Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister of State for giving me the opportunity to raise this matter. I am speaking on behalf of the Maher family in south Kilkenny. Their son has autism and for the duration of his life the family has fought for any services they have received for him, be they educational or health. The family has always had to fight long and hard battles to get anything for him. I commend them. I have much respect and admiration for them because they have had a very hard battle.

Their son is now 16 years old and when I say the family is at a crisis point I do not do so lightly. This is not something I would have considered raising as a Topical Issue if it were not important to do so. Their son is no longer in school. When this matter came to a head the family was promised 36 hours of home support by the HSE. A behavioural therapist visited their home and it was a very positive intervention. They were very happy with it and felt it would result in many improvements for their son, with a positive knock-on effect on the rest of the family. However, without explanation or consultation, the hours were cut to ten and the behavioural therapist was not seen again in the home. The hours were increased to 15 two weeks ago, but that is still less than half the number the family were promised. The boy is unable to be in school which is detrimental not only from an educational point of view but also from a social point of view and all that is associated with being a teenager in school. He has already been denied that, so it is rather disgraceful that it is proposed to deny him the home support hours.

I have the family's permission to raise this matter. The boy's father is a paramedic and he has had to take indefinite leave from his job to help his wife in the home each day. This will have a negative impact on the family from a financial perspective. They will end up needing a great deal more support down the line if no intervention is made now. They need the 36 hours of home support. It is not a huge amount to seek, given everything else they have gone through. The hours were agreed and decided, so obviously they were considered necessary. The family also needs the behavioural therapist to come to the home to carry out his work, as agreed.

I ask the Minister to intervene and ensure the family gets this support. I also ask him to meet with the family to hear directly from them about their experiences. They represent not only themselves but many families in Carlow-Kilkenny who have had difficulties. There appears to be a difficulty with services for people with autism in the constituency. The family will be delighted to travel to Dublin to meet the Minister of State. I ask him to facilitate that visit and also to intervene and ensure they get the 36 hours of home support and the behavioural therapist visits they badly need for their son.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Funchion for raising the important issue of home support hours for people with disabilities. I will take this opportunity to outline the current situation with this matter.

I assure the Deputy of the Government's commitment to providing services and supports to people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. The commitment is outlined in A Programme for a Partnership Government. It is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

One way the HSE is working to improving the quality of life for people with disabilities is through the provision of home support hours. In the HSE’s National Service Plan 2016, the priority was to provide 2.6 million home support hours to more than 7,300 people with a disability. The actual number of home support hours provided in 2016 was higher, at 2.9 million hours. This reflects the responsive nature of the service and takes account of the fluctuation of assessed need over time, as the needs of individual people change. This is particularly relevant in the Deputy's case.

This year the Health Service Executive is committed to maximising the provision of health and personal social services, including home support services, within available resources. In its National Service Plan 2017, the HSE expects to deliver 2.75 million home support hours to more than 7,400 people with a disability. This is an increase of 150,000 hours more than the last year’s target. The goal is to help as many people as we can. This is a positive development, which I hope we can build on in years to come.

The Deputy has raised the matter of an individual case and the home support hours which are being provided to that person. I am reluctant to speak in any great detail about the specifics of any one case. This is especially true when it comes to speaking on the floor of the Dáil. However, given that the Deputy has permission from the family, it is fine by me. I have made enquiries about the case and I understand the HSE is engaging closely with the family involved.

Due to the specific nature of the needs of the person in question, it was agreed to introduce home supports on a gradual basis. Initially, the person is receiving home support at a ratio of two staff working with the person with a disability for ten hours. Given that there are two staff involved, this equates to 20 hours of home support. The hope is to increase this gradually to 15 hours, or 30 hours when we take the two staff into account. The HSE has informed me that the family is aware that the service will be closely monitored and reviewed by relevant professionals, in consultation with the individual, his parents and a family advocate. I will meet the family and will arrange it through the Deputy any time over the next few weeks. Parents of autistic children and teenagers have to be a major priority in the delivery of services.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister of State and I welcome the fact he will meet the family. It is a positive development. I would have a different understanding on the HSE's engaging closely with the family and the service being provided on a gradual basis. The ten hours of home support is in place for a year. How gradual is it? Will they have to wait another year for the hours to increase? I take exception to the issue of the two staff. There is possibly a need for two staff and I have no difficulty with it. However, the family should not be classed as having 20 hours because two staff are there. The two people are in the home for only ten or 15 hours and it is an unfair calculation on the part of the HSE.

I welcome that the Minister of State is willing to meet the family and maybe we can discuss it further at that stage. Although I would be reluctant to raise something like this as a Topical Issue matter, it is important and sometimes it is the best way to highlight the situation on behalf of the family and many others in my constituency who suffer as a result of a lack of support services for children, particularly teenagers who have autism. It can be very difficult when a person reaches the teenage years and is in that in-between stage between child and adult. I will follow it up with the Minister of State.

Finian McGrath (Dublin Bay North, Independent)
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I will take up with the HSE again directly the issues the Deputy raised. They are very important. I will ensure the Carlow-Kilkenny disability services will continue to engage with the family on an ongoing basis regarding their son. An inter-agency and interdisciplinary case review was held on 25 January when health professionals recommended that, given the person's situation, it would be appropriate to introduce home community support for him on a phased basis. The home support services started on 30 January, one week ago. Further meetings will take place as determined by the individual's needs and will involve relevant inter-agency and professionals, the family and their advocate. The HSE has also advised the family that it is available to collaborate with the relevant professionals in the Department of Education and Skills. This is important.

I was directly involved in the negotiations regarding the HSE social care plan and I saw the gap there. The Deputy probably noticed that in the plan, funding for personal assistant, PA, hours has increased for 2017. In 2017, we expect to deliver 1.4 million PA hours to 2,357 adults with physical or sensory disabilities. This is an increase of 100,000 hours compared with 2016. When dealing with individuals and huge sums of money, we must ensure the service is delivered, in this case, to the particular young person with the intellectual disability. These are issues I want to hear about from the Deputy and the family at our meeting in the coming weeks.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The Minister of State's response suggested two staff were working with the person for ten hours. Were those two people working simultaneously with the person for the ten hours?

Finian McGrath (Dublin Bay North, Independent)
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Yes.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The question could be interpreted as giving people to believe there were 20 hours of support. Therefore, I would be concerned at the nature of the response. I am sure it is not yours.

Finian McGrath (Dublin Bay North, Independent)
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I take the Ceann Comhairle's views on board. I already told the Deputy I would raise the issue with the HSE. I take the Ceann Comhairle's point. It is an important issue.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Thank you. It is much appreciated.