Maureen O'Sullivan (Dublin Central, Independent)
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64. To ask the Minister for Health to address serious concerns regarding intellectual disability care given successive cuts to funding, staff and available care, given that an ageing population is impacting on intellectual disability care and that carers, such as parents, are often elderly and given the need for care for such persons. [3941/16]

Maureen O'Sullivan (Dublin Central, Independent)
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My question relates to cuts to both staff and services in the intellectual disability area. As we have an ageing population, it is impacting more severely on intellectual disability care. Where are we going with this?

Kathleen Lynch (Cork North Central, Labour)
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The Government values the role which people with disabilities play in Irish society. I believe they are playing a far greater role now, which is a significant change. The Government also values those who support and care for them and is committed to facilitating the full inclusion of people with disabilities in the life of the community through access to individualised personal social supports and services. The vital role performed by carers is acknowledged in the national carers’ strategy, published in 2012, which sets the strategic direction for the policies, services and supports provided across the public sector for family carers.

This year the Government will provide €1.56 billion for health-funded services and supports to enable all individuals with a disability to achieve their full potential and maximise their independence. The quantum of services to be provided, together with key deliverables and priorities, are outlined in the HSE’s national service plan for 2016. The HSE is committed to protecting front-line services for people with disabilities and at a minimum maintaining the overall level of service provided in 2015 with targeted improvement in priority areas.

The Deputy will be happy to know that these areas include: the reconfiguration of children's therapy services, for which an additional €4 million has been provided; the provision of services for 1,500 young people on leaving school and rehabilitative training, which has been allocated an additional €7.25 million; the development of alternative respite models, with €1 million targeted in this area; the reconfiguration of residential services, supported by €20 million in capital funding; and quality improvements to increase compliance with national standards for residential centres for children and adults with disabilities. As the Deputy is well aware, this is now being inspected by HIQA, which, I know, she also welcomes.

Maureen O'Sullivan (Dublin Central, Independent)
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Like everybody else, I would welcome the increase in funding the Minister of State has mentioned.

That is all very well on paper but, in the same way we are told about all this extra funding for housing, we are not seeing it in reality. The reality for people with an intellectual disability is that there are problems with their respite grants, along with a lack of respite places. Since 2008, before this Government entered office, the budget for this area has decreased by almost €160 million but demands are increasing while staff numbers have fallen by 15%. There is an issue in the context of having enough intellectual disability nurses because it is a specialised area. However, what has been happening is that agency staff are who do not have extra training in dealing with people with intellectual disabilities are being employed.

Another issue I have raised here before concerns our accident and emergency departments and how we need to look at them in a different way. It cannot be the free-for-all whereby everybody presents at these facilities. Those with addiction issues who present at accident and emergency need access to specialised services, while those with intellectual disabilities who present need to be treated in special areas. We need nurses who are trained to deal with people with intellectual disabilities to work in accident and emergency departments.

I hope the funding to which the Minister of State referred , particularly that relating to respite services and places for aging parents, will become a reality.

Kathleen Lynch (Cork North Central, Labour)
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There is very seldom an issue on which Deputy Maureen O'Sullivan and I disagree. However, we cannot have separate accident and emergency departments for people with disabilities, for those who are older or for all the different conditions because that would be unrealistic. The Deputy and I know that it would be unaffordable and foolish to promise it. I completely accept, however, that within an accident and emergency department or emergency department there must be somebody with specific knowledge of particular areas, such as, for example, what we are doing in respect of suicide awareness. We should have that for older people and those with disabilities, be they physical or intellectual.

The problem with disabilities is that one is either going to do it or one is not. If one does not take action, the matter is quickly brought to one's attention. In the context of residential services, we are dealing with 9,000 people. Some 22,000 people have access to day services, 35,000 day-only respite sessions have been provided and 180,000 overnights have been granted with regard to respite residential support. In addition, some 1.3 million personal assistance hours have been provided, 2.6 million hours have been provided in the area of home supports and, as pointed out in reply to a question on this matter on a previous occasion, 160 people were moved out of institutions in the past year. It is a slow process about which we need to be careful.

Maureen O'Sullivan (Dublin Central, Independent)
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I want to highlight the example of a grandmother I met recently. There are many issues with addiction in the Dublin Central constituency. This grandmother, like so many others, took on the care of five grandchildren because their mother was an addict. They are all adults now but the youngest is 18, has Down’s syndrome and is autistic. The grandmother is waiting to go into hospital for various operations but she has the worry of what will happen to her 18 year old grandchild. While St. Michael's House provides a fantastic service, it cannot give her any guarantees. This young lad, let us call him John, loves St. Michael's House. He is challenged and stimulated there, his friends are there and he is really well looked after. He is 18 but will be out next summer, like so many others who are 18 years of age. Will the Minister of State guarantee that out of this funding a follow-up service will be provided? Young people with Down’s syndrome, autism and so forth need access to some form of service when they reach 18 years of age. I have met others in similar circumstances involved in activities which are not stimulating them and from which they are not getting any benefit. We owe them so much. They can also give so much as well. We know people with intellectual disabilities who are great members of society and who give so much. I am seeking a guarantee for those with the conditions to which I refer who are over 18 years of age in order that they and their families will not be subjected to the type of stress they have experienced up to now.

Kathleen Lynch (Cork North Central, Labour)
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For many years when I was on the Opposition benches, every June and July there were protests outside the gate in respect of people with intellectual disabilities who were about to leave second level or rehabilitative training and who had nowhere to go. Deputies Kelleher and Ó Caoláin will remember this too. There was always a crisis. What we have done since I came took up my position is ensure that such crises do not arise. We have put aside almost €8 million this year for the 1,700 people who will be coming out of that section. We have done that every year since I came into this post.

On the young man in question, John, if I could guarantee things, I would guarantee everything. However, that is not realistic. There are other methods and we are doing things differently.

St. Michael's House has been very adventurous in the type of things it has allowed the people in its care to do, and it is the one group with which I am always impressed when I present certificates in terms of new action to be taken by the people themselves. There are other ways of doing things but I fully accept that this grandmother must have additional concerns over and above what one would have regarding an 18 year old in those circumstances.