Louise O'Reilly (Dublin Fingal, Sinn Fein)
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6. To ask the Minister for Health the number of hours of respite care offered to families of children with disabilities in the first nine months of 2017 as compared with the first nine months of 2016; and the way in which this compares with the number of applications for respite care by families for their child with a disability in the first nine months of 2017 as compared with the first nine months of 2016. [40778/17]

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The question is straightforward. I doubt if there is a Deputy in the House who does not receive daily requests for help and assistance from parents and carers who are desperate for respite. We are speaking to people who have not had respite for years rather than months and some who have not had any respite.

Simon Harris (Wicklow, Fine Gael)
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I am taking this question on behalf of the Minister of State, Deputy Finian McGrath. We discussed this matter yesterday at a meeting of the Joint Committee on Health.

I am very much aware of the importance of respite service provision for the families of children and adults with disabilities, including the impact the absence of respite service provision can have on other parts of the health service and the well-being of families. As Deputies are aware, the provision of respite services has come under additional pressure in recent years. More 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, thankfully live longer lives. A Programme for Partnership Government recognises the need for respite services to be developed further and the Minister of State and I are committed to ensuring this happens.

A number of factors impact on respite capacity. A significant number of respite beds are regularly utilised to allow unplanned emergency admissions, leading to a decline in the number of available respite nights against planned activity. As I indicated to members of the joint committee yesterday, one of my greatest concerns in respect of disability services is the large increase in the number of emergency admissions and the need to address this issue adequately. The regulatory and policy context has also changed the manner in which residential and respite services is provided, as agencies must, correctly, comply with regulatory standards.

As a result, capacity has generally decreased with the requirement for personal and appropriate spaces. Beds can no longer be used for respite where residents go home at weekends or for holidays. This is an example of how additional beds are not available when they would have been previously. It is not a criticism, only the reality. Implementation of the national policy on congregated settings is also reducing available capacity.

In the HSE's social care operational plan for 2017, some 6,320 people with disabilities are expected to avail of centre-based respite services, totalling 182,506 overnights. Based on existing levels of service and in addition to the centre-based respite service, it is planned that between 2,000 and 2,500 persons will avail of respite services such as holiday respite or occasional respite with a host family. It is also planned that a further 41,100 day-only respite sessions will be accessed by people with disabilities. Furthermore, the HSE has been funded to provide 185 new emergency residential placements, and new home support and in-home respite for 210 additional people who require emergency supports has been allocated. This marks a significant change in the way that respite services are delivered.

The most recent available data from the HSE indicate that 81,836 overnight respite sessions were accessed in the first six months of this year compared with 90,861 in the first six months of last year. The number of day-only respite sessions accessed for the same period in 2016 was 22,351 compared with 22,051 in 2017. The HSE is also developing an eHealth case management system, which will facilitate the tracking of all residential and home support-emergency respite services across all HSE divisions.

Additional information not given on the floor of the House

The HSE social care division has also committed to developing home sharing as a person-centred and community-inclusive type of support for people with disabilities involving the development of an implementation plan in 2017. This will address the priority recommendations of the national expert group report on home sharing published in 2016. It will be led by the national designated disability lead in this area.

The HSE continues to work with agencies to explore various ways of responding to this need in line with the budget available.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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When I last raised this issue, it was on Leaders' Questions, which the Minister for Education and Skills, Deputy Bruton, was taking that day. I raised the case of Jacob Dooley, whose mother and father were in a desperate situation. As often happens in such circumstances, they had to turn to the media just to get some movement on their son's case.

I asked specifically about the number of hours provided compared with the number of hours requested. My clear understanding is that the latter far outstrips the former. The Minister, Deputy Harris, cited the figure of 182,506 overnights as representing some sort of progress, but we see the truth in our clinics and here. People have protested outside Leinster House about the unmet need on more than one occasion. Has anything been done to quantify it and, if so, will the Minister share the figures with us? I believe that there is a large amount of unmet need.

Simon Harris (Wicklow, Fine Gael)
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I do not think that the Deputy is in any way incorrect. In fact, she is entirely correct. There is not a Deputy on this side of the House or the other who is unaware of the fact that there is unmet need. To be honest, developing a policy to address it will be challenging. The Deputy will be fair enough to acknowledge that this is not just a resourcing issue. Also involved is the availability of beds, for example, where places that used to provide X number of beds can now only provide Y number due to regulatory standards. Previously, a respite bed could be used at the weekend for someone who was normally there during the week, but that cannot be done now.

The social care division of the HSE has committed to developing a number of proposals, including home sharing as a person-centred and community-inclusive type of support for people with disabilities, which will involve the development of an implementation plan. This will address the priority recommendations of the national expert group report on home sharing published and will be led by the national designated disability lead in this area. This could be a good thing, given that home sharing that is in compliance with new national standards will be developed.

We also need to examine the number of emergency residential placements. This year has seen an increase of 185. It is a priority for the Minister of State, Deputy Finian McGrath, and me in the context of budget 2018 because it has a knock-on effect on the availability of respite for children and young adults. This is a challenging issue and the Minister of State is prioritising it. We will continue to do what we can.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Is "home sharing" the new term for foster care? I met a group in Kerry recently. Although they could not take it in the end, some of its members had been offered the option of foster care. I do not need to tell the Minister, given that he has read about it in the newspapers,-----

Simon Harris (Wicklow, Fine Gael)
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No.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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-----but foster care for people with disabilities has received a negative airing recently. That is not meant disrespectfully to the hundreds of people-----

Simon Harris (Wicklow, Fine Gael)
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Sure.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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-----who do fantastic work providing foster care for people with disabilities. Foster care is in no way a solution, however. If that is the direction that we are going-----

Simon Harris (Wicklow, Fine Gael)
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It is not.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I thank the Minister for confirming that it is not.

As to quantifying the unmet need, it strikes me that, if the number of requests is not assessed against the number of available hours, the Minister will not know how many hours will be needed or be in a position to plan for them.

Simon Harris (Wicklow, Fine Gael)
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Let me clarify.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Please, do.

Simon Harris (Wicklow, Fine Gael)
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That is not what home sharing relates to. Home sharing relates to a situation whereby - this goes along with the decongregation agenda - one can safely and appropriately enable a number of people with disabilities to share a space within the community. If I did not explain that clearly, I am happy to do so now.

The Deputy is correct, and there is no point in beating around the bush. There is no centrally maintained list of people awaiting these services. It is not that I have an answer that I am simply not providing the Deputy. This is done on a community health organisation, CHO, level. As with our waiting list conversations, we must find a way of seeing the full range of needs. The HSE is working on better co-ordination of the existing residential base through the establishment of a residential executive management committee in each CHO and the development of an eHealth case management system that will facilitate better and more effective management and tracking of all residential and home support-emergency respite services across all CHOs and for each funded service provider. We do not want each CHO to be a silo. This system will provide a detailed inventory and a bed registry map of current service capacity, which will help us to match capacity to demand. I will be happy to share further information on this with Deputy O'Reilly.