Seán Kyne (Galway West, Fine Gael)
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I thank the Office of the Ceann Comhairle for selecting this issue for discussion. I also welcome the Minister of State, Deputy Lynch, to the House. I was here this time last year raising a similar issue and thankfully the difficulties were addressed for the parents and children in question. Unfortunately, we are back again this year with new parents and new children facing the same concerns. I acknowledge that under the HSE national service plan 2013, €4 million was made available to meet the needs of those leaving school and of rehabilitative training, which is welcome. However, according to information I have received, that sum will not be enough.

HSE west has been allocated €932,000 of the €4 million. In Galway, the allocation is €210,000 but an additional €600,000 will be needed to deal with the number of children coming on stream this year. There are about 80 children in Galway, 46 of whom will need additional resources and of these, the Brothers of Charity have 19. The Brothers have endured five years of cuts and rationalisation. They have eaten into their own reserves and have been very prudent in recent years. Those reserves are now gone. At this stage they have stated that they will not be able to take in any new service users and if they do, it will be at the expense of services to existing users. This is not acceptable. There are safety concerns involved too as the Brothers feel it would not be safe to take in additional children. It is also worth noting that this is the first year that children in the Ábalta special school in Galway will be coming on stream. Many of these children have high-level needs and some have a requirement for 24/7 care. Will new resources be made available, in addition to the €4 million that has already been allocated, to ensure that these children and their parents have peace of mind and to ensure there will be services available to them in September?

Seán Crowe (Dublin South West, Sinn Fein)
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I wish to draw the attention of the Minister of State to a very severe, extreme and unusual case of a family in crisis. The case centres on a young man with severe autism. His mother has cancer and two of his siblings have special needs. The difficulty is that there is a mandatory court order relating to this case which expires on 28 June. This is an emergency situation. The family is clearly in crisis and is seeking support. I am hoping the Minister of State has something in her file to indicate that they will get the support they need. I want reassurances that a plan will be put in place for this young man. He weighs 18 stone and is 6 ft. 3 in tall. He has enormous difficulties. In other circumstances, he would probably be in a residential setting but his family does not want that. They want to keep him at home but considerable resources are needed to do this. The circumstances are unusual and we must give as much support to the family as possible. The young lad was allowed to stay in school for an extra year and the family have asked if the setting could be the same.

Aside from this specific case, we need to think in terms of a transitional period for children like this, particularly those with severe autism. We need to develop transitional services so that the move from school is not so abrupt for these children. I hope that this case might trigger changes within the Department in this context.

Jonathan O'Brien (Cork North Central, Sinn Fein)
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The Minister of State knows as well as I do that there is a problem regarding the transition of students with special needs from school. We have both attended meetings where there has been criticism of the transfer of students from primary to post-primary, where the process of integration must be started all over again. We are also both aware of the fact that the HSE is completely reconfiguring the provision of some of its services and this is affecting children from special schools. I know I am speaking to someone who knows more about this than most and the Minister for State has spoken many times about the importance of the mapping of services. I am critical of the Department of Education and Skills because it is not working cohesively with the Department of Health when it comes to children with special needs and the provision of services for them. There seems to be a breakdown in communication. I would be interested to know how much communication is taking place between both Departments. It is critical in dealing with children with special needs, particularly those with autism, that a continuation of services is maintained. Such children really need a sense of continuity in terms of the provision of services. I ask that both Departments would put more emphasis on ensuring that dialogue and communication in this regard is ongoing.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputies for the manner in which they have raised this issue. They have made rational, reasonable arguments, which I appreciate. I take on board what Deputy Crowe has said about a family that is clearly in distress. They are anxious not only about their own future, but also that of their son. Too often it is the case that people's anxieties are not taken into account.

I am pleased to take this opportunity to outline, on behalf of the Minister for Health, the position regarding the matter raised by the Deputies. I should say at the outset that the Government does not comment on individual cases - I am sure Deputy Crowe was expecting that - but our policy is to enable young people with disabilities to live independent lives to the greatest extent possible. I recognise the importance of life-skills training and day services to people with disabilities who are leaving the education system and every effort is being made, within available resources, to provide services to all 2013 school leavers.

Day services for adults with disabilities provide a network of support for over 25,000 people who have a wide spectrum of need, ranging from those with severe and profound disabilities who may need long-term specialist service provision, to people with lower support needs and greater potential for community participation and inclusion. The HSE, through its occupational guidance service, works with schools, service providers, service users and families to identify the needs of young people with disabilities who are due to complete their second level education. The aim is to address the needs of individuals in the following ways: through health-funded rehabilitative or life skills training, health-funded day services, FÁS-funded vocational training or an extension to education placement for a specified time.

Service providers and the HSE are working closely together to identify how the needs of those individuals who require day services or training places in 2013 can be responded to within available resources.

I have asked to be kept informed of progress on a weekly basis.

The demand for services for school leavers continues to grow. The HSE expects that more than 700 school leavers require new day services or life-skills training in 2013. Although the 2013 allocation for disability services has been reduced by 1.2%, the HSE's national service plan includes an additional €4 million to provide appropriate services for school leavers and rehabilitative training graduates in 2013. This funding is being allocated to each HSE region based on its percentage of population. Even with the additional funding, the provision of the required level of new services will be challenging in the context of the overall budgetary position and the moratorium on staff recruitment. In addition, the physical capacity to provide further services may not be present in all agencies and we are very conscious of this. While the HSE makes every effort to provide day services or training places to school leavers with special needs, this has always been dependant on the availability and location of appropriate places coupled with the needs of the individual school leaver. However, the voluntary sector and the HSE are committed to the best use of available resources in a creative and flexible manner, so as to be as responsive as possible to the needs of this cohort.

In respect of the particular young person referred to by the Deputies, I am informed the HSE is working with the local service provider to assess how the needs of this young man may be best accommodated. I understand he will require an extensive support package and a proposal has been made by the service provider to the HSE for consideration. This proposal, which is costed at €117,000 per year, will be considered in the overall context of the individual's needs and the needs of other school leavers in the area. No decision has yet been made in this regard but the HSE has assured me a day service will be provided for the young man in question in September with the location and type of service yet to be agreed.

We will always have this issue year in year out but we are determined it will not come about as a result of crisis every year. We should know how many people will leave every year and what are their needs and we should be planning on a year by year basis. It will not always be the same type of service. Some day when we have a little more time perhaps I will speak to the Deputies about what Genio did last year to find places which are different, more community-based and more inclusive. These did not suit everyone but they suited 79 people. This is the type of thinking we need to bring about including, as Deputy O'Brien rightly stated, the whole of Government approach we also need to bring to all of this.

Seán Kyne (Galway West, Fine Gael)
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I thank the Minister of State for her response and I appreciate the ongoing work taking place on this issue and the work Genio has done for many years. The additional €4 million provided under the HSE service plan is welcome but it is not adequate. I appreciate the Minister of State and the HSE are liaising and negotiating with service providers but they need to ensure at this stage they will have services for the children. Yesterday the parent of a child with autism stated it is crucial for the child to have a transition period for any new placement well in advance of September. As of now there is nowhere to transition to because of a lack of planning and insufficient funding for school leavers with special needs. I appreciate the Minister of State said this will be an issue every year, but the parents acknowledge the HSE knows the numbers involved every year and as we are now in the middle of June they are concerned they still have this level of uncertainty. Will the Minister of State through the HSE and the service providers continue to do everything to ensure these children have a placement in September?

Seán Crowe (Dublin South West, Sinn Fein)
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In the case we are discussing the child received an extra year and it was known this would happen a year ago. I understand a care plan was being worked out at Christmas. The difficulty with this is the cost involved. Many children with extreme autism or extreme needs are in a residential setting. In some cases four nurses and four carers may be involved. The family believes it is blessed and not cursed. Many people listening to this at home will wonder how the family copes. There is a responsibility on us as public representatives to support such families. His mother wants to keep him in the home. His medical prognosis for the future is not good because of the medication. I have never seen such medication as I did in a press in this house. The woman in question has three children with severe needs. Her husband is not well and clearly she is not well either. She will have an operation shortly for her cancer. We are speaking about a very unusual case. I hope this care package will become operative and the family will be supported.

Jonathan O'Brien (Cork North Central, Sinn Fein)
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Leaving aside funding and budgets there are other issues on which we can be pro-active and the Minister of State touched on one. We need to plan further in advance. We know how many school leavers we will have and in what area of the State they live. We know what type of services are available. We need to put more emphasis on long-term planning. I urge the Department, the HSE and the Department of Education and Skills to ensure this happens. If it does not happen we will continually deal with crisis after crisis and nobody wants to see this. I do not believe any Deputy wants to see this year after year. Will the Minister of State take this on board and see whether there are ways we can improve how we plan for school leavers?

Kathleen Lynch (Cork North Central, Labour)
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The €4 million is in the context of the economic situation in which we find ourselves and the enormous budget we spend on disability. As Deputy O'Brien rightly stated, it is about pulling it all together and genuinely taking a serious look at how we bring all of it together under one roof. We would definitely have better outcomes as a result. It is not about saving money, it is about getting a better outcome.

With regard to the budget, I managed to secure a cut of only 1.2% when everything else was being cut by 4% or 5%. We discussed this at length with those who operate in the disability sector and they have been doing a tremendous job in recent years under difficult circumstances. They told me if we could manage to keep the overall cut low they could manage much of what needs to be done, but this can only continue for a certain length of time. As I stated in my reply, even if we had €10 million to spend this year on school leavers, which we do not, I am not certain there is capacity in the organisations themselves to take on all of these people. We need to take a serious look at this. In response to Deputy O'Brien, we have managed to map all of what is available and this is a significant first step in how we reconfigure the service, but the service does need to be reconfigured.