Declan Breathnach (Louth, Fianna Fail)
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I remarked at a meeting of the Committee on Budgetary Oversight earlier that things are still unwell in the state of Angola. Despite the Department of Health's provision of more than €17 billion, an increase of 11.6% on last year's budget, its overrun is projected to be more than €150 million by the end of the year. I believe managers are being told by the budgetary oversight group in the Department of Health to take corrective measures. Sruthan House is clearly one of the victims. What we used to call cuts are now called interventions or operating to a budget.

Last week, service users in Sruthan House, Dundalk, and their families received a letter from the HSE saying the facility would close down by the end of the year. Sruthan House is operated by the HSE in partnership with the Irish Wheelchair Association and provides respite and holiday service for adults with physical or sensory disabilities or both. It has operated for the past 23 years and caters for more than 50 clients with a staff of 14.

I have seen the letter that was sent to clients and it is an understatement to say I am appalled. The letter said that because of the prioritising the provisions of services to enhance cost efficiency and continuous quality improvement, Sruthan House will be closing by year end. Clients were told that the HSE would continue to offer respite services through facilities in Roscommon, Sligo and Dublin.

How can closing this 23 year old service, which has had no complaints and nothing but admiration, and telling people with these disabilities to travel in excess of 100 km to a service in Roscommon, Sligo or Dublin, be described as quality improvement?

The HIQA inspection of the premises in October 2018 found the facility to be fully compliant with all of the regulations and the inspector noted the close bond that existed between the staff and clients, many of whom had made personal connections after using the services for years. The inspector observed an atmosphere of friendliness in the house and that the staff were kind and respectful towards residents through positive, mindful and caring interactions. Questionnaires submitted to the residents and their families relayed positive comments about staff at the centre. One resident summed it up by stating the staff were very friendly and provided a welcoming home from home atmosphere. Clients further commented that Sruthán House has given them back their lives. Family members have said the facility is invaluable and that clients look forward to the next day when leaving Sruthán House. Sruthán House allows those with physical and sensory disabilities to meet new people and get a few days away from home. It is simply irreplaceable.

The HSE's letter went on to invite clients and family members to discuss their concerns about the proposed changes. The letter began by stating it will close in December this year and suddenly decided to invite staff to discuss the proposed changes. It was a cold, crass letter telling these people with disabilities they are losing the respite service in their community after 20 years. They are simply not in a position to travel the distances in question.

I am aware of the commitment of the Minister of State to disability services and two disability service houses have been opened, in Balbriggan and Dundalk, to which he committed. I ask him to tell me the sense in providing two new facilities while closing an excellent service. It does not make sense and corrective action needs to be taken before December.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this important issue and for the opportunity to outline the position on Sruthán House. 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. This commitment is outlined in A Programme for a Partnership Government. It is guided by two principles, namely, equality of opportunity and improving the quality of life for people with disabilities.

Respite 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 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, the HSE will provide more than 182,500 respite nights and 32,662 day respite sessions to families in need throughout the country this year. In 2018, there was a significant improvement in respite provision, as the Deputy mentioned. An additional €10 million was provided to fund 12 new respite houses, which are up and running. This is one in each HSE CHO area and three additional houses in the greater Dublin area to respond to the high demand for respite in this area. These houses provide additional respite for families that need it. All 12 houses are now open and fully operational.

A total of €2 million of the additional money is being targeted at alternative respite services. These are practical and important solutions. Alternative respite is working well locally, with good examples of summer camps, evening and Saturday clubs having taken place, benefitting hundreds of adults and children. Further additional respite initiatives are planned for 2019 in each HSE CHO area.

With regard to Sruthán House and Louth disability services, I found out earlier from the HSE that Louth disability services are prioritising the provision of services to enhance cost efficiency and continuous quality improvement in line with the best standard practice. The residential respite service at Sruthán House will, therefore, cease operation by the end of December 2019. To facilitate this transition, Louth disability services are reviewing respite service delivery and have invited the service users be a part of this process to identify what service will best meet their individual and family needs. Louth disability services remain committed to providing services to people with physical and sensory needs and will continue to offer respite through a number of options. These include a number of respite services in different locations, such as Woodhaven House, which is a supported holiday facility in Sligo for people with MS, Cuisle, which is the Irish Wheelchair Association's national holiday centre in Roscommon and the Carmel Fallon Centre, which is the Irish Wheelchair Association's holiday centre in Dublin. Services will be provided but, of course, this will all be done in consultation with all the families of people with disabilities.

Declan Breathnach (Louth, Fianna Fail)
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I do not doubt the sincerity of the Minister of State with regard to disability services but I am terribly disappointed by the response. As he indicated, he was informed of this today. I call on him to ensure that Sruthán House and its services are supported through and beyond this year. Cost containment is the reason for the closure. It is all about cost containment and budgetary measures and not about the people who need the services. If we do not get to grips with this, the vulnerable people in disability services will further suffer. Closing this facility, which caters for those with physical and sensory disabilities, is a direct result of a health budget that is being allowed to overrun. For the life of me, I cannot understand why we speak about providing new services, and we are all for that, but then dissipate and restrict services for the most vulnerable in our society.

It is in the hands of the Minister of State to get to grips with what management is being dictated to deliver at the expense of people in my community and beyond. I am quite sure that before the end of this year, these services and others will be cut unless provision is made to meet the shortfall that will exist in the budget, which I am confident, I am sad to say, will be in excess of €132 million. There is no way vulnerable people in this society or in my community should suffer as a result of inability to handle a budget.

Finian McGrath (Dublin Bay North, Independent)
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I have listened carefully to the Deputy's concerns of Deputy. I accept, and I am aware of, the importance of access to planned respite, which ensures people with disabilities receive opportunities to socialise, and facilitates families to receive a break. Short breaks provide an important opportunity for individuals to meet new people. The Deputy raised the valid point of the €17 billion going into the health services. Within that €17 billion is €1.904 billion for disability in the HSE's service plan for 2019. This is an increase of 7.5%.

I remind the Deputy that the additional funding provided last year will continue in 2019 and, in particular, the €2 million allocation to be spent on alternative respite services remains a high priority for the HSE. This is not about reducing services. That is the key issue. They are not being reduced. An alternative service will be provided and maintained. In fact, it is about improving services and the quality of the services. It is about making the best use of current resources. As I stated earlier, the HSE will work with service users and their families in identifying what service will best meet their individual needs. I am informed the HSE will set out detailed plans for the service once the consultation process is completed.

The consultation process is very important. I take the point about the travel issue, as well as respite care services. My vision for respite care services is that they should be provided as near as possible to the families and the local community. I also take on board the points made by the Deputy about Sruthán House. I will make his views known on these issues, as well as my own, because I share some of the concerns raised.