Michael McGrath (Cork South Central, Fianna Fail)
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7. To ask the Minister for Health his plans to address the chronic lack of residential placements for disability services in County Cork [28197/18]

Michael McGrath (Cork South Central, Fianna Fail)
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This issue relates to the lack of residential placements for people with a disability. I had a good exchange with the Minister of State, Deputy Finian McGrath, about this issue a few weeks ago during a Topical Issue debate. I am glad that the Minister, Deputy Harris, is here to listen to the exchange. This is not just a Cork issue. It is a national issue but it has been highlighted to me, as is often the case, through individual cases and people in quite a chronic situation. The waiting list is appalling. I would like the Minister of State to update the House about what measures are being put in place to tackle the lack of residential places for persons with a disability, both children and adults.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Michael McGrath for raising this issue of residential places in disability services in Cork. I take it on board and we recently debated it in the Dáil ourselves. 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 which will empower them to live independent lives. As part of its ongoing service provision, this year the HSE will provide over 8,300 residential places to families in need across the country. Residential places make up over two thirds of the disability budget. That is a figure that people often do not know. Our policy is for people with disabilities to be supported to achieve their full potential so that, where possible, they can live on an everyday basis among family and friends in the community. All residential placements for adults with disabilities are considered following detailed clinical assessments by HSE services. Access to places for those with the most complex needs are allocated on a priority basis and the availability of appropriate services.

A significant underlying challenge relates to the unmet need for residential and respite care that arises from the absence of investment during the economic downturn. The HSE national database figures indicate an annual requirement of over 400 residential places per year. As a result, the service is experiencing a high annual demand for emergency residential places to respond to the most urgent cases. In 2018, the HSE national service plan provides for support for 385 persons through 130 emergency places, 135 in-home supports and 120 in-home respite supports. I am informed by the HSE that there are currently 1,093 placements being provided in the Cork-Kerry community healthcare area. The demand for residential places is in excess of places available. I accept questions and will respond accordingly.

Additional information not given on the floor of the House

A residential placement committee made up of all service providers has been established who work collaboratively, and in partnership, to respond to the growing need of service users and their families. This committee is planning for the future, while also reviewing existing services and the varying level of need. Families need support to care for their loved ones at home and the Government is committed to providing a range of accessible respite care supports for people with a disability and their families. There is an absolute need for increased respite care and in 2018 an additional €10 million specifically to enhance respite care was provided. In April of this year, this extra funding enabled the opening of an additional service in Listowel, County Kerry. Up to the end of last month, an additional 108 respite nights were provided to 15 persons. Additional respite is planned towards the end of the year in west Cork, which will facilitate referrals from across County Cork. In the meantime, a range of alternative respite options will begin in the coming weeks across County Cork.

Michael McGrath (Cork South Central, Fianna Fail)
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There is a serious issue with respite provision but this question focuses on residential placements. It surprised me when I did some digging that the HSE could not provide any data on the number of people on a waiting list for residential placement nationally, so I started to probe the issue locally. In Cork alone, between the Cope Foundation and the Brothers of Charity, two outstanding service providers, there are 252 adults and children on a waiting list for a residential placement. The Cope Foundation has 175 of those and 27 of them are deemed to be priority 1. They are critically urgent cases.

There are situations where elderly parents, who are not getting any younger and who have medical needs themselves, are caring for adult children who, in some cases, have very high dependency needs. It is becoming incredibly difficult for them and they are just about coping day by day. They need to know there is light at the end of the tunnel but they are being told by their service provider there is no hope. They might be 30th or 40th on a local waiting list and the service is not even getting enough funding to clear the emergency cases. That is what they are being told.

Finian McGrath (Dublin Bay North, Independent)
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I am sorry to hear they are being told that there is no hope. We gave one of the services mentioned, Cope Foundation in Cork, increased funding in the last two weeks. I have already visited and met the management team there, and I will be going back in the future.

I take the point on the issue of residential places, where we have a particular problem. The Deputy mentioned the Brothers of Charity, who are providing 184 residential places, Cope Foundation is providing 437 residential places and the Cork Association for Autism is providing 16 places. There is work going on, although I accept we have a hell of a lot more to do. With regard to funding for disability services, we have to prioritise residential services, particularly those where older parents are taking care of adults with an intellectual disability but have no residential care available.

With regard to the HSE budget, in 2018 we are spending €1.7 billion, an increase of €92 million on last year. The figures are as follows: there were 182,500 respite over-nights, 42,552 day respite sessions, 135 new home supports for emergency cases, 130 residential places and 120 in-home respite supports for emergency cases. There was also the additional €10 million to provide respite services.

The bottom line, when we break down all the figures, is that in budget 2019, as I and the Deputy know and as I have said to the Government, we need 400 emergency residential places.

Michael McGrath (Cork South Central, Fianna Fail)
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I thank the Minister of State. As I said to him before, he will have our support and we will raise it in the budget negotiations. Respite care and residential placements are a priority. I know it is not easy, I know the residential places are very expensive, but this must be a priority. The Minister of State must also be familiar with individual cases. The human stories, whereby there are elderly parents struggling to just manage day by day with adult children who they love dearly but who have significant needs, are quite tragic. The parents concerned simply cannot meet those needs any longer. There is nowhere for them to go and no help for them. These people are lucky if they can get respite. I acknowledge that while respite is not available for everyone, the service providers are doing their best with the resources they have.

In a fair, decent and compassionate society, this issue must be a priority. I am not questioning the Minister of State's bona fides. He has political support, certainly from Fianna Fáil, in pressing the need for extra funding for residential placements in 2019. We will provide that support.

Finian McGrath (Dublin Bay North, Independent)
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I appreciate that support and I know that the Minister is on the same page. Health and disability are key issues for our society.

To add a little hope, additional respite is being planned for towards the end of the year in Cork, which will have referrals from all over the Cork area. In the meantime, a range of alternative respite options will be beginning in the coming weeks across County Cork.

To return to the core issue, we need to ensure that this year's budget contains support for these emergency places. As I said, last year we managed to have 135 new home supports for emergency cases and there were also other home supports. The bottom line - and the figure for which I am pitching - is that we would ensure 400 residential emergency places are available every year to ensure we deal with these priority cases. There are a lot of families doing fantastic work but, as they get older and sometimes themselves have disabilities, they need support. It is up to us, as a compassionate Government and a compassionate Opposition, to ensure we prioritise the funding and supports for these people. I would try to give a message of hope to the many people with disabilities and their families. We are improving the services every day.