Dáil debates

Thursday, 14 December 2017

Topical Issue Debate

Services for People with Disabilities

8:45 pm

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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This issue is in respect of the National Rehabilitation Hospital in Dun Laoghaire but there is no negative connotation in terms of its staff or the work they do. The National Rehabilitation Hospital has a strategic partnership with a private company, Ability Matters, which provides prosthetic limbs. The difficulty in that regard is that many people who acquire a prosthetic limb do not do so from that company. If such a person does not acquire it from that company, he or she is denied access to services in the National Rehabilitation Hospital. However, the State provides a large amount of funding to the hospital every year and pays for its consultants, staff and the team that provides rehabilitation services to patients. The limb provided to the person, be they in Cork, Dublin, Waterford or elsewhere, is usually paid for by the HSE using State funding. Thus, the State funds the prosthetic limb and the hospital that is meant to provide rehabilitative services but if the patient does not purchase the prosthetic limb through the National Rehabilitation Hospital he or she is denied services there. The National Rehabilitation Hospital is denying services to citizens of the State and providing professional services only to people with whom it has a contract.

It is totally outrageous. We find that Government funding is working in such a way that there is a cosy little arrangement which does not work for the people.

A constituent of mine came to see me to discuss a prosthetic limb he had received from a company in County Galway. When he needed rehabilitation services, he was refused access to them in the National Rehabilitation Hospital. That is how this issue came to light. I contacted many other providers throughout the country of prosthetic limbs and they all told me the same story. There is a nod and a wink and someone needs to get to the bottom of it. The truth is that it is not about money. The service is not being provided because of a reference to some value for money statistic or the prosthetics sold by this company are cheaper; in most cases they are up to 20% to 25% more expensive than those sold by other providers. The issue needs to be dealt with quickly because people are suffering because of this cosy little arrangement.

I express my disappointment that when Topical Issues were about to be taken, the Minister of State with responsibility for people with disabilities left the Chamber. This is no reflection on the qualities of the Minister of State present, but the Minister of State with responsibility for people with disabilities should be answering the questions I have asked.

8:55 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I apologise to the Ceann Comhairle and the Deputy for my late arrival. I did not expect-----

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I do not think the Minister of State is being criticised for her late arrival. Others-----

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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It is more the early departure of the Minister of State, Deputy Finian McGrath.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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As the Deputy said, I am taking this Topical Issue on behalf of the Minister of State. I received this statement a short while before I entered the Chamber. The Deputy will not be happy with what I have to say-----

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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I know that.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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-----but I will read the statement and hope something will come of it. I extend my apologies to the Deputy because, having read it, I do not believe the reply is comprehensive.

On behalf of the Minister of State, I thank the Deputy for raising this matter and giving me the opportunity to respond. The National Rehabilitation Hospital provides complex specialist rehabilitation services for patients who have acquired a physical or cognitive disability as a result of an accident, illness or injury and require specialist medical rehabilitation services. We are all aware that such injuries or illnesses can have significant implications for individuals and their families. They impact on their social, educational, vocational and recreational participation and present serious challenges to their quality of life.

Effective rehabilitation draws on a broad range of disciplines to meet the particular needs of individuals, with the object of assisting them to return to their lives in the community. The National Rehabilitation Hospital provides patients with every opportunity to meet their rehabilitation goals through personalised treatment plans which are delivered by consultant-led interdisciplinary teams that are expert in their fields. Rehabilitation programmes at the hospital are tailored to meet the individual needs of both paediatric and adult patients. Depending on the level of limb loss and a person's general health and fitness, the activities that can be undertaken with a prosthetic limb could range from running or other sports to returning to employment, walking a few kilometres and simply being able to get around the house.

The Minister of State has requested the Health Service Executive to provide a response on the specific operational matters raised by the Deputy concerning the very important service provided by the National Rehabilitation Hospital. The executive has advised that the hospital is reluctant to provide a response on the matter the Deputy has raised without the input of the consultant in charge of prosthetics at the hospital. The consultant was, unfortunately, unavailable today. The executive has also informed me that it expects to be in a position to provide a more detailed response tomorrow on receipt of information from the hospital. The Minister of State will forward the information requested to the Deputy as soon as it is available, which I hope will be tomorrow.

Photo of Martin KennyMartin Kenny (Sligo-Leitrim, Sinn Fein)
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That is a very disappointing answer. The Minister of State is saying he will be able to respond on the specific operational matters raised when the consultant comes back to the hospital to deal with them. The issue is not about the consultant but the arrangement at the hospital. It is a management issue. There is no problem with what the consultants do or the clinical service they provide.

A number of companies throughout the country provide prosthetic services. They include Atlantic Prosthetic Orthotic Services, APOS, in Galway; Independent Disablement Services, IDS, in Dublin; Sota Prosthetics & Orthotics in Cork, as well as and others. They all provide an excellent service, but if patients need rehabilitation, particularly if they need to go to Dún Laoghaire for, say, a week, every excuse is found for why they cannot take them. That is the problem. There is a cosy little cartel and it needs to be dealt with quickly. There are patients throughout the country who endure the agony of losing a limb and then the mental torture of trying to deal with and work through that issue. They receive prosthetic limbs and must try to teach their bodies to cope with them. They find this difficult and there is both frustration and annoyance. The only way they can deal with it is by receiving intensive physiotherapy in some place like Dún Laoghaire. However, they are refused such services, unless they play by the rules set, which is totally inappropriate and wrong.

I appeal to the Minister of State to ensure this issue will be dealt with properly because it is simply unfair on the constituent with whom I am dealing. They having been looking to see whether they could go to Belfast or somewhere else to have the issue sorted out because the reality is that, for some reason or other, the people in Dún Laoghaire are slamming the door in the faces of Irish citizens who are taxpayers just like everyone else and deserve an equal service. This is not happening and not only is it unfair, it is also simply wrong. It is wrong that in this day and age people who are suffering in such a way are being let down by the State. They feel very let down. There are steps in this Chamber that we move up and down. Everywhere people with disabilities go, whether it be a restaurant or anywhere else, they face all of these difficulties. The least we can do is ensure there are adequate rehabilitation services available for them.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I made it very clear to the Deputy in my opening statement that I was not happy either with the answer I had received. I will relay the Deputy's concerns to the Minister of State, Deputy Finian McGrath, in the morning. My mother-in-law was an amputee for 30 years and I was in the National Rehabilitation Hospital with her many a time. The work the staff did on her was remarkable. It is very difficult for a person who loses a limb at any stage in his or her life to cope without proper rehabilitation. It defies logic that because they do not have a specific limb from a specific company people cannot access the national rehabilitation service to be looked after. On a personal level I will pursue this issue tomorrow with the Minister of State and, if needs be, the hospital through the Minister because the reply is inadequate. I agree entirely with the Deputy that it should not be up to a consultant to respond on a Topical Issue he has raised on such a sensitive matter which has affected a great many people. Many of us in the House know people in our families and neighbourhoods who rely totally on the National Rehabilitation Hospital in Dún Laoghaire to look after them when they need extra help to get back on the road again. I will convey the Deputy's concerns to the Minister of State tomorrow and give a guarantee that he will receive a reply.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The Minister of State's response is appreciated.

The Dáil adjourned at at 9.50 p.m. until 10.30 a.m. on Friday, 15 December 2017.