Dáil debates

Thursday, 26 September 2019

Saincheisteanna Tráthúla - Topical Issue Debate

Disability Services Funding

1:30 pm

Photo of John McGuinnessJohn McGuinness (Carlow-Kilkenny, Fianna Fail)
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Last week, I met with SOS on Callan Road, Kilkenny about the services that it delivers. It was originally founded on the basis of delivering lifelong services of various kinds to people with intellectual disabilities. In recent years, because of the lack of funding and the fact that it is not being paid for the services delivered, the range of services it has and its capacity to deal with different clients who come forward are now under threat. It is unable to provide that lifelong service to its clients. SOS is an extremely good service that works efficiently and well. The manager there, Mr. Francis Coughlan, has done everything in his power to ensure that the money he gets is spread evenly and deals with the issues. At present, he has 50 cases. They are called business cases but they are really cases requesting funding from the Department to satisfy the need of an intellectually-challenged individual. There is no decision from the Department on these cases. In fact, to bring its services to where they were previously and keep them at a standstill would require €1 million. SOS would have to have those 50 cases dealt with immediately, with full funding being granted. These is no respite care for those who use the service and SOS has urgently asked that the Minister would consider providing the funding to have two respite beds available when they are needed for those who are attending that service.

To give the Minister an example I raised with the Taoiseach, a client of that service for 30 years has been in St. Luke's General Hospital since last November. He is medically discharged but there is no place for him within SOS because it cannot provide the funding. The infrastructure and the building are there. It requires immediate funding of €600,000 for that project. The hospital setting is costing nearly €2,000 per day and is inappropriate for the man's needs. He is not getting the services that he requires. His parents are deeply concerned that this is an emerging trend within that organisation that is so well-respected and supportive of the parents and the clients. They were deeply concerned and expressed their worry, as the parents or the guardians of the children in care, about who would look after the children when their lives were over. This is a question that has to be answered. Francis Coughlan and SOS deserve a direct reply and response.

The management of the services by the HSE is appalling. It is willing to stand to one side and allow these services to deteriorate and to allow people to be left in inappropriate settings in hospitals.

There is literally no response. When I asked the Taoiseach that morning I was taken aback by the cold way in which he answered the question. I followed him out of the Chamber and gave him a written note about the difficulties facing that individual but I am now talking about the overall plan to provide the life care services required by the clients by SOS. I ask the Minister of State to address the issue comprehensively and to deal with the fact that this man has been in hospital since last November. That is a separate issue but he is a client of SOS.

1:35 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I am taking this debate on behalf of the Minister of State, Deputy Finian McGrath. I thank Deputy McGuinness for raising this important issue and for giving me the opportunity to outline the position with regard to the provision of respite services to clients of SOS in Kilkenny.

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. 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 circles, and gain new experiences. Respite care is crucial in helping to reduce family stress, preserve family units, 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 this year to families in need right across the country. In 2018, there was a significant improvement in respite. An additional €10 million was provided to fund 12 new respite homes. This comprises one in each HSE community healthcare organisation, CHO, area and an additional three houses in the greater Dublin area to respond to the very high demand for respite in this region. These 12 additional houses are providing additional respite for families that need it.

This year the HSE will also fund a number of alternative respite services. These are practical and important solutions, such as summer camps and evening and Saturday clubs, which benefit hundreds of adults and children. The number of adult service users continually increases as service users transfer from child to adult services. This impacts on the level of respite existing service users receive.

The budget allocation for SOS in 2019 is approximately €10.7 million, which represents an increase of 4.5% on the 2018 allocation of €10.2 million. This allocation provides for the maintenance of the 2018 level of approved services in 2019.

South East Community Healthcare is proactively working with the SOS CEO and team to develop a plan that will contribute to resolving the organisation's financial position in a structured way over a time-defined period. In addition, the respite house in Tullow, County Carlow is expected to open in due course. To ensure the continued provision of respite services across the south east, a task force group has been established to review respite services and ensure delivery in a fair and equitable way that meets the needs of the service users. SOS Kilkenny is a member of this task force group.

If Deputy McGuinness would like to forward me some information regarding the person about whom he spoke, I will bring it to the attention of the Minister, Deputy Harris, straight away.

Photo of John McGuinnessJohn McGuinness (Carlow-Kilkenny, Fianna Fail)
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I thank the Minister of State for her response, but she is being misled by the HSE. I ask that she rings Dr. Cathal Morgan, Ms Janette Dwyer, and Ms Kate Killeen White, all of whom work for the HSE. Each of those three are involved in managing services in the area in which SOS Kilkenny is located. The Minister of State should ask them why that man is in hospital and why services in SOS are being continually run down. She should ask them why the 50 business cases are not being approved and why there is no direct engagement with SOS to assist Francis Coughlan in delivering the services committed to.

The Minister of State says that the budget is there and that approved services will be maintained at their 2018 levels. The 2018 levels do not reflect the amount of activity that should be taking place in the service. It represents a reduction on the services provided in 2017, which was itself a reduction on 2016. The Minister of State's comment was not inaccurate, but it is very misleading to say that services are at their 2018 levels. We do not want them at those levels. We want to fulfil the commitment given by those who started the service, which was to deliver a lifelong service to those who need it. That is not being done. It is not being achieved. People and their families are appalled that the HSE has not responded. It is showing no humanity and no compassion whatsoever. It is hard to stand by and listen to that type of answer from the HSE or the Department of Health when they know full well that the services are pushed to the pin of their collar and are unable to deliver what is demanded of them, let alone what they wish to deliver, because clients requiring services are turning up in great numbers. The HSE is turning a blind eye.

I revert to the issue of management. Those in management must explain why this is happening. They must be made accountable and must be transparent. I again encourage the Minister of State to make those three phone calls and to seek some form of humanity, compassion or relief in respect of what SOS is trying to achieve in Kilkenny.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I reiterate that the Minister of State, Deputy Finian McGrath, is very aware of the importance of access to planned respite and that he assures the Deputy that everything possible will be done to help those who need respite, particularly families with an ongoing need for respite for their child and adult members in order to have a break. I have taken down the names of HSE staff the Deputy mentioned. Will he repeat the last person? I got the first two. I will certainly ask the Minister, Deputy Harris, to make contact with these people and to ask that the manager of the SOS service be assured that the HSE knows that the services being provided at present are not adequate, particularly for that young man who needs the service but who cannot take it up because funding is not available. Will the Deputy give me the name of the last person again? I got the first two; I just missed out on the last one. I will then go back to the Minister and ask him to engage with the HSE's management team for the area.

Photo of John McGuinnessJohn McGuinness (Carlow-Kilkenny, Fianna Fail)
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The names were Ms Kate Killeen White, Ms Janette Dwyer, and Dr. Cathal Morgan, who is the national director. If I may, my point is not just about that man but about the overall services provided by SOS.