Dáil debates

Thursday, 8 November 2018

Saincheisteanna Tráthúla - Topical Issue Debate

Disability Services Funding

3:45 pm

Photo of James BrowneJames Browne (Wexford, Fianna Fail)
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I lend my support to Deputy Ó Caoláin. This is my third or fourth Topical Issue debate in a row where I did not have the line Minister present. I had an urgent matter in Wexford this morning and I drove back up but I may as well have phoned it in as come here to debate the issue.

I raise the issue of St. Aidan's services in Gorey and I understand that this voluntary organisation is threatened with imminent closure. St. Aidan's services in Gorey provides day, residential, respite, preschool, elderly and training services across Wexford and also provides meals on wheels. It has been in its current location for 36 years and was established in 1968. It has over 300 service users per annum and has 130 staff, yet this week the staff will be paid on a delayed basis because of what St. Aidan's says is a shortage of promised funding from the HSE.

The service users, their families and the staff have been informed that the centre is in imminent danger of closure unless its finances are addressed as a matter of urgency and the issue has reached a crisis point. As the Minister of State can imagine, the information that has been provided has caused a huge amount of distress to the staff, the service users and their families.

I am told that a core deficit was identified in 2016 and the HSE agreed in 2016 to provide funding to the organisation to address it. The deficit arose as a result of the organisation providing HSE services without HSE funding. Additional costs have been incurred as a result of upgrading that was required to meet Health Information and Quality Authority, HIQA, standards.

This year the HSE has a budget of €17 billion and the money required to keep vital services open and 130 staff employed is a minuscule part of that. The high quality experience of the staff would be irreplaceable should this service shut down and the cost of providing an alternative service to service users will be far in excess of the money that is not being provided.

St. Aidan's in Gorey is not looking for special treatment, it is simply looking for fairness and for the HSE to honour the agreement it says the HSE made with it. St. Aidan's provides outstanding care in Gorey and also to the service users in Enniscorthy, New Ross, Wexford town and throughout the south east.

The latest information I have received this week is that the staff who were meant to be paid today will not be paid until tomorrow but the HSE has come and looked for a €100,000 rebate to be paid in December which would be deducted from December's payment. I am being told that effectively means there will not be enough money to pay the staff in December.

This issue has been going on for four years, various people have raised it during that time and there is no resolution in sight. It is a matter of urgency that this matter is addressed. It has reached crisis point and as I understand it the service is about to collapse.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I apologise that the Minister of State, Deputy Finian McGrath, is not here and I am taking this Topical Issue on his behalf. As Deputies know, I am a Minister of State at the Department of Health and I will, when asked, try to facilitate as many Ministers and Ministers of State as possible and come here on their behalf.

On behalf of the Minister of State, Deputy Finian McGrath, I thank Deputy Browne for raising the issue of funding in relation to St. Aidan’s care services in Gorey, County Wexford.

The 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. Disability services are provided to enable each individual with a disability to achieve his or her full potential and maximise independence, including living as independently as possible.

Services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups.

Services, in the main, are provided either directly by the HSE or through a range of voluntary service providers. Voluntary agencies provide the majority of services in partnership with and on behalf of the Health Service Executive. HSE disability services have been allocated €1.8 billion in 2018. This includes residential services for 9,000 people, day services for over 24,000 in addition to 182,500 respite overnights, 1.46 million hours of personal assistant services and 2.93 million hours of home support services.

This funding is providing disability services throughout the country across all community healthcare organisations, CHO, areas and is spent in line with nationally agreed policy for disability services while at the same time endeavouring to maximise value.

St. Aidan’s services in County Wexford provides a range of services for adults and children with intellectual disabilities which includes residential care, day services for adults with disabilities, preschool education for children with disabilities, day activation, rehabilitative training, a garden centre and respite services for children with high support needs.

St. Aidan’s receives funding under section 39 of the Health Act 2007 from the HSE and is scheduled to receive €5 million in 2018. St. Aidan’s has identified deficits to the HSE in its agency’s core funding and costs associated with HIQA compliance, and has indicated that this may affect the services it provides.

HIQA is the statutory independent regulator for residential services in the disability and older persons sectors. All residential services are inspected by HIQA and compliance with a number of quality and safely regulations is required for registration. Regulatory compliance is a requirement under the service level arrangements agreed between the HSE and voluntary service providers. Service providers are expected to meet any costs associated with HIQA compliance through their core HSE funding allocation. The Deputy should note that increases in funding can only be considered within the parameters and scope of funding available to the HSE. Local HSE disability services continue to have ongoing liaison and engagement with St. Aidan's regarding deficit issues arising in the context of resources available. The HSE will be producing the 2019 national service plan in accordance with the relevant legislative provisions and funding allocation and additional funding may be considered in this context.

I might have missed one of the issues the Deputy raised. He might come back to it.

3:55 pm

Photo of James BrowneJames Browne (Wexford, Fianna Fail)
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I am not having a go at the Minister of State or the line Minister. However, this is becoming a habit in the House and this case illustrates why it is an issue. The staff here are being paid a day late this week. I have been told there will not be enough money to pay the staff in December. There are 300 service users. Everyone is under stress, including staff, service users and their families. The answer that has been typed out for the Minister of State to read does not answer any of my questions. It does not address the situation of ongoing issues between St. Aidan's and the HSE regarding funding for the past two and a half years. It does not say whether the Minister is going to engage with the situation with either St. Aidan's or the HSE. No solutions, proposals or ideas are set out to deal with this situation and we will go home today none the wiser. Most of the Minister of State's reply just tells us what we already know. What does the Minister say to the staff who are being paid late through no fault of St. Aidan's which does not have the funding? What is to be said to families and service users? Will there be any intervention? The HSE's CHO 5 states that it has no money to pay because it has run out of cash. The matter has gone up the line to senior HSE management, but that is not addressed in the reply. The HSE and the Department have been given fair warning about this situation, which has now reached a crisis point. If things fall apart in the coming weeks, the responsibility will lie at their doorstep.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I have little to add. I do not have any initial answers to the questions he asked. The matter raised centres on the provision of funding to avoid the closure of St. Aidan's care centre in Gorey and I do not know anything about why staff have not been paid.

Photo of James BrowneJames Browne (Wexford, Fianna Fail)
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The HSE and the Department are aware.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I assure the Deputy that I will bring his very relevant concerns to the Minister on my way back up and ask for a reply to be forwarded to him. I have taken notes and will ensure that happens. However, I do not have the specific answers in the reply or even in the other material I was given.

Photo of James BrowneJames Browne (Wexford, Fianna Fail)
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I thank the Minister of State.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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Given the nature of the reply and the seriousness of the issue, the line Minister might meet Deputy Browne. It is a matter of some urgency.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I will relay his concerns when I go back up to the office.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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It would be helpful in respect of finding a resolution to the matter.