Dáil debates
Tuesday, 1 July 2008
Services for People with Disabilities
10:00 pm
Michael Creed (Cork North West, Fine Gael)
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I thank the Ceann Comhairle's office for facilitating me in raising the plight of intellectually and disabled people who have finished their education in the special education school in St. Gabriel's, Bishopstown, County Cork. They have received letters from their service provider, the Brothers of Charity, indicating that there is to be no subsequent placement for them. They had expected an adult or a day-training placement. Unfortunately, no such placement has been offered.
As the Minister of State will appreciate, this is causing great consternation to the young people concerned and their parents. Such treatment might well be considered the thin end of the wedge but many more people can expect a similar outcome because of the lack of planning and foresight of the Government in preparing for the downturn in the economy and the recession we are experiencing.
If such is the case this week, I shudder to think what will happen to the most vulnerable, needy and voiceless in our society the week after the House closes, when the Cabinet will take its decision to slash and burn services. If this is a hallmark, or a foretaste, of what we can expect, then God help the most needy in society. An old political slogan from the era of Charles J. Haughey stated that health cuts hurt the old, the sick and the handicapped. Undoubtedly, that adage still applies.
I have no doubt that the Minister of State's heart is in the right place. I urge him to step out from behind his prepared script tonight and reassert the primacy of this House. This is a House, not a Government, a House that voted to ring-fence €50 million of moneys for the care of people with a disability. Who is running the country? Is it the Oireachtas, by way of its Votes and specific funds for specific purposes, or is it the Health Service Executive and its bookkeepers, who are so involved in cash management?
If it is simply a case of cash management within the HSE, then it should be remembered that the service providers — of which there are many, and voluntary organisations also — provide excellent care, sheltered employment, rehabilitation and assisted living home support, the whole range of services for people with a disability. It should not be the case that these service providers and voluntary organisations are driven to a situation where they are obliged to communicate with their clients and with the parents of these unfortunate people with a disability. They have been forced to tell parents that, as matters stand, there is no placement for their children in these organisations next September. That is entirely unacceptable. It causes trauma not only to the young people by putting an obstacle in front of them that prevents them achieving their potential, but also their parents.
At the weekend I was contacted by parents of one such person. Both parents work and it is not an option for them to leave their child unattended throughout the day at home. These are real situations involving real people. Who is in charge? If the Government and the Oireachtas votes €50 million for people with a disability, it behoves the HSE to communicate with the voluntary organisations and service providers and ensure that those funds are delivered. It is not acceptable management that these people should be treated like pawns in a political game between the Government and the HSE.
This issue was raised earlier today by my colleague, Deputy Olivia Mitchell, who spoke about one of her constituents. Each of the 166 Deputies has come across similar experiences. Who is in charge? Is it the Government, the Oireachtas or the HSE? If we vote €50 million specifically for disability purposes, these people should not be denied a placement next September.
The Minister should step out from behind his brief and prepared script and reassert the primacy of democracy in this House. He must provide for the most vulnerable people because if this is the way the Government intends to act next week, or next month, when the Oireachtas is in recess, God help the most vulnerable and voiceless ones in society. They will be the victims of Government cutbacks and of recession and that is not as it should be.
John Cregan (Limerick West, Fianna Fail)
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The Minister of State will respond to both matters together.
Kieran O'Donnell (Limerick East, Fine Gael)
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The fact that I speak tonight is a clear indication that this is a national problem. I speak specifically on behalf of the parents of young adults who attend St. Vincent's in Lisnagry, County Limerick. The service providers, the Daughters of Charity, have been forced to write to parents. Nine young adults are involved, three of them school leavers, the other six finishing a rehabilitative training course. I have a letter dated 25 June and I have no doubt that many such letters have been sent to parents of children with an intellectual disability because the service providers were not informed by the HSE that they can go ahead and recruit staff. The letter states, in part:
The Daughters of Charity have applied for funding to the Health Service Executive in order to provide the appropriate adult day service for your daughter this year. Unfortunately, funding has not been released and, as a result, the Daughters of Charity are concerned that we may not be in a position to offer new services in 2008. Therefore we cannot guarantee a service for your daughter in September. The HSE is fully aware of our inability to provide additional services without additional funding.
I put a question to the Minister for Health and Children, Deputy Mary Harney. I am glad to see that the Minister of State with responsibility for the disabilities area, Deputy John Moloney, is in the House tonight. It is appropriate that he is here and I am glad that he recognises the seriousness of the situation.
I asked the Minister to clarify that multi-annual funding for the disability sector promised in the programme for Government is to be fulfilled in 2008. I got a reply just over a month ago which stated: "The Government has fulfilled its promise in relation to the 2008 element of the multi-annual investment programme 2006-2009 by allocating additional funding of €50 million to the HSE's 2008 budget".
That is not true. The funding has not been allocated. The Government must put its money where its mouth is. I understand from my soundings that the Department of Health and Children is engaged in discussions with the HSE regarding how the €50 million will be spent. I require an explanation from the Minister of State, Deputy Moloney, who has responsibility for the disability sector. Is the Department of Health and Children using this issue as no more than an exercise in cash management? Will the Government come forward and provide the funding? The Minister of State's constituency colleague, the Taoiseach, Deputy Brian Cowen, has repeatedly said that he has a personal commitment to people with disabilities. Where is it?
In the instance I raised, concerning the Daughters of Charity at St. Vincent's in Lisnagry, three of the nine young adults left school last Friday. They have no future and do not know where they stand and neither do their parents. Furthermore, the other six young adults who will finish their rehabilitative training programme this month are in a similar situation. The Government must put its money where its mouth is. This is an appalling situation.
I understand the HSE's national disability steering group was to meet today to discuss this issue. I hope the Minister will be able to state the HSE will provide the funding. I hope he is aware of what happened at the meeting because what is occurring is absolutely disgraceful and appalling. I want to be able to tell the parents and young adults associated with the Daughters of Charity Service for Persons with Intellectual Disability, St. Vincent's, Lisnagry, that the Daughters of Charity can proceed with recruiting the staff. I refer to two care workers, one nurse and one programme supervisor. A capital allocation of €120,000 is required to enable certain of the buildings on the campus to be adapted in order to provide the adult services.
I have written to Seamus McNulty, the assistant national director who is responsible for disability services in the HSE. I expect the Minister of State, Deputy Moloney, will honour the commitment the Government made at budget time to provide the €50 million to one of the most vulnerable sectors of society. We should not have to be here tonight. The Daughters of Charity, along with many other service providers for the intellectually disabled, should be recruiting at present and should be able to tell the parents and young adults that they will be availing of proper adult day care services from 1 September. I want to hear a positive response from the Minister of State.
John Moloney (Laois-Offaly, Fianna Fail)
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I fully appreciate the comments made by both Deputies Creed and O'Donnell. I have been asked not to read my prepared script and have no difficulty doing so. I have no difficulty reiterating for the House the commitment of the Taoiseach. The commitment in the programme for Government will be honoured.
John Moloney (Laois-Offaly, Fianna Fail)
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I have only a few minutes in which to respond and want to do so.
It is false to allege the country is run by some conglomerate, such as the HSE; it is run by the Government. In referring to my script, I will deal with all the issues raised by the Deputies.
Kieran O'Donnell (Limerick East, Fine Gael)
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When will the funding be provided?
John Moloney (Laois-Offaly, Fianna Fail)
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The funding will be in place for the children in question. There has been a delay in explaining how soon it will come through. Most of the concerns raised, quite properly, by the voluntary organisations were raised because they had not heard that the funding was in place. The reality is that once we can commit ourselves to allocating the funding, the issue will be dealt with.
I am pleased to take this opportunity to address the important issues raised by Deputies Creed and O'Donnell. As they will be aware, within the health and training sector, a range of training, health and personal social day services are provided by several State agencies, including the HSE, non-statutory agencies funded by the HSE and specialist training providers funded by and behalf of FÁS, to young people with disabilities when they leave school.
On the question of training, particularly the provision of life skills training, otherwise referred to as rehabilitative training, the HSE and HSE-funded agencies provide such training services for persons with disabilities to enhance their individual skill level. The services focus on the enhancement of an individual's care, fundamental skills, life skills and social skills.
The outcome of rehabilitative training is not predetermined but is dependent on the level of the development capacity of each individual. Consequently, it is important that training services be matched to a person's need. In meeting such needs, the HSE employs guidance officers at local level to assist in the profiling of young school leavers with disabilities to appropriate training and day services. The guidance officers work with school leavers, their families, school authorities and service providers to ensure that school leavers with disabilities have access to appropriate services.
The co-ordination and planning of services to meet the needs of people with disabilities form a central tenet of the national disability strategy. A critical element of such co-ordination and planning is the requirement to provide financial support for the development and implementation of services.
On funding requirements for service development for HSE-funded services, the Government has set aside specific funds for service delivery for people with disabilities under the multi-annual investment programme. Significant additional funding has already been provided and has been spent on developing new and enhanced health and personal social services for people with a disability, including young people leaving school in the period 2006 to 2007. These areas will continue to be the focus of developments for the remaining years of the multi-annual investment programme, 2008 and 2009.
The Government provided the HSE with an additional €75 million in both 2006 and 2007. This funding resulted in an additional 506 day places and 492 day places in 2006 and 2007, respectively.
John Moloney (Laois-Offaly, Fianna Fail)
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I am coming to the point.
John Cregan (Limerick West, Fianna Fail)
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The Deputies should allow the Minister of State to continue.
John Moloney (Laois-Offaly, Fianna Fail)
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I entered the House to be totally up-front with my colleagues. I take responsibility for my portfolio and, since the subject in question is clearly my area of responsibility, I will deal with it.
Michael Creed (Cork North West, Fine Gael)
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Is the €50 million guaranteed?
John Moloney (Laois-Offaly, Fianna Fail)
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The Deputy will hear about that in a few minutes. I would like to have ten minutes in which to respond. I have listened to both Deputies Creed and O'Donnell, who were allowed five minutes each. They asked me to be accountable and I entered the House to be accountable.
Michael Creed (Cork North West, Fine Gael)
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I do not see a reference to €50 million anywhere in the Minister of State's script.
John Moloney (Laois-Offaly, Fianna Fail)
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If the Deputy listens, he might hear such a reference.
John Moloney (Laois-Offaly, Fianna Fail)
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An Adjournment matter was selected and I came to the House to answer questions, yet I cannot get the opportunity to speak.
John Cregan (Limerick West, Fianna Fail)
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Allow the Minister of State to continue without interruption.
John Moloney (Laois-Offaly, Fianna Fail)
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Day services were enhanced through the provision of additional supports to deal with school leavers or other adults with significant disabilities. The supports include 52 places in 2006 and 66 places in 2007.
The increase in services in recent years has ensured that young people with intellectual disabilities and autism have appropriate services in place to ensure a smooth transition from secondary school. This is what we are tying to achieve this evening. In some cases, the funding provided supported school leavers to access appropriate day services in line with a person-centred plan. In many cases, this funding provided places for individuals completing rehabilitative training, thereby creating training places for other school leavers. The HSE and HSE-funded agencies also provide a range of other day services, designed to meet the needs of adults with disabilities.
The multi-annual investment programme for disability services makes provision for the development of additional day, residential and respite places each year between 2006 and 2009 for people with intellectual disability and autism. The €50 million to which the Deputy keeps referring was provided to the HSE in budget 2008 for additional services to people with disabilities, including 467 additional day places for people with intellectual disabilities. As the Deputies will be aware, the commencement of the planned developments in disability services this year was delayed due to a financial review in the HSE. This did not just concern the disability sector but pertained to the whole spectrum of health services.
I am more than pleased to inform the House that the HSE has assured me, following discussions all week, that it is now in a position to roll out the planned developments, as outlined in its 2008 service plan. It is not a case of the Government alone taking credit as all Deputies are involved in their capacity as representatives of people with disabilities. It was agreed that nobody would want to see the disability sector short-changed or funding reduced.
Kieran O'Donnell (Limerick East, Fine Gael)
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Will the HSE be writing to the service providers?
John Moloney (Laois-Offaly, Fianna Fail)
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I have asked that it do exactly that.
Kieran O'Donnell (Limerick East, Fine Gael)
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Will it be tomorrow?
John Cregan (Limerick West, Fianna Fail)
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Allow the Minister of State to continue without interruption.
John Moloney (Laois-Offaly, Fianna Fail)
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I want to respond and recognise the seriousness of the case. On the real issue, which concerns people entering new services, I am saying those services will be guaranteed.
Kieran O'Donnell (Limerick East, Fine Gael)
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Is the Minister of State guaranteeing that personally?
John Moloney (Laois-Offaly, Fianna Fail)
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I am giving that personal commitment.
Kieran O'Donnell (Limerick East, Fine Gael)
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Is he guaranteeing the services will be provided?
John Moloney (Laois-Offaly, Fianna Fail)
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There is not much point in my keeping my views to myself and it is up to the HSE to let people know the position. I would not be in a position to write to or ring everybody.
Michael Creed (Cork North West, Fine Gael)
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The Minister of State——
John Cregan (Limerick West, Fianna Fail)
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Allow the Minister of State to finish.
Kieran O'Donnell (Limerick East, Fine Gael)
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The Minister of State is missing the key point.
John Moloney (Laois-Offaly, Fianna Fail)
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I am making the key point that the positions outlined in the service plan for 2008 are now secured and, quite clearly, the HSE will be making a public announcement on that. It issued a press release this evening announcing the funding.
Michael Creed (Cork North West, Fine Gael)
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It is a disgrace that it put the people——
John Cregan (Limerick West, Fianna Fail)
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I will suspend the sitting if Members do not co-operate. Allow the Minister of State to finish his script.
John Moloney (Laois-Offaly, Fianna Fail)
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I do not believe for a moment that the disability sector was ever under threat.
Kieran O'Donnell (Limerick East, Fine Gael)
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What about the letters?
John Moloney (Laois-Offaly, Fianna Fail)
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Letters were issued, quite rightly, by the voluntary organisations to warn people. Can I finish my script?
Kieran O'Donnell (Limerick East, Fine Gael)
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Does the Minister of State understand the difficulty and the worry this has caused?
John Cregan (Limerick West, Fianna Fail)
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The Minister of State should continue.
John Moloney (Laois-Offaly, Fianna Fail)
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I certainly do and I share the Deputy's concern. Developments will include new day places for young people leaving school and additional therapy supports for preschool children and for children with autism. It also is important to point this out. I also understand the Health Service Executive will be able to finalise the position in respect of the commencement of the developments, including those required to meet the needs of school leavers with disabilities, over the next ten days. I suggest this should be a sufficiently strong commitment to be able to assure the Deputy and all concerned.
John Moloney (Laois-Offaly, Fianna Fail)
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Within ten days, the HSE will be in a position to do this. I understand the Deputies' specific questions regarding adult day training for students at St Gabriel's, Cork, and St. Vincent's, Lisnagry, are being considered by HSE in the context of its funding priorities for 2008.
I also wish to inform the House of some developments in areas related to the issues raised by Deputies Creed and O'Donnell. As for services for adults with a disability, the HSE is in the process of undertaking a comprehensive national review of HSE-funded adult day services. This review will seek to advise on the reconfiguration and modernisation of existing adult day services to reflect the core principles of the health strategy, namely, access, quality, accountability and person centredness. The review includes, as part of its work, examining and reviewing the range of day services such as activation, rehabilitative training and sheltered work.
To date the strategic review of HSE-funded adult day services has consulted widely with service users, families and service providers and is about to engage in discussions with all parties to the sectoral plans, including the Departments of Enterprise, Trade and Employment and Social and Family Affairs. A census of HSE-funded adult day services has been completed and the findings will help inform decision making in this process.
As a further significant development in support of the national disability strategy, the Office for Disability and Mental Health was established by the Government in January this year. The office brings together responsibility for different policy areas and a range of services which have an impact on the lives of people with a disability and people with mental health difficulties. The main focus of the office is to improve co-ordination and communication across Departments and agencies in the delivery of disability and mental health services.
I have been appointed Minister of State with responsibility for equality, disability and mental health and my objective is to move the disability agenda to a level which compares with the best in the world. We should do so in partnership with all stakeholders.
I agree the difficulty may have been due to the delayed announcement. However, I emphasise that people should be there to guarantee that whatever funding is allocated to the disability sector will remain intact.