Dáil debates

Tuesday, 14 May 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Services for People with Disabilities

6:30 pm

Photo of Margaret Murphy O'MahonyMargaret Murphy O'Mahony (Cork South West, Fianna Fail)
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As Fianna Fáil's spokesperson on disability, I thank the Ceann Comhairle for selecting this issue. It is both topical and serious. I acknowledge first the fantastic work RehabCare does for 3,000 people in 117 locations nationally. The centre most familiar to me is in Bantry in south-west Cork. I acknowledge sincerely the fantastic work that is done there. I understand that after many requests by RehabCare, the Minister of State, Deputy Finian McGrath, the Minister for Health, Deputy Simon Harris, and the HSE met representative of RehabCare last week. I understand also that there will be a further meeting tomorrow. I hope sincerely that it will resolve matters and ensure these vital services can continue to operate. Behind every service user is a family and I ask the Minister of State, Deputy Finian McGrath, to keep that in mind as he meets these people. I suggest humbly that the Minister of State brings his cheque book with him when he tries to resolve this issue.

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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The Minister of State, Deputy Finian McGrath, and I are good friends at this stage given our ongoing engagement and discussion on people with disabilities. Our RehabCare service in Cavan-Monaghan is no different to the wonderful services the Minister of State will have seen and it includes the services at the Holy Family School and in Analee View respite centre in Cootehill. There is a broad range of facilities, including the centre in Bailieborough where there is a RehabCare centre. There is also one in Cavan. Cavan-Monaghan might have one of the largest service user bases in the country. Again, we see people with disabilities being sidelined and not being viewed as a priority. I am not talking about the Minister of State in that regard as I know he has a deep understanding of and appreciation for people with disabilities. He knows the importance of respite and rehabilitation care, whether provided in day service or residential settings. These are services without which families cannot function. Families depend on them. Most families are providing a 24/7 service themselves for 12 months a year. Respite care, day services and residential care are very important, including for adults with disabilities. It was most unfortunate to see last week how far staff and management were pushed in having to write to families to tell them services were on the verge of collapse. I hope the Minister of State has come to the Chamber today with positive news from which families can take some comfort.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Deputies Murphy O'Mahony and Smyth for raising this important issue. I know they care passionately and genuinely about disabilities. They have campaigned for and supported developments for the last number of years. I thank them for giving me the opportunity to outline the position in relation to RehabCare. The Government is committed to providing services and supports to people with disabilities which will empower them to live independent lives, provide 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. This commitment is outlined in A Programme for a Partnership Government and it is guided by two principles, namely equality of opportunity and improving the quality of life for all people with disabilities. Significant resources have been invested by the health sector in disability services over the past number of years. This year alone, the Health Service Executive has allocated €1.9 billion to its disability services programme, which represents an increase of €346 million since 2016. This is the highest ever level of funding in the history of the State. I thank my colleagues opposite for their support in that regard. I recognise that support.

I acknowledge the important services and the commitment to people with disabilities and their families provided by the staff of the Rehab Group. The Rehab Group provides short-term and long-term services to young people and adults with physical, sensory and intellectual disabilities, mental health difficulties, autism and acquired brain injury. Services are co-ordinated through Rehab's three service delivery divisions, RehabCare, the National Learning Network and Rehab Enterprises. RehabCare provides health and social care supports to about 3,000 adults and children each year, enabling them to become active members of their own communities, achieve life goals and experience new opportunities. The National Learning Network provides a range of flexible training courses and support services for some 5,000 students, including jobseekers and people with an illness or disability, from age 16 upwards who need specialist support in 50 centres around the country. The National Learning Network provides a wide range of vocational training and education programmes which are funded by SOLAS, as well as rehabilitative training, funded by the HSE. Rehab Enterprises does not receive funding from the HSE. The Rehab Group is funded by the HSE under section 39 of the Health Act and operates in all nine HSE CHO areas. Services are provided through a service arrangement which is signed on an annual basis and reviewed continually. The 2019 budget allocation for the Rehab Group is €56.1 million, which is €1 million more than in the previous year.

Last Tuesday, the Minister for Health, Deputy Harris, and I held a joint meeting with Rehab and the HSE. I have met representatives from the Rehab Group and many families of service users personally over the last three years also. Arising from reported financial challenges, Rehab and the HSE have committed to work intensively with a view to understanding the group's financial position and cost base. My primary concern is to ensure continuity of disability services for service users and their families, delivered in line with strong governance mechanisms in a cost-effective and equitable manner which is consistent with care and support needs.

RehabCare has agreed not to issue a notice of termination, pending the outcome of this intensive work with the HSE. The Minister and I have committed to meeting RehabCare and the HSE tomorrow, Wednesday, 15 May, at 5 p.m. The answer is that I am pushing this agenda very strongly and I thank the Minister for his support.

6:40 pm

Photo of Margaret Murphy O'MahonyMargaret Murphy O'Mahony (Cork South West, Fianna Fail)
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I am glad the Minister of State acknowledges the fantastic work done by RehabCare but he is still not answering my question. I know it is difficult to pre-empt the meeting tomorrow but I was hoping he would state that he will continue to fund this fantastic organisation. I am a bit disappointed with his response. Does the Minister of State think that the HSE could provide the services that RehabCare provides and is he prepared to state that the HSE would provide a better service?

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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As my colleague, Deputy Murphy O'Mahony stated, what RehabCare does for people on the ground is magnificent. It is in no small way a relief and a support for families. As we would say in Cavan-Monaghan, the Minister of State's response was watery. We have nothing tangible to take back to our families or to the management of RehabCare across Cavan-Monaghan. I appreciate that it may be difficult for the Minister of State to provide anything concrete ahead of that meeting tomorrow. However, I would ask that everything be done to ensure that these services continue and that there will be no break in the day service or the residential service. In recent times, people with disabilities and service users in places such as Steadfast House in Carrickmacross have been hit with ongoing charges in respect of their daily services, whether it be to get their bus or their lunch. There seems to be all these sneaky ways of introducing charges that take away from the little bit of social protection these people enjoy. I reiterate the point that RehabCare is providing a fantastic service and everything should be done to ensure that this continues.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Deputies Niamh Smyth and Murphy O'Mahony again for their support on this issue. I support RehabCare and I am supporting it in government. That is my clear position. I also agree strongly that my job is to look after people with disabilities. I am not interested in any other aspect of the issue. The families are my job. Of course we need tangible results and I am hoping to get them tomorrow.

I mentioned the HSE's 2019 budget earlier. This year, €1.9 billion has been allocated to the HSE's disability service programme. That is an increase of €346 million during the lifetime of this Government. This will fund the provision of a wide and complex range of services and supports to people with disabilities. Additional funding this year is being focused on a number of priority areas as a result of ongoing demographic changes and the fact that population is increasing. These areas include: the expansion of community disability services to meet the needs of school leavers; the 100 new therapy posts to address the assessment of need waiting lists for children with disabilities; personal assistance and home support service hours; and residential and respite places. At our meeting last Tuesday, which was difficult and direct, both RehabCare and the HSE remained committed to working together intensively with a view to making substantive progress in arriving at a solution in respect of this issue. The Minister and I are working closely together on this issue. I have also raised it at Government level. A further meeting is scheduled to take place tomorrow and I hope major progress will be made in respect of the genuine concerns the Deputies have raised. As stated, my focus is on the people with disabilities and their families. I want to see the funding going there and I want to see them get maximum support.