Pat Gallagher (Donegal, Fianna Fail)
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There has been a misunderstanding. Deputies Breathnach and O'Dowd will be aware that if both had submitted this matter, then we could have allocated time as desired but in these exceptional circumstances I ask Deputy Breathnach, who has three minutes, to go ahead.

Declan Breathnach (Louth, Fianna Fail)
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I wish to bring the disgraceful lack of respite places in County Louth to the Minister of State's attention today. Last year, the acute lack of proper respite facilities in Louth reached a crisis point. Families in my area are suffering from ongoing unacceptable distress as the crisis continues to escalate. I am aware that the Minister of State has been contacted by many of the families and care groups. Let me outline some of the severe hardship cases that my office and other Deputies in Louth are dealing with. Most important, I ask the Minister of State to provide the funding for a facility that has been identified to provide care for 30 people. It would cost €800,000 to provide care for 30 people per annum. The service provider Praxis Care is ready to provide the service, and a premises has been identified. It just needs confirmation from the HSE that the funding will be provided. The facility could be operational within three to four months. The service would provide respite to young adults in Louth, Meath, the north midlands and north Dublin. The premises identified is just off the M1 in Drogheda.

I want to give some examples of the extreme hardship the families are going through without access to respite care for their loved ones. A family with a severely disabled 26 year old daughter has been looking for respite care for three years now. Her mother rang up giving four months' notice to get four nights' respite for a trip planned for her wedding anniversary. The family was told immediately there was none available even though ample notice had been given. She was not able to get respite in May to enable her to attend her granddaughter's Holy Communion. Recently, the family was granted two nights, which was not enough time in which to plan anything meaningful. Two nights is not enough of a break for the family. The mother said she was too exhausted to do anything with the time.

She is distraught. There is another mother who has an 18-year old son and she is very conscious that as yet there are no specific plans in place for how adult respite will be delivered to her son. She is aware of many other families in the same predicament. Her son continues to display high-risk and challenging behaviour. Respite is a complete lifeline to them and they are extremely worried and worn out.

Pat Gallagher (Donegal, Fianna Fail)
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Go raibh maith agat. I call Deputy O'Dowd.

Declan Breathnach (Louth, Fianna Fail)
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I would like Deputy O'Dowd to expand further on the issue because we are ad idemin Louth on this issue.

Fergus O'Dowd (Louth, Fine Gael)
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I thank Deputy Breathnach for agreeing to allow me to speak on this. I appreciate his commitment, which we share, as does Deputy Adams. We have met regularly with the HSE and with Drumcar and St. John of God's to try to get a solution to the problem that continues. It will continue until adequate and proper funding is provided. I welcome the commitment of the Minister of State and the Taoiseach to deal with this issue, but the scale of it is huge. There has been no increased investment by the HSE into respite care since 2008. The estimated number of new places required nationally by 2020 is 2,133. In our own HSE area, that number is 316. There is no sign of any of these places at this moment in time. There is huge distress, upset and concern. There are people crying on the phone, elderly people breaking down at meetings and parents in their 80s distraught and terribly upset. People are listening and Ministers are listening, but we need the action and we need it now.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputies Breathnach and O'Dowd for raising this very important issue because it gives me the opportunity to outline the position on the need for respite care for children, young adults, and ageing adults in the community in Louth. I want to make it very clear that this Government’s ongoing priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities that 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. I accept that point. 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, are living longer lives. The HSE acknowledges, as do I, the need for additional respite for adults and children with intellectual disabilities and the difficulty experienced by families with regard to the lack of respite places available. The HSE is working with agencies to explore various ways of responding to this need in line with the budget available.

To support these alternative ways of providing respite, funding has been provided to the HSE to provide 185 new emergency residential places and new home support and in-home respite for 210 additional people who require emergency supports has been allocated. The HSE’s social care operational plan for 2017 aims to provide 182,000 overnight stays in centre-based respite services, in addition to 41,000 day respite sessions.

HSE Louth disability services have recently received a draft costing proposal submitted by a local service provider. The nature of the proposal is for the provision of a residential respite service for young adults with complex needs and challenging behaviour. No discussion has been had with the service provider regarding the costings as received for the proposed provision of a respite house that the service provider is considering developing in the Louth area. The HSE has confirmed in local discussions with the service provider that it is not in a position to give assurances to any provider regarding the independent commissioning of such a service outside procurement. The service provider was advised that if the organisation were to proceed to develop same, it would be the organisation's decision to do so.

I emphasise that further discussion is ongoing at CHO 8 level regarding the emerging need for additional respite services and the options to be developed to meet these needs. The HSE has advised that additional funding would be required for the development of respite services in Louth, but there is a problem with regard to that. As Minister of State, I intend to seek additional funding for residential and respite services as part of the 2018 Estimates process.

Only yesterday, I had a meeting with the Taoiseach on the social service plan for 2018. This item was at the top of our agenda.

Declan Breathnach (Louth, Fianna Fail)
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I am disappointed with the Minister of State's response as it is deeds and actions that are needed, not words. I could go on for the next hour about cases that have come to the attention of my office. The Minister of State has been written to about many of those cases. For example, two social workers left Drumcar last December and since then no social worker had been there at all until last week. Just one social worker was appointed to facilitate the needs of these families. If the Minister of State cannot give a commitment to give the money needed to solve the problem in Louth immediately, I want to make a suggestion to him and I ask him to consider it. In the short term, could he not allow retired accredited intellectual disability nurses provide respite for these families in their homes? While it is not an ideal solution, that would alleviate the distress and worry of these families. Most important, I call on the Minister of State to get the funding to which I have referred to provide the facility that has been identified. Let us get action on this. Words are no good.

Fergus O'Dowd (Louth, Fine Gael)
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I absolutely agree with everything Deputy Breathnach has said. It is universally true in every home in Louth where there are people with disabilities. There is an absolute lack of clarity, support and services. Yet, at the same time, more than €30 million is spent on the services of St. John of God's. It is reducing its services but is not giving the funding back to the HSE or to other groups that want to provide the services. It is not doing its job.

I appreciate the Minister of State's commitment to increased funding for Louth. What the Minister of State needs to do is attend the meeting with us, the HSE and Drumcar to sort it out once and for all. These families deserve better. No later than this afternoon, I got a call from a constituent who has a 21-year old disabled son who never got respite. Despite applying for it, they got no answer this year - no answer at all. It is a disgrace and is unacceptable. I appreciate the Minister of State's hands-on involvement in all the issues we bring to his attention. I ask him to please deal with this issue. We will talk to him after this debate to get action and commitments.

Finian McGrath (Dublin Bay North, Independent)
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I accept the points raised by Deputies Breathnach and O'Dowd about needing action and deeds. Even in the last couple of days, I have written to the CEO of and people directly involved in St. John of God's about the management of money. That is a separate debate but, at the same time, I am not happy with the way some of the money is being spent on services. It is unacceptable to hear that a family has told Deputy O'Dowd that they have received no respite.

The management of money in services is very important. I take Deputy Breathnach's point about the retired nurses. That is a good idea. There are 101,000 families claiming the carer's grant, which is worth €1,700 and was restored recently to those families. They could use some of that money to pay for respite while we get the long-term issue resolved. However, I accept the point that we need action on respite services. We need good management of the resources. We do not need all the money going to senior managers in St. John of God's services, because the people on the front line deserve the respite services. That is the direction I want to go in.

I also appreciate sensible ideas. We could use some of the nursing support hours. In this year's budget, I got an extra €16.2 million to support 395 people through funding for the new home support, which is in-home respite for emergency cases. Perhaps some of that money could be used for those ideas. I saw a group of nurses in north Dublin recently who have retired from St. Joseph's intellectual disability service in Portrane and are doing an excellent job of helping out the services that are in crisis.

I will talk to Deputies O'Dowd and Breathnach about meeting those directly involved, in particular parents who have not received the services. I would like to hear from them first hand.