Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I thank the Minister of State, Deputy Phelan, for coming to the House to deal with the issue of respite care services for children in counties Cavan and Monaghan. Respite care service provision has reached crisis point for over 100 families across counties Cavan and Monaghan who are on a waiting list for support. Respite care services for children and adolescents with disabilities across counties Cavan and Monaghan have deteriorated significantly in recent months, with more families unable to access the services they so badly need. Parents and carers are becoming increasingly frustrated at the lack of respite care services, so much so that a parents action group has been set up to highlight the issues the families are facing. The parents action group for respite care services held its first meeting in Cootehill, County Cavan before Christmas. It was a robust, heated and highly charged meeting, as parents are at the end of their tether.

I have been raising this issue on the floor of the House for months in an effort to relieve the plight of these parents and ensure proper, consistent supportive services will be put in place. On 4 January the parents took to the streets in a demonstration to convey their anger at the lack of respite care services. They protested outside the entrance to St. Davnet's in Monaghan to highlight their concerns. I do not need to tell the Minister of State that they are the parents of children with disabilities, physical and intellectual, who face huge challenges every day of their lives. They should not have to resort to protesting on the streets outside a hospital, but they felt it was necessary to have their voices heard and have the HSE take this matter as seriously as it is for them.

The only facility currently available to parents who need respite care for their children is Annalee respite care centre in Cootehill. The centre has five beds, but no places have been available since mid-September. I understand beds recently became available, but there was a crisis up until that point. I commend the hard work of the chairperson of the parents action group, Jennie Farrelly, who, with a delegation which comprised Niamh Brannigan, Kate McCabe, Seamus Cahill and my colleague, Deputy Brendan Smith, recently met the Minister of State, Deputy Finian McGrath, to raise their concerns. I take my hat off to these parents who not only take the time to hold public meetings and protest but also to come to Dublin to meet the Minister of State.

I am not exaggerating when I say services in this area are in crisis. Listening is not enough. The parents need action. They need another centre dedicated to children who need respite care services. They face enough challenges in life without having the lifeline of respite care withdrawn from them and being left for months without a break. It is utterly disgraceful that they have been abandoned in a vacuum with no end in sight. The obvious response of the HSE in the midst of the crisis was to find alternative accommodation or offer increased home care support hours to the families, but it did nothing. It is my understanding the service has resumed since 11 January, but I would like the Minister of State, Deputy Phelan, to outline what plan is in place to deal with the backlog which has built up in the past five months.

John Paul Phelan (Carlow-Kilkenny, Fine Gael)
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I am taking this debate on behalf of my colleague, the Minister of State at the Department of Health, Deputy Finian McGrath. As my version of the response does not reference specifically counties Cavan and Monaghan, if the Deputy needs me to obtain specific information, I will.

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 which will empower them to live independent lives. Respite care services are an important part of the range of services supporting people with disabilities and their families. Short breaks can also provide an opportunity for individuals to meet new people, widen their social circle and gain new experiences. Respite care is crucial in helping to reduce family stress, preserve the family unit and provide stability. The need for increased respite care services is acknowledged and the HSE continues to work with all service providers to explore various ways of responding to this need in line with the budget available. As part of its ongoing service provision, this year the HSE will provide over 182,500 respite care nights and 32,662 day respite care sessions for families in need across the country.

In 2018 there was a significant improvement in respite care provision. An additional €10 million was provided to fund 12 new respite care houses, one in each HSE CHO area, plus an additional three houses in the greater Dublin area to respond to the very high demand for respite care in this area. The additional houses are providing additional respite care for families who need it. To date, ten houses have opened and the remaining two are scheduled to open shortly. When fully operational, they will provide for 19,000 extra over-night stays and 2,520 home sharing night stays annually. Some €2 million of the additional money is being targeted at alternative respite care services. These are practical and important solutions, with alternative respite care provision working well locally, with good examples of summer camps, evening and Saturday clubs, benefiting hundreds of adults and children.

In 2018 community-based, alternative respite care projects delivered 15,144 in-home respite care hours to 400 users and 1,296 Saturday evening-holiday club sessions to 1,500 people. The number of adult service users continually increases as service users transfer from child to adult services. This impacts on the level of respite care existing service users receive. In addition, a number of service users have associated mobility needs, which means that they can only access downstairs bedrooms. This also affects the level of respite care they receive. In preparing its 2019 national service plan additional finding will be focused by the HSE on a number of priority areas arising from ongoing demographic changes. They include the expansion of community disability services to meet the needs of school leavers; 100 new therapy posts to address assessment of need waiting lists for children with disabilities; personal assistance and home support service hours, residential places and respite care places.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I appreciate that the Minister of State is not the Minister with responsibility for disabilities or health, but I thank him for coming to the House to address the issue. I would thought that the HSE would provide him with detailed information on the crisis in counties Cavan and Monaghan. As I said, this is not the first time I have raised the issue. My colleague, Deputy Brendan Smith, has also raised it on a number of occasions. There are parents in the region who have had no access to respite care services for five months.

I am aware the parents action group met officials from the HSE this morning. I am not exaggerating when I speak about the frustration and the significant number of families - more than 100 - who have been affected by this and when I say the parents are at the end of their tether. One family who came to me have a daughter who has a severe physical and intellectual disability. She is almost ten years of age and they have never been offered respite care. They are on a waiting list but these lists are so long. The one facility available is taken up because there is a child who has difficulties and needs to be housed on their own for whatever reason. There is no other facility to accommodate the parents and children who are on a waiting list.

We cannot carry on like this. These people are the most vulnerable in society. These are parents are exasperated and exhausted and are losing faith in the system, which they should be able to rely on for some support. Disability services within the HSE are crucial because most of these parents are the main carers for their children and provide care 24 hours a day, seven days a week. All they are asking for is respite, which might be one night in five or six weeks.

The facility may be back in action but for five months more than 100 parents have had no respite care. That is not taking into account the parents and children who are on the waiting list and who have never had respite care. A plan must be put in place. Will the Minister of State convey to the Minister responsible the need for an action plan to deal with the crisis specific to Cavan-Monaghan?

John Paul Phelan (Carlow-Kilkenny, Fine Gael)
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I certainly will pass this message on. I know from my own family the importance of respite hours and that Deputy Smith is not exaggerating the issues for those people concerned. I am not surprised they have taken to the streets because for the parents of children with either developmental or disability issues, the most important person in their lives is the child they want to help. I will tell the Minister of State, Deputy Finian McGrath, about the Deputy's concerns and ask him to respond directly to her. The matter, as listed here, does not specify Cavan-Monaghan but I will ask him and his officials to give the Deputy a specific answer on Cavan-Monaghan.