Pat Gallagher (Donegal, Fianna Fail)
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Bogfaimid ar aghaidh anois go dtí an chéad cheann eile in ainmnithe na Teachtaí O'Dowd, Adams agus Breathnach. Níl an Teachta O'Dowd anseo. Níl sé ábalta bheith i láthair. Glaoim ar an Teachta, Gerry Adams, who has two minutes.

Gerry Adams (Louth, Sinn Fein)
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Go raibh maith agat a Leas-Cheann Comhairle. Gabhaim buíochas leis an Cheann Comhairle as an deis an t-ábhar tábhachtach seo a phlé inniu. I thank the Ceann Comhairle for the opportunity to raise the serious ongoing lack of scheduled respite services for people with disabilities in County Louth. Táim buíoch as an tacaíocht ó na Teachtaí eile atá i láthair ón Dáilcheantar sin. Tá muintir Chontae Lú buartha agus tá imní mór uirthi i dtaobh an drochscéil faoin easpa seirbhísí. People with disabilities and their families live in a state of perpetual crisis, especially in Louth and east Meath. I am contacted regularly by families who are in dire need and they all have a similar tale of never-ending fights to access services from the State which should be theirs by right. There is a particular absence of sufficient scheduled respite services for citizens with intellectual disabilities and complex needs. I have raised many examples of this in the Dáil with the Minister and recently with the Taoiseach himself.

I raised the situation faced by Sam and his family. Sam is an 18 year old man with severe autism, challenging behaviour and complex needs. He is now 18 and as a result he cannot avail of previous respite services that he once attended. The family is constantly worried about what may happen if there is a family crisis and they cannot care for him. His mother has met with the Minister, Deputy Simon Harris, and the Minister of State, Deputy Finian McGrath, and she is meeting with the HSE's early years manager. She built a community-led campaign which has submitted proposals to the Government yet it seems that her son's needs are invisible. The Minister is aware of these cases and he cannot abdicate responsibility to the local HSE area because it has not been given sufficient resources to expand services.

I think the Minister of State, Deputy Finian McGrath, has a good heart in these matters, and it should not fall upon parents, families and community activists to be responsible for ensuring funding. That is the Minister of State's job. I ask him to ensure that urgent and immediate emergency funding for existing respite service proposals that are in the possession of the HSE should be provided with all speed.

Declan Breathnach (Louth, Fianna Fail)
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As the Minister of State is aware, we have highlighted the plight of families in Louth who have been looking for respite for their loved ones since this Dáil began. We have organised meetings with the Minister of State and other Ministers and have had numerous representations on behalf of the families. Deputy Adams referred to a perpetual crisis; I would describe it as breaking point. It is wrong that this is allowed to continue. The families themselves could end up seeking residential care since they are under such stress and that would create an even greater cost for the State. There is a proposal to provide respite care to give these families a much-needed break which represents real value-for-money and cannot be ignored any longer. I am dismayed that no funding is available in the short term to fund this facility or indeed any additional respite facilities and services. Following a meeting with the head of social care in Louth HSE and the regional director of St. John of God Drumcar, we were told that HSE capital funding is being used for the ongoing programme of decongregation. Surely, of the overall funding in the Louth HSE, respite care should be a priority. The identified proposal would cost €300,000 each year, representing real value for money. This would purchase 13 weeks of respite care per annum in a six-bed facility with premises and staff suitably trained for adults with challenging behaviour. Up to six persons could receive respite care at any one time and breaks could be for a few days or even a week.

The situation in Louth and the need for resolution has the support of all five Members of this House and, indeed, the single Member of the Seanad from that area. We have met the Minister of State about it. The situation is deteriorating, these families are at their wits' end and we need action rather than talk.

Finian McGrath (Dublin Bay North, Independent)
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I thank my colleagues for raising the important issue of respite and for giving me the opportunity to outline the position on the provision of respite services in County Louth. This Government’s ongoing priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing service and support 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, and I accept that aspect of the debate, particularly in the last years. These services were devastated for seven or eight 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, live longer lives, which is an important aspect of the debate. A Programme for Partnership Government recognises the need for respite services to be developed further and I am committed to ensuring that this happens. I have been in talks about these issues with the Minister, Deputy Paschal Donohoe, in the last few days and respite services are at the top of my agenda for the Estimates.

A number of factors impact on respite capacity. One problem is that a significant number of respite beds are regularly used to allow unplanned emergency admissions, leading to the number of available respite nights being down against planned activity. The regulatory and policy context has also changed the manner in which residential and respite services are provided, as agencies comply with regulatory standards. Capacity has generally decreased with requirements for personal and appropriate space. Beds can no longer be used for respite where residents go home at weekends or for holidays. These are the current rules. Implementation of the national policy on congregated settings is also reducing available capacity.

In the HSRs social care operational plan for 2017, 6,320 persons with a disability are expected to avail of centre-based respite services totalling 182,506 overnights. There is work going on, but that does not mean that I do not accept the issues in Louth the Deputies have talked about.

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 based on existing levels of service, a further 41,100 day-only respite sessions will be accessed by persons with a disability.

Furthermore, the HSE has been funded to provide 185 new emergency residential placements and new home support and in-home respite for 210 additional persons who require emergency supports has been allocated. This marks a significant change in the way that respite services are delivered.

The HSE social care division has also committed to further 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.

In the context of respite services in County Louth, 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 continues to work with agencies to explore various ways of responding to this need, crucially, in line with the budget available. As I said earlier, that is something I am pushing strongly during the Estimates negotiations.

The HSE has advised me that additional funding would be required for the development of respite services in Louth but that no such funding is available in the 2017 budget allocation. From my point of view, I will continue to seek additional funding for respite and residential places as part of the ongoing discussions on the 2018 Estimates process. That is the key point here in relation to delivering respite services, particularly in this context in the County Louth area.

Gerry Adams (Louth, Sinn Fein)
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I know the Minister of State a long time and I stated earlier that he has a good heart on this issue, but I ask him to leave aside his script. The Minister of State has not answered the question. My party has put forward a proposal, which is with the HSE, for a dedicated respite service for citizens in County Louth and east Meath. That is what we asked the Minister of State to make a statement on.

In the previous budget, we were told that funding for badly needed respite services was a budget priority. We have not even been told that on this occasion.

The reality is that when an emergency respite care facility has to be provided for one person all the scheduled respite services for others are cancelled. As I have stated previously, what I found in dealing with these family members is the issue of stress. The stress upon parents and carers, and in some cases grandparents, is awful to behold.

There is an opportunity to sort this out. My party has brought forward practical propositions. There are people prepared to provide this service.

I come back to what my credo is about, and I am sure the Minister of State will agree.

Pat Gallagher (Donegal, Fianna Fail)
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Tá an t-am caite.

Gerry Adams (Louth, Sinn Fein)
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Because one has a disability does not mean one does not have rights. Society has a responsibility to provide one with one's needs.

Pat Gallagher (Donegal, Fianna Fail)
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Tá an t-am caite.

Gerry Adams (Louth, Sinn Fein)
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Tá a fhios agam. I ask the Minister of State to depart from the script and forget the Civil Service speak. There is a straightforward proposition being put to him. The Minister of State should tell us that he will ensure that this is a budget priority.

Declan Breathnach (Louth, Fianna Fail)
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I do not often find myself agreeing with Deputy Adams but as the Minister of State spoke, I wrote down, "Not one word other than further discussion exploring options." That is of no benefit to the family of a 26 year old severely disabled daughter who have been looking for proper respite care for three years. Even when she gives a few months' notice, she is told there is none available. I will not go into the story of Sam. We have heard it often here. A 93 year old man looking after a 53 year old son with Down's syndrome needs respite for him to get a break. His daughter helps out but has her own teenage daughter with Down's syndrome to look after. Finally, an 80 year old lady who suffered a stroke in April is the main carer for her with Down's syndrome of 36 years of age. The Mum now has her own care needs and they do not know how they will cope. I could go on ad infinitumon this but time does not allow me.

We need action. I said that at the outset. I understand the constraints. Deputy Adams, Deputy O'Dowd and the other Deputies who cannot be here have made it clear €300,000 will solve this problem covering Meath, Louth and a large part of north Dublin. The Talbot Group is in a position to provide what Deputy Adams has referred to. Indeed, other discussions have taken place with other organisations.

We met the Minister of State in July. I respect the Minister of State's office equally but this cannot be allowed to continue indefinitely. In fact, when I came into the Dáil, I asked the then Ceann Comhairle that we would champion the issue of disabilities in this House. That is certainly not championing it in County Louth or right across the country.

Finian McGrath (Dublin Bay North, Independent)
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I disagree with some of the tone of my two colleagues in relation to championing. First, let us get a couple of issues off the pitch here. I totally support the rights of all people with disabilities. When I entered into negotiation last year, we got €1.68 billion. That is an increase of €92 million. Second, of course, I accept the Deputies' argument that there are huge problems in Louth. Of course, I accept that it is my responsibility to do something about it. That is the first point - get that off the pitch.

I am open to all practical proposals. Since our last meeting in July, I went back to the HSE and put some of those proposals on the table. Over the past ten days or two weeks, and over the summer period, I have been putting in my own proposals in that regard but I remind Deputies as well that I will need support in there. There is a certain amount in the so-called "pot" and I am pushing for those issues. It is important that I get support from all Deputies in the House.

On respite, I will give the Deputies reassurance here today. The Minister is well aware that respite is top of my agenda when it comes into negotiations and over the past four or five weeks it was on it. I accept that we have problems in Louth. I have problems down in Kerry. I can name the counties where the problems are. Equally, I can name the countries that have the services, and good luck to them. The point is we have to deal with those issues.

From my point of view, I will give a commitment today in the House that I will do my best in pushing that agenda. I will also give the Deputies a commitment that I will come back to them on the debate today. Also, I will need the Deputies' support in relation to these particular issues on the broader political agenda.

It is also important to be aware that within six months of this Government's creation we were the first to restore the respite care grant. There are 121,000 people - some of those families the Deputies are talking about - getting €1,700 to buy their own respite services independently in the meantime until we fix the problems that have been neglected for many years. That is the situation.

As far as I am concerned, every person in the State with a physical or intellectual disability has to be treated the same as the rest of us. Such people and their families should be guaranteed respite services as of right. I will keep pushing that agenda. As for how I get on, I will let people judge that.