Michael Healy-Rae (Kerry, Independent)
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I raised this matter two weeks ago during Questions on Promised Legislation and got no reply from the Taoiseach. That is why I am raising it today. I thank the Minister of State at the Department of Health, Deputy Finian McGrath, for visiting the excellent facility in Beaufort in County Kerry. I requested him at that time to do so and was very glad that he did. He also called to other facilities in County Kerry.

Students with profound special needs or requiring round the clock medical attention are being forced to miss days at St. Francis Special School in Beaufort, County Kerry as the HSE provides only general nursing hours there three days a week. At least two students living in constant danger of medical emergencies cannot attend St. Francis Special School on Tuesdays and Thursdays in the absence of general nursing care. Funded entirely by the Department of Education and Skills with St. John of God's as its trustees, St. Francis Special School is dependent on the HSE to provide the vital medical assistance its students need. While many students benefit from individual nurses the general nursing service is crucial to the delivery of education at St. Francis Special School. Currently, however, it is provided only on Mondays, Wednesdays and Fridays and staffed by two part-time nurses. Parents are also seriously concerned about the loss of physiotherapy, speech and language therapy and occupational therapy hours that occurred under the HSE's reconfiguration plan. They signed up to this in 2013 on the understanding that the service they were then giving would be fairer for all students in the mid-Kerry area, students in St. Francis Special School and those in mainstream schools with less profound needs.

It is crucial that the absence of general nurses at St. Francis Special School on Tuesdays and Thursdays is rectified and that nurses are provided on these days. Children should not have to remain at home on those days. It is simply wrong. I compliment the staff at the school from the bottom of my heart. They do excellent work but they are not trained medical experts and can only do so much. I ask the Minister of State please to ensure that on Tuesdays and Thursdays general nurses are provided for St. Francis Special School in Beaufort. This is of vital and paramount importance.

I want also to highlight the fact that the structure in Beaufort is coming under attack because of the policy on congregated settings adopted in 2011. I have said before in the House that this policy should be changed because if new people are not allowed to enter the excellent facility at St. Mary of the Angels, whose campus includes St. Francis Special School, over time the facility will close. That will also affect St. Francis Special School. I have said on numerous occasions that one shoe does not fit all sizes. The Government should change this policy to allow St. Mary of the Angels to take in admissions again because when a centre like that is closed by stealth, a centre of excellence is closed. Beaufort and St. Francis Special School are centres of excellence. The personnel, the management, teachers, nurses, the staff working in the kitchens and those taking care of the personal needs of the patients make it a real centre of excellence. I would like the Government to acknowledge that and revisit the congregated settings and deal with the issue I have raised, to provide the necessary nursing care on the days when the nurses are absent.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy for raising this issue. I am aware that St. Francis Special School is situated on the grounds of St. Mary of the Angels and I understand that there are 55 children enrolled in the school with needs varying from moderate to severe.

A new extension, opened in September 2015, facilitated some of the then existing classrooms to be converted into specialised physiotherapy, speech and language and occupational therapy facilities, including a dedicated art room. This is very positive as it means that a multidisciplinary team on site has played a huge part in enabling each pupil to achieve his or her true potential.

With regard to the particular issue raised by the Deputy, I am aware that, in 2013, HSE Cork Kerry reconfigured children's disability services in Kerry to children's disability network teams with access based on need, in line with national policy. I am advised by the HSE that the specific need within the school was recognised on foot of an assessment of need, which took place some 18 months ago. The assessment was undertaken by the public health nursing service on which the existing resource provision of three days nursing has been based. The current nursing arrangement has been facilitated from primary care services.

A more recent assessment by the public health nursing service has indicated increased complexity of care needs for the children attending the school. The initial recommendation was to increase the service from three to five days per week. The HSE has informed me that a review of this assessment is under way to examine the additional level of resources that may be required to address these complex needs and to set out what the overall requirement will be. It will also look at how the existing allocation of nursing support may be optimised to meet the changing needs of the children.

I fully recognise the concerns of parents whose children are unable to attend the school on a full-time basis. I sincerely hope the HSE can progress this assessment as speedily as possible and find a resolution that will have a positive outcome for these children. This Government is committed to providing services and supports for 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.

I can advise the Deputy that €8 million in additional funding was invested in 2014 and 2015 to fund 200 additional posts to support the implementation of the national programme on progressing disability services for children and young people under 18 years of age. A further €4 million in additional funding was provided for 75 therapy posts in 2016.

Michael Healy-Rae (Kerry, Independent)
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St. John of God's has recently written to families with family members in St. Mary of the Angels requesting the payment of additional money every month. One family has paid €400 per month for the last 20 years and is now being asked to pay €195 on top of that, which will leave them struggling. What will St. John of God's do if the family cannot pay? They cannot tell their children to leave the facility.

I would sincerely love to catch a hold of the person in the HSE who dreamt this whole thing up a number of years ago of using the word "reconfiguration" rather than the simple, ordinary and down-to-earth word "cut". Any time the HSE has spoken about reconfiguring something, it means it is going to cut the service and its funding. However, it does not use that ordinary common word. Rather, it uses the highfalutin term "reconfiguration of services". The person who first said that would want to be given a good shaking for ten minutes to bring him or her down to earth and to show that a reconfiguration is the same as a cut. It is certainly not enhancing a service and it is doing nothing to improve things. It is a cut. A cut is a cut, not a reconfiguration. It is not the Minister of State's fault. I do not direct this at him. I direct it at those hiding within the HSE who dreamt this up with their spin doctors a number of years ago. They were allowed to get away with it by politicians in this House at the time who should now tell them that there is no such thing as reconfiguration. It is a cut. Those words are being used by the Minister of State here now because, quite simply, he was told to use them by the HSE. The Minister of State and his colleagues should be telling the HSE that they never again want to see a memo from the HSE containing the word "reconfiguration" on it because it is rubbish. The HSE should be told to stick it and change it to the word "cut". At least then we could see exactly what is being said.

I appreciate the Minister of State's response. I have raised the issue with him and I give him a commitment that I will continue to raise it in the House to the best of my ability as it is right to do on behalf of the children and their parents and grandparents.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy. I must differ somewhat with him on the word "reconfiguration". It does not always mean a cut. One of the better examples of reconfiguration was the reconfiguration of cancer services in Ireland. Everybody must accept that the reconfiguration and delivery of those services nationally was one of the more outstanding successes of politics and the HSE working together. While it was difficult and a lot of people had to make a lot of difficult choices, in the fullness of time, which is the best place to be to judge, we see that it has been a reconfiguration story of which we can all be proud. In respect of cancer services, it is something that has mattered a great deal to a lot of us on a personal level. As such, I take issue with the Deputy notwithstanding his entitlement to his own opinion. I do not agree that reconfiguration is always a bad word.

On the specific issue, I have given the Deputy the best answer the HSE and I can provide. The HSE has acknowledged that there is a need for additional nursing here and it is looking to see what level of resources are required. I will ensure the HSE speeds up its assessment of the increased need and try to get this up and running for the children in that school. It is the least they deserve. I thank the Deputy and the Leas-Cheann Comhairle.