annual investment programme for disability support services for the period 2006 to 2009.

An integral part of the national disability strategy is the multi-annual investment programme announced in the 2005 budget, which provides a commitment to a cumulative capital and revenue programme of €900 million, with the bulk of this funding being spent on health services for people with a disability over the period 2006 to 2009. These commitments include the development of new residential, respite and day places for persons with intellectual disability and autism in each of the years covered by the programme.

With regard to the specific matters raised by Deputy Bruton, I understand from the HSE that St. Michael's House has received an additional €4 million in its 2008 annual funding, which has increased from €78 million in 2007 to €83 million in 2006. In addition, I understand from the HSE that St. Michael's House has been given an indicative allocation of new places across the greater north Dublin area in respect of 2008, as follows——

Richard Bruton (Dublin North Central, Fine Gael)
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I want to make one brief point to the Minister of State.

Máire Hoctor (Tipperary North, Fianna Fail)
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——Residential places — ten; respite places — two; and day places — 15.

Richard Bruton (Dublin North Central, Fine Gael)
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Will the Minister of State give way to allow me to make one brief point?

Máire Hoctor (Tipperary North, Fianna Fail)
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The HSE states that St. Michael's House also received an indicative allocation of five residential places in 2008——

Richard Bruton (Dublin North Central, Fine Gael)
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I want to make the point that this is less than half of what was in the plan.

Máire Hoctor (Tipperary North, Fianna Fail)
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——for children in the Meath local health office. Two new residential places and two new day places have been allocated to St. Michael's House in 2008 from the Dublin mid-Leinster region.

As the Deputy is aware, an additional €50 million was allocated by the Government for the provision of disability services in the 2008 budget. The 2008 service plan, developed by the HSE and approved by the Minister for Health and Children, Deputy Harney, included the €50 million for the development of additional disability services. The standard expenditure sanction issued to the HSE for 2008 stipulated that the prior approval of the Department of Health and Children and the Department of Finance would be required in the event of any proposal to spend this money for any other purpose.

Richard Bruton (Dublin North Central, Fine Gael)
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Is the Minister of State admitting that this money is now being veered away from disability services?

Máire Hoctor (Tipperary North, Fianna Fail)
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Clearly, it is essential that the HSE lives within is overall budget for the year. It needs——

Richard Bruton (Dublin North Central, Fine Gael)
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Acting Chairman, the Minister is saying that money which was voted by this House for disability services is now being considered to be veered away for other purposes — to meet deficits elsewhere.

Charlie O'Connor (Dublin South West, Fianna Fail)
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There is no provision——

Richard Bruton (Dublin North Central, Fine Gael)
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This is worse. If the Minister of State would only listen instead of just talking through the thing. This is supposed to be communication.

Máire Hoctor (Tipperary North, Fianna Fail)
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——to manage its activity levels and cost drivers appropriately to achieve this and the Minister does not believe it is desirable to resort to using development funding to offset expenditure pressures arising in respect of ongoing health services.

Richard Bruton (Dublin North Central, Fine Gael)
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I am around this House for a long time and any proper Minister would respond to issues raised in a serious manner. This is a disgrace.

Máire Hoctor (Tipperary North, Fianna Fail)
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I understand that the HSE is currently reviewing its overall financial position for the year and the roll out of planned development in disability services is being considered in that context. The Minister has been in communication with the HSE with a view to an early determination on the matter.

Richard Bruton (Dublin North Central, Fine Gael)
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This is a disgrace. This is admitting the money we set aside for disability is now under consideration to be veered to meet deficits in the HSE, and the disabled, elderly people and the physically disabled will suffer the consequences of that.

Charlie O'Connor (Dublin South West, Fianna Fail)
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The Deputy has made his point, but Standing Orders do not let me allow him to do that. I have to stick to Standing Orders and sometimes I have to apologise.

Richard Bruton (Dublin North Central, Fine Gael)
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There is a certain level of understanding that we listen when there is a valid point to be made. There is no point in us listening to a prepared script off a word processor, without getting an opportunity for the Minister to even take in the points being made, let alone respond to them.

Charlie O'Connor (Dublin South West, Fianna Fail)
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The Deputy will have to find another way of raising the matter, and I apologise.