Gerry Adams (Louth, Sinn Fein)
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I thank the Minister of State for being present. It is no exaggeration to say that people with disabilities and their families in my constituency of Louth-East Meath and across this State are being treated deplorably. I have met dozens of families with citizens with intellectual disabilities and they all tell a similar tale of the never-ending fight to access services from this State. These are services which should be theirs by right. The anger of parents in particular is palpable. They are furious at how their loved ones are being treated and they feel that nobody is listening.

I will give the House some examples and I thank those individuals for permitting me to tell their stories. Michael McManus was born in 1962. He suffered a seizure at two years of age which resulted in severe brain damage. As a result, Michael today, at 54, has the mental age and development of a two year old. Michael's family provided for all his needs at home until it was no longer possible for them to do so. This is a sad enough story but it is the State's attitude to Michael and people like him which really angers those who care for him. The day of Michael's mother's death, he was moved by the then health board to residential accommodation. His family later realised that Michael had been moved to a psychiatric facility in County Monaghan. Here, among other major issues, the family reported that Michael was attacked in his bed by another resident. It was only after a sustained campaign, including legal representation, that Michael was eventually given a place in St. John of God's-St. Mary's Drumcar facility, which is located in my constituency. There are many troubling issues with the Drumcar facility and I have raised these directly with the management and the HSE and in the Dáil. However, the fact is Michael has lived happily there for over 20 years. He now faces the possibility of being moved again as part of the decongregation policy.

Sinn Féin supports decongregation. Evidence backs the assertion that it delivers better quality of life for people in residential accommodation. However, we have to be sensitive about it. We have to consult with those people and we have to do it at their pace. For Michael and others, my office has been in contact with Drumcar, his home. These families are not against decongregation per sebut they have simply not been consulted by the HSE regarding the future plans for their loved ones. This, I am sure the Minister of State will agree, is totally unacceptable. The families have real fears that if their loved ones are moved, their quality of care will reduce, they may be moved to inappropriate locations and they will be traumatised by being taken out of their familiar surroundings.

Other families have cared for their loved ones all their lives. They describe themselves to me as "the first generation to bring the disabled babies home". This was a time when babies with disabilities were being put into mother and baby homes and other institutions. They have reared them from infancy. Now, their children are in their 40s or older. These people, now elderly themselves, have met a brick wall in terms of the future care of their now adult children. They are part of the Dundalk Parents and Friends of the Intellectually Disabled. They have been campaigning for years and working with the HSE, Louth County Council and the Department of Housing, Planning, Community and Local Government in order to provide future homes for their children in Dundalk.

One size does not fit all, particularly for people with additional needs. For every family like Michael's there is another family who cannot wait for their loved ones to be moved to a community setting. Will the Minister of State meet these families to hear their experiences and discuss the future care of our disabled citizens?

Helen McEntee (Meath East, Fine Gael)
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I thank the Deputy for raising this extremely important issue and for giving me the opportunity to outline the position on services for people with disabilities who need respite supports. I am taking this issue on behalf of the Minister of State, Deputy Finian McGrath, who sends his apologies for not being present.

The Government's ongoing priority is the safeguarding of vulnerable people in the care of the health service and it is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide them with 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 provision of respite services has come under additional pressure in the past number of years. An increasing number of children and adults are now seeking access to respite and the changing needs of people with a disability are also having an impact, as they, along with the rest of the population, live longer lives.

The HSE acknowledges the need for additional respite for adults with intellectual disabilities in County Louth for adults and children with a disability and their families. I agree with the Deputy that one size does not fit all and it is important to outline the respite that is currently provided at the following locations in County Louth. Respite for adults with a physical disability is provided by the Irish Wheelchair Association at Sruthan House, Dundalk, which is a three bedroom house that operates six nights per week in a community setting social model providing holiday respite. Respite for adults with intellectual disabilities is provided by Moorehall Healthcare in a three bedroom house that operates seven nights per week in a community setting social model, providing holiday respite in Ardee, County Louth, with approximately 80 adults availing of this service. Respite for adults with intellectual disabilities is also provided by St. John of God's north east service in a seven bed house on the campus at St. Mary's, Drumcar, to which the Deputy referred. The house operates seven nights per week in a medical nurse-led model, with approximately 42 adults availing of this service. Respite for children with intellectual disabilities is provided by St. John of God's north east service in a seven bed house on the campus at St. Mary's, Drumcar. The house operates seven nights per week in a medical nurse-led model, with approximately nine children availing of this service. Respite for children with intellectual disabilities is also provided by RehabCare at the Maria Goretti Centre, Lordship, County Louth in a four bedroom house. This house operates six nights per week, with approximately 80 families availing of this service.

Again, I agree there needs to be absolute consultation with individuals and their family members should circumstances change. If there are particular cases the Deputy wants to pass on to me, I can certainly bring them to the attention of the Minister of State, Deputy McGrath. A Programme for a Partnership Government recognises the need for respite services to be developed further and the Minister of State with responsibility for disability has acknowledged this. These matters will remain on the agenda of the Minister of State in the context of budgetary provision in the coming years.

Gerry Adams (Louth, Sinn Fein)
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I know the Minister of State is stepping in for the Minister. I have raised some of these issues directly with the Minister, including another case of a 42 year old constituent who is non-verbal and has high support needs. I raised that issue with the Minister of State, Deputy Finian McGrath, in the Chamber five weeks ago and I am still waiting for a response. The HSE told me this man's need for a residential placement has been identified but that a business case for additional funding for this placement was not successful. What is his family to do? That is the question. They cannot meet his needs at home any longer so what are they to do? This is another forgotten citizen in the greatest little country in the world in which to do business. I could go on and on.

The Minister of State is also a constituency Teachta Dála and she meets with families who are looking for speech and language therapy, occupational therapy, medical assessments and supports. It is a never-ending life of worry; it never stops. If one rears a child from infancy until they are in their 40s, as in these cases, there is no respite. One of these men, a 42 year old, spends all night in the house of his elderly parents walking up and down the stairs without cease. There are currently 7,176 children waiting over one year for assessments or initial therapies under early intervention services. I am reminded it is only one year since we celebrated and extolled the centenary of the 1916 Rising and, in all of that time, these children and their parents have been trying to get early intervention services. Now that the lofty rhetoric of ministerial speeches has faded, the reality of life for these citizens with disabilities and their families stands in stark, tragic contradiction of all the fine words.

I am sorry the Minister cannot be here although I understand Ministers cannot be here every time to take Topical Issues. However, the Government needs to get real and tell these parents what its plans are for dealing with these citizens.

Helen McEntee (Meath East, Fine Gael)
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There is an absolute recognition not just by the HSE but by the Minister that additional supports and additional funds need to be put in place specifically for these groups of individuals, the adults in their 40s and 50s who are living at home with their parents, who are in their 70s and 80s. It is absolutely not a situation in which they should be, and additional support needs to be provided for adults with high support needs and those in emergency and crisis situations.

However, we do find ourselves in a situation in which we have limited resources. We must work within the budgetary constraints, all the while trying to provide support for the most vulnerable in our society. The Deputy is right. In my own county of Meath, we need additional support and additional respite for our children, young adults and the parents of those people as well.

To outline the specifics in County Louth, funding for this year for children's respite from six to 18 years amounts to €438,000. For adult intellectual respite, there is €531,000. For adult physical and sensory respite, there is €440,000. Of the €31 million allocated for the adult intellectual disability and children's respite in St. John of God, a portion of that is going to Louth. The Minister and I agree that this is not enough. Again, a case has to be put forward and, within the constraints of the budget, every effort will be made to provide support and respite for those who need it most.