Dáil debates

Tuesday, 4 October 2016

Topical Issue Debate

Services for People with Disabilities

5:55 pm

Photo of Martin FerrisMartin Ferris (Kerry, Sinn Fein)
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On Saturday, I visited St. Mary of the Angels along with Councillor Damian Quigg. We met the residents and staff there. Currently, there are 76 residents in St. Mary of the Angels and 16 residents are affected as they are housed in two places, the St. Brendan and St. Fidelis units, which hold nine and seven residents, respectively. This is a response to a HIQA report and St. John of God services being non-compliant with two living conditions elements. Apparently, the St. John of God service position is that there should be consultation and agreement with the HSE to set up a national task force to progress decongregation, with St. Mary of the Angels as a national pilot site. St. Fidelis is top priority and the plan was drawn up in agreement with the HSE.

This has caused consternation with some of the residents and their families. Some of the parents have already been contacted by St. Mary of the Angels about a proposed move for their children to various sites in communities around Kerry. Some have been told that the names of their sons and daughters are on the list for council houses. None of the parents would disagree with allowing residents not totally dependent on others leaving if they could move into the community. That is a given. Many of the residents have been there a long time and some have been there for as many as 29 years. It is their home away from home and they are used to the service. It is an excellent service and I would like the Minister of State to visit and see it for himself if he had the opportunity.

The service includes a general practitioner who visits the centre each week and an out-of-hours GP service. There are regular medical assessments, on-site services, allied health specialist services and speech and language and occupational therapy. There is also massage, music therapy and physiotherapy, along with a hydrotherapy pool, special sensory rooms and heated water beds. It is a fantastic service for Kerry and beyond. I hope what we are hearing is not true. With a bit of investment from the Government for the St. Fidelis and St. Brendan centres, we could resolve the issue.

Photo of Danny Healy-RaeDanny Healy-Rae (Kerry, Independent)
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I thank the Minister of State for taking this very important matter. I ask him to reverse the decision being made by the HSE and St. John of God services. Not only are they talking about moving 17 people out of these wards, they are also talking about closing down the entire facility. We are told this is a HSE national policy that was ordained in 2011. One size does not fit all and I am sorry but many of these people are not fit to live on their own. I saw that for myself on Friday last. We would all be delighted if some of those at the facilities could make in the outside world but it is my firm belief - and that of many of hose involved - that this is only an attempt by the HSE to throw responsibility back on the families. These are old people and it is difficult enough for them to mind themselves. They are brothers and sisters with their own families and are involved in a tough struggle to survive as matters stand. Their relatives come home for weekends and at other times.

That is very much appreciated.

The cost of keeping one person in a house in a community is €600 per week. Neither the HSE nor the country has that kind of money. I know of an 89 year old woman who had two hours of home help per week which has now been cut back to one hour. Hospital beds are not available for patients who need operations and those operations are being held up. I ask the Minister of State to determine how much time HSE officials have spent on this project. Is this how valuable money is being spent?

I thank the staff who work in the centre for the loving care and attention they give to the residents and to their families. They are part of the extended family really. They work together and provide a great service. I ask the Minister of State not to break this up.

6:05 pm

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Deputies Martin Ferris and Danny Healy-Rae for raising this issue. I have also been speaking to a number of their colleagues about this matter, including Danny's brother Deputy Michael Healy-Rae, in the last 24 hours. It is important when dealing with this issue to look at the facts and at what is happening on the ground. Of course, I will always listen to public representatives and to the concerns of parents.

In June 2011 the report, Time to Move on from Congregated Settings - A Strategy for Community Inclusion was published by the HSE. The report identified that approximately 4000 individuals with disabilities were living in congregated settings, defined as where ten or more people reside in a single living unit or are campus based. It found, notwithstanding the commitment and initiative of dedicated staff and management, that there was a significant number of individuals still experiencing institutional living conditions where they lacked basic privacy and dignity and lived their lives apart from any community and family.

St. John of God service in Kerry has been identified as one of the priority sites for de-congregation. The HSE is committed to working with St. John of God services and the families to transition 17 residents in ward-style accommodation from the current unsuitable accommodation on campus to more appropriate settings in the local community. The HSE has put in place comprehensive transition plans which include extensive engagement with the individuals themselves, their families, carers and advocates, as well as the service provider, to ensure

In May 2014 all families received correspondence from St. John of God services advising them that a development committee was being set up to explore with service users and their families the community options available within the county and to plan a strategy for future housing requirements. Reassurance was given to families that individual plans would be made in conjunction with each person and their family. In April 2015 at the regular family forum meeting an overview of the HIQA regulations and an update on de-congregation was provided. Throughout 2015 and 2016, the primary focus of St. John of God Kerry services has been on addressing the high risk areas of the HIQA action plan and in particular the issues relating to fire safety. There was significant consultation with residents and their families while this work was undertaken as some residents were temporarily relocated while

On 18 September 2016, a family forum meeting took place at which the HIQA inspections and de-congregation were discussed again. Concerns were raised and many family members were worried that their relative would not be suitable for community living. It was agreed that a family representative group would be set up and a meeting with the senior management of St. John of God Kerry services would be scheduled. In total, 78 people currently residing on the Beaufort campus will ultimately be supported over a number of years to move to more suitable accommodation in the community, depending on available funding and on sourcing suitable houses in the community.

Earlier this year, I announced that we are providing €100 million in capital funding from now until 2021 to ensure that people are able to move out of congregated settings and into their own homes in the community. I want to emphasise that the appropriate supports and resources are being put in place to ensure that people are supported as they move out of residential centres. I want to assure any concerned residents or family members that the process of moving a person with disabilities out of a congregated setting is not something that happens overnight. This process of moving people to more suitable accommodation in the community will take place over a number of years and will be done in full consultation with all residents and their families.

Photo of Martin FerrisMartin Ferris (Kerry, Sinn Fein)
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I thank the Minister of State for his response and do not doubt his sincerity concerning the residents of St. Mary of the Angels.

Effectively concern centres on two units, namely St. Fidela's and St. Brendan's. The other 60 residents are housed in chalets and state-of-the-art facilities. It would appear, however, from the Minister of State's response that the whole of St. Mary's will be closed down over a period of time.

The people I have spoken to have told me there has not been any consultation to date. I hope that will change. They are hugely concerned and worried because their loved ones have been at St. Mary's for many years. As I said earlier, one individual has been there for 29 years and has known no other home. The parents and relatives of the residents are very satisfied with the services provided and speak glowingly of the staff and facilities.

A lot of the money used in St. Mary of the Angels was raised by local people when the State failed them.

Photo of Danny Healy-RaeDanny Healy-Rae (Kerry, Independent)
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St. Mary of the Angels should have been the last place to be de-congregated, given its tranquility, the beauty of its location between Carrauntoohil and Beaufort and the fact that it is in the heart of the county, making it accessible to everyone equally. If there is a problem with the two wards then the Department should, as locals have suggested, build more bungalows on the land. The State got the land for nothing, from a retired farmer and his daughter. Is this what he wanted done with it? Did he want the centre to be closed down and the land to be sold off to pay for more HSE officials? I ask the Minister of State to visit the centre himself. What is going on there is wrong and what has been proposed is wrong. The Minister of State will only understand what we are talking about when he sees the centre for himself. If he does not do that, he will hear plenty more about this. It will not be closed very easily.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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Again, I thank my colleagues for raising this matter. I also thank them for the invitation which I will seriously consider. I spent the summer visiting centres all over the country but have not reached Kerry yet -----

Photo of Martin FerrisMartin Ferris (Kerry, Sinn Fein)
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We will look after him if he comes down.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I assure Deputies Ferris and Healy-Rae that I will visit the centre. I would be delighted to see it.

To be honest, I disagree with some of the points made by the Deputies. I want bring an end to the situation where persons with disabilities are housed in large institutions. That is my policy, vision and plan. I have €100 million over five years at my disposal to do something about this. Of course, I listened to what the Deputies said regarding the fears and concerns of parents. I also take the point that in the past people were moved into the community but were not provided with support services. That will not happen on my watch.

I agree that we must be very vigilant about how money is spent. Further, I accept the point that there was no consultation and that is not acceptable. I had a meeting in my office about 20 minutes ago with representatives from St. Michael's House. St. Michael's House provides fantastic services and is very focused on consultation with parents through a parents forum. It recognises the importance of letting the service users and their families make important decisions. I accept the argument that one size does not fit all. I accept it totally.

We need to have an equal partnership between the service providers and the people with disabilities. Two days ago, I came across a centre in Dublin city that has started the process of moving out from a congregated setting into smaller units in the community. Members of staff have been transferring as well. The CEO of that company told me that the transfer was very difficult for some of the staff and some of the individuals for the first few weeks. Some of the staff had been working in the institution for so long that they had become institutionalised. Having said that, they are now in the community. Services are being provided to four people in a beautiful house in south Dublin. That is the way I want to go forward. As far as I am concerned, the days of institutions are over. I will listen to the parents and engage in full consultation with them.