Dáil debates

Thursday, 11 February 2010

Priority Questions

Services for People with Disabilities.

4:00 pm

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
Link to this: Individually | In context

Question 5: To ask the Minister for Health and Children the action she will take to ensure the Health Service Executive engages in discussions with an organisation (details supplied) to provide the estimated €1,970,000 per annum additional financing required to enable the expansion of its home care services for severely disabled children to children under the age of six years; her views on the fact that such an extension of services offers significant cost reductions to the State and also the uniform delivery of better services for severely disabled children and their parents; her further views on the conclusions of the report entitled, There's No Place Like Home - A Cost and Outcomes Analysis of Alternative Models of Care for Young Children with Severe Disabilities in Ireland, published on 3 February 2010. [7125/10]

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

The HSE provided funding of €585,000 to the Jack and Jill Children's Foundation in 2009 and will be happy to consider the report "There's no Place like Home" as part of its engagement with the foundation this year. Neither my Department nor the HSE was involved in the preparation of this report. I agree that, in general, children's needs are most appropriately met and provided in the home, and that we need to ensure more efficient use of resources. However, many children availing of services provided by the Jack and Jill Children's Foundation also avail of other disability services and the report did not compare the respective costs of the home-based care provided by the foundation to the cost of similar services provided by the HSE.

The current economic and budgetary position means we can only continue to fund new services by reducing costs and greater efficiency, including achieving greater integration of services provided by the statutory and non-statutory sectors. I should mention in this context that my Department is undertaking a review of the efficiency and effectiveness of the health and personal services provided to people with disabilities. This review is part of the Government's value for money and policy review programme. The review will focus, in particular, on the scope for achieving greater efficiency and effectiveness from the substantial resources expended on services for people with disabilities and will support the future planning and development of such services. I can assure the Deputy that the issues raised in the Jack and Jill Children's Foundation report will be considered as part of that review.

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
Link to this: Individually | In context

Will the Minister of State acknowledge that it was not possible for the report to consider any home-care services provided by the HSE and the costing of those services with the Jack and Jill Children's Foundation services because the information is simply not available? There is a lack of uniformity across the country in the services available for severely intellectually disabled children. Would the Minister of State agree that the Jack and Jill Children's Foundation catering for 1,200 families with severe intellectual disability since 1997 has done extraordinary work? Would he accept that in the context of the provision of care for such children the annual average cost to deliver acute hospital care for a severely disabled child is €147,365 compared to the average cost of €16,427 per annum for the child to have home care by the Jack and Jill Children's Foundation?

Would the Minister of State acknowledge that it is desirable that the services provided by Jack and Jill Children's Foundation be extended to children between the ages of four and six as many of the State and HSE-provided services do not kick in until a child is six? It would require an additional grant of €1,970,000 per annum to the Jack and Jill Children's Foundation to ensure that a universal service is available to all families with a severely disabled child so that the child could be provided with home care uniformly across the country. Would the Minister of State not merely encourage, but specifically ask the person in charge of these services in the HSE - it is not always clear who that is - to sit down with representatives of the Jack and Jill Children's Foundation to work out how to most efficiently and cost-effectively provide the essential services needed for all children under six with severe intellectual disability?

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

The Deputy has asked a number of questions. There is no dispute over the figure of €143,000 as compared to the cost of care provided by the Jack and Jill Children's Foundation. I acknowledge the value of care provided by the Jack and Jill Children's Foundation. I dispute the Deputy's contention about availability of comparative information. That information is available.

Naturally, when we consider the €1.6 billion that is now provided to support people with disabilities, that is the main frame for the review. I do not want to use the review in the context of a money saving exercise - it is far from that. It is an attempt to ensure that the €1.6 billion that is being provided provides the maximum level of care. The review is not all about value for money or savings. It is also about policy. It is very important in the context of what the Deputy just said and in particular by the way of the services being provided by the Jack and Jill Children's Foundation that we also look at the proposal by way of direct payment to families and clearly this is part of the policy review.

I must accept the point the Deputy makes that in comparison to the cost to the State of the care provided by the Jack and Jill Children's Foundation, the jury is certainly in on that one - the value is far greater. The review proposals are not long term - they will be with the Department by June. In the meantime, I intend, with the departmental officials, to meet not just representatives of the Jack and Jill Children's Foundation, but also many other providers to ensure they are involved in the review.

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
Link to this: Individually | In context

I very much welcome that the Minister of State will meet representatives of the Jack and Jill Children's Foundation. That would be a major step forward. I understand that while the Jack and Jill Children's Foundation on occasions works in co-operation with different sections in the HSE, its representatives have found it impossible to identify a person in charge who will sit down and talk to them about the national service it provides. I ask the Minister of State to communicate with me as to who they should contact in that regard and to encourage the HSE to engage in such discussions.

Does the Minister of State have the figure for the cost being incurred on an annualised basis by the HSE service to assist the parents of severely intellectually disabled children who are providing home care to them? I ask him to make the comparator public. What is needed is a coherent uniform service delivered by the most cost effective and well staffed service provider. The Jack and Jill Children's Foundation has an extraordinary imprimatur from all families to whom it provides assistance. I ask the Minister of State to consider a policy direction to the HSE to provide this service through the Jack and Jill Children's Foundation and to extend it to children aged between four and six.

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

I take precisely the advice the Deputy is giving. I have already initiated those policy decisions under a number of headings. I have no difficulty meeting the HSE and providing publicly the comparator figures. I insisted that two people from the disability sector - one from the intellectual disability sector and one from the physical disability sector - should be on the review committee examining the funding for disabilities to ensure that everything the Deputy is saying would be put in place.

I agree with the Deputy that probably owing to the changeover from the old health board system to the HSE there has been certain confusion as to who is the lead in disabilities in each area. I do not use the review in the context of a long-fingered approach. I am talking about having the review completed and report published by mid-June. That part will bring total clarity to those in charge in each specific local health area.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

That concludes Priority Questions.

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
Link to this: Individually | In context

Even the Minister of State does not know who is in charge.

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

I do not want to reduce it to that level of common-----

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

Go raibh maith agat, a Aire Stáit.

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

Let me just say-----

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

Go raibh maith agat, a Aire Stáit.