Pa Daly (Kerry, Sinn Fein)
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I am glad of the opportunity to raise this at such short notice. Recently, I met a family from Killarney, Steve O'Mahony, his wife, Teresa, and their daughter, Alexis. I want to raise an issue on their behalf. We discussed a cut that has been made to disability funding. This cut was not made by the HSE or the Department of Health. It is the removal of funding for ceiling track hoists from housing adaptation grants. Alexis is six years old next week. She has cerebral palsy, quadriplegia, subluxation of her right hip and a high risk of aspiration, that is food or drink going in to her lungs. Alexis is completely dependent for her daily care. She requires constant repositioning for washing and to prevent injury, and she needs two people to hoist her.

The Minister of State will be aware of housing adaptation grants. Kerry County Council has a budget of €3 million to spend on housing adaptation grants, which help our elderly and disabled family members, making life easier for them living in the community. Grants are available to make repairs or improvements to their homes. According to a letter received last month by Mr. Steve O'Mahony, in September 2020 the Department of Housing, Heritage and Local Government informed local authorities that ceiling hoists should not be included in the housing adaptation grant. Since then, most local authorities no longer provide funding for the provision of the hoist itself although they may fund the structural works, that is, to place hoist tracks in the ceilings. Mr. O'Mahony had raised this issue in July last year and he was told by the Department that departmental officials were engaging with the HSE. That was in July. Again, in September, following a question, he learned that officials were still engaging with the HSE.

While these discussions take place, however, those with disabilities, their carers and their families are suffering. Steve, Teresa and Alexis have a quotation for €5,000 for the provision and supply of a ceiling track hoist. According to Alexis's occupational therapist, OT, a hoist will improve the efficiency of lifting, improve Alexis's quality of care, require fewer caregivers, decrease her care needs and reduce physical discomfort and injury to her five-year-old body parts. It facilitates more time to her parents to provide care for their child. Alexis has other equipment needs that occupy a lot of floor space and, as she grows, it is highly recommended, again by the occupational therapist, that a ceiling hoist will ensure comfortable mobility and a dignified experience for Alexis and her carers. It will give this family a break. This is essential for this family.

Families like the O'Mahonys are already struggling with the physical, mental and financial costs of care. There is, according to the OT, a risk of a high incidence of musculoskeletal injuries among caregivers. Teresa, Alexis's mother, already has back injuries as a result. Decisions like these, or the lack of a decision in this case, exacerbates and compounds their struggles. I am asking the Minister of State to make a decision that basic fairness to this family and fairness to people with disabilities demands. Their home is ready to go. Will the Minister of State reverse the decision, please, and allow funding for these essential works from housing grants?

Malcolm Noonan (Carlow-Kilkenny, Green Party)
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I thank the Deputy for articulating the case of Alexis and her family and the comments by the OT about improving the quality of care and reducing physical discomfort. These are really vital issues for her care, well-being and her quality of life.

My Department provides funding to local authorities under the suite of housing adaptation grants for older people and people with a disability to assist people in private houses to make their accommodation more suitable to their needs and to facilitate early return from hospital stays.

The detailed administration of the grants, including their assessment, approval and prioritisation, is the responsibility of the local authorities. The current housing adaptation grant for older people and people with a disability scheme is underpinned by secondary legislation. The provisions of regulation 7 of the Housing (Adaptation Grants for Older People and People with a Disability) Regulations 2007 set out the types of mobility aids the grant can be used for, including accessible showers, access ramps, grab rails, stair lifts and so on. The Department has also provided guidance to local authorities since the scheme came into operation in 2007.

Medical aids and devices that require the assistance of a carer who is specially trained in their use are not currently funded under the scheme. Consequently, the funding of ceiling hoists, which are medical devices that require specialised training to use, are not provided for under the scheme. However, funding can be provided for the infrastructure to support a hoist, for example, the reinforcement of a ceiling. In order to provide clarity on this matter, a specific question on the funding of hoists was included in the frequently asked questions document issued to local authorities in 2020, which clarified that funding was not available for ceiling hoists.

I can confirm that officials from my Department are engaging with the HSE and the Department of Health on this issue as it is important that there is a clear avenue for funding of hoists going forward. Officials met in March to specifically discuss fixed-track ceiling hoists and it is hoped that a suitable agreement on funding of hoists will be reached over the coming months. My Department is committed to ensuring that the grant is appropriately targeted.

Housing for All commits to undertaking a review of the range of housing grants available to assist with meeting specific housing needs both for our ageing population and people with a disability. An initial element of this review has begun and is currently focused on the existing grant limits and income thresholds applicable to the grant schemes. The wider scope of the review, to be completed this year, is also under consideration and is being informed by ongoing engagement with external stakeholders, including the Department of Health, the HSE, the Irish Wheelchair Association and the Disability Federation of Ireland.

This probably does not provide comfort to the family the Deputy has spoken about but certainly it offers some hope in the sense that the discussions between the HSE and the Department will lead to some conclusion that might have a more streamlined response, as he has requested. I await his response.

Pa Daly (Kerry, Sinn Fein)
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I thank the Minister of State. What is going on here is unbelievably bureaucratic in that the reinforced ceiling costs can be provided for but something that requires the assistance of a carer cannot. In this case, a carer inevitably means Mr. and Mrs. O’Mahony. They are caring for their daughter who has a severe disability - cerebral palsy and quadriplegia - but are excluded from the scheme. The Minister of State’s answer would be great except it is the same answer the Department gave in July and September of last year and again last month. While these negotiations are taking place, the family of this child, who I met at the St. Patrick’s Day parade, continue to suffer. Steve O’Mahony said that families like his do not want these hoists for their children out of choice but because they are a basic necessity. Every day that this drags on, he said, is another day of physical stress caused by constantly moving the person with the disability, washing them and so on.

Will the Minister speak to his officials to see if the scheme can be expanded? I would not ask him to do so if it were not essential for young Alexis to be helped and her family to be given a break.

Malcolm Noonan (Carlow-Kilkenny, Green Party)
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I assure the Deputy I will take this matter back to the Department. I agree with him. A conclusion should have been brought to the discussions between the Department and the HSE to provide clarity to families. Perhaps the issue here is that medical aids and devices such as a hoist require the assistance of a carer and specialised training. That may be the matter under negotiation. As I am not sure, I cannot state that is the case. I will take the specific case of this family back to the Department because it is one that is reflected in other families across the country who are experiencing similar issues. These are good grant schemes, which have provided help to thousands of families. However, there is an issue that needs to be addressed as a matter of urgency. I will take the matter back to the Department on the Deputy’s behalf.

Pa Daly (Kerry, Sinn Fein)
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I thank the Minister of State. I will provide him with the name and address of the family.

Malcolm Noonan (Carlow-Kilkenny, Green Party)
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I would appreciate that.