Jan O'Sullivan (Limerick East, Labour)
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Question 37: To ask the Minister for Health and Children if she will address the funding shortfall of the Brothers of Charity Services in Limerick which has led to the loss of respite services for 63 families and to the reduction in residential services for other clients; if her attention has been drawn to the fact that every possible saving has been made in order to avoid this loss of service but that it has been unavoidable due to a cut in funding of more than €1 million for 2010; and if she will make a statement on the matter. [26065/10]

Barry Andrews (Dún Laoghaire, Fianna Fail)
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The Government's commitment in the area of disability is consistent. Significant additional resources have been provided for services and supports in this area under the multi-annual investment programme 2006 – 2009, as part of the national disability strategy. Overall, approximately €1.6 billion is spent annually by the health services on disability programmes, including residential, day care, respite, assessments and rehabilitation services.

I am aware of the valuable contribution the Brothers of Charity services make to the provision of services to people with intellectual disabilities in Limerick. During the period 2005-08, the Brothers of Charity services nationally received more than €631 million in funding from the HSE. In 2009, approximately €177 million was provided to fund these services. This sustained level of investment reflects the significant growth and development in the services provided by the Brothers of Charity during the past five years.

Arising from the introduction of cost containment and efficiency measures in the 2010 budget, the HSE advised all agencies providing services on its behalf of their financial allocations for 2010 and the required adjustments. The HSE is aware of the challenges which this reduction in allocations will present to organisations to ensure they meet the needs of service users and in planning for emergencies that arise throughout the year. In this context, it is vital that all providers work creatively and co-operatively to ensure the maximum level of services are maintained within the funding resources available.

The HSE plans to maintain access to appropriate treatments and services for clients during 2010 despite current resource pressures. The HSE is very much aware of the importance of respite service provision for the families of both children and adults with disabilities, including the impact the absence of respite service provision can have on other services, for example, residential and day care services. Respite services throughout the country are being reviewed on an ongoing basis and the majority of local health offices have reported that services are being maintained, albeit with some difficulty. In all areas, disability managers are working closely with agencies to ensure those with the most urgent needs are prioritised. There has been a continued expansion in the availability of residential support services, especially planned or emergency centre-based respite services, which have grown substantially. A total of 4,599 people availed of this type of service in 2008, allowing them to continue living with their families and in their communities. Additional information not given on the floor of the House.

The HSE is working in partnership with the voluntary service providers to deal with issues that arise from funding allocations, to ensure the needs of service users are prioritised and addressed and that frontline delivery is given priority. Disability service providers, including those in the Limerick area, have been asked to submit their plans for the maintenance of service levels within available resources and to discuss with HSE management how current challenges can be addressed. As part of this process, the Brothers of Charity services have prepared a detailed document for discussion with HSE personnel at local level. In response to the Brothers of Charity proposal to close one respite service on 14 June, which is affecting 19 service users, local discussions are taking place regarding the implications of this for users of its respite service and the HSE is endeavouring to ensure an alternative service will be made available.

The HSE is aware of the pressures the Brothers of Charity services are experiencing in maintaining existing service levels and responding to the respite needs of service users. While significant changes have been applied to frontline services, in many cases these changes have not necessarily resulted in service reduction but in a different model of service delivery being applied.

The HSE will continue to work in partnership with the Brothers of Charity in dealing with issues that arise from service cuts, to ensure the needs of service users are prioritised and addressed. However, any planned reductions must be risk assessed and risk managed by the Brothers of Charity. There are also plans to develop a local forum in Limerick of all service providers, both physical and sensory and intellectual disability, with a focus on the needs of service users now and in the future.

Jan O'Sullivan (Limerick East, Labour)
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The Minister of State has given a very general answer to a very specific question. I raise this question on behalf of the 63 families in the mid west who look after their intellectually disabled loved ones at home and who now have nowhere to put them. For example, I speak on behalf of a woman who is looking after her brother. Her parents are dead and she has no other brothers or sisters. She has nowhere to go. Another woman is concerned about going into hospital and reckons she will have to bring her adult son, who is over 40 years of age, with her to hospital.

I will not be satisfied until I get a direct answer to the question of when the respite centre in Clonisle, Limerick, will be re-opened. I seek a very simple answer to a very simple question. The amount of money involved is €157,000. It is not a large sum of money but it must be found for this purpose this week.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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I did not get to the end of the answer. More specifics are available. Disability service providers, including those in the Limerick area, have been asked to submit their plans for the maintenance of service levels within available resources. As part of this process, the Brothers of Charity services have prepared a detailed document for discussion with HSE personnel at local level. In response to the proposal to close one respite service on 14 June, which affects 19 service users, local discussions are taking place regarding the implications of this for users of its respite service and the HSE is endeavouring to ensure an alternative service will be made available.

Jan O'Sullivan (Limerick East, Labour)
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I am not satisfied with discussions and talks. We need action. It is not possible to leave families who look after their loves ones at home and who save the State a fortune by not putting them into residential care with no respite whatsoever. Talks are no good. They may solve other problems. There is a shortfall of €1 million in terms of what the Brothers of Charity received this year and other services are threatened. However, my question refers specifically to the opening of the respite house. I demand that the Government finds the €157,000 necessary to keep the house open. Otherwise, they are leaving dependent families, who have nowhere else to go, with an adult intellectually disabled person who may have to attend hospital with them. That is not good enough. Normally, I do not get as angry as I am today when I put questions in the Chamber. However, I am very angry on behalf of those families and parents.

I do not care whether the HSE is in talks with the Brothers of Charity or with the Department of Health and Children. I call for someone to represent the interests of the families affected. It is not enough to simply hold ongoing talks. We need a direct answer. When will the institution open such that the families concerned may sleep in their beds at night?

Barry Andrews (Dún Laoghaire, Fianna Fail)
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The position is that discussions are ongoing. No one disputes the value of respite services to families under extreme pressure and who have children or older adults with intellectual disabilities. No one disputes the value of the service the Brothers of Charity provides in this area. Solutions must be found. I agree with the Deputy and there is no dispute in this regard. This is the purpose of the discussions. While I understand the level of anger expressed by the Deputy and that the issue has a particular significance in her area, unfortunately, in this area, the HSE is seeking ways to solve the issue.

Reference has been made to a demography fund. An additional €19.5 million is being provided nationally for service throughout the country. Part of the ongoing discussions refer to that fund. It is a national fund but it refers to an additional 24 respite places in the HSE west area. I assure the Deputy that she will be updated with the outcome of those discussions.

Jan O'Sullivan (Limerick East, Labour)
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I express my disappointment that the Minister of State directly responsible, Deputy Moloney, is not here. The Minister of State, Deputy Barry Andrews, is not responsible. I would have thought that since the Minister of State, Deputy Moloney, is not here, the Minister for Health and Children would have answered the question because these families cannot be left in the lurch with no answer from either the senior Minister or the Minister of State responsible.

Brendan Howlin (Wexford, Labour)
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As the Deputy knows, the Government is collectively responsible and any Minister can speak on behalf of the Government.

Jan O'Sullivan (Limerick East, Labour)
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Since the Minister of State is not here for whatever reason, I would have expected the senior Minister to have answered the question. I will ask the senior Minister to address this issue as a matter of urgency today.