Róisín Garvey (Green Party) | Oireachtas source

I welcome the Minister of State, Deputy Rabbitte, to the House and congratulate her. It is great to see fresh legs for this new challenge we face because it is a tough one and there is a long legacy behind her. I wish the Minister of State the best of luck with the challenge she faces.

As she is very aware, day services provision was closed down, or limited to a skeleton support during the first lockdown. Since July, day services were reintroduced on a phased basis. I am delighted to hear the Minister of State refer to day services as an essential service. I hope that means that from today all the service providers will provide the full service they were providing pre-Covid. Let us see how that works out, as that is what everybody wants.

At present, the services remain patchy to say the least. Many adult service users are still not back in any day service, despite a clear commitment from the Government on a national level. Unfortunately, this has not always translated to the local level. Equally, several of the service users who are back are only getting a limited service, that is, a few days per week. We ask the Minister of State to urgently address the anomalies.

Several service users are adults with complex needs requiring hands-on support 24-7. Some of my friends have adult children with disabilities. It is hard enough to be a parent, not to mention the parent of a child with a severe disability and no supports. Cases are now documented of parents working fewer hours in their own jobs as they do not have additional support to ensure their adult children have appropriate care while they work. Other carers indicate they are suffering severe stress and burnout, as they have not had any real break for weeks or even months.

Carers also report increased stress, anxiety and inappropriate and agitated behaviour in their adult children who do not understand why they are not getting the services that are built into their routines. Families also report additional stresses among siblings and other family members because it is stressful for them as well. Some siblings are trying to study for their leaving certificate or trying to do other things in the house. It is an issue for the whole family, not just for individuals.

Dr. Susan Crawford has the patience of a saint. She started the first autism unit in Clare 22 years ago. Just a few weeks ago she was in the High Court, still fighting for services for her son. During Covid he went into repeated fits and catatonic states. She is still fighting 25 years later. It seems like every parent is left fighting for the services even though we know on a national level they are being provided and funded. Something is wrong. The main issue seems to be the lack of communication or joined-up thinking. Even if it is on the HSE hub that the services are available, they are not always there on the ground. Something is not right. I do not know the reason for the gap but it seems more like an abyss than a gap because the money is being provided and the workers are in place. I do not know what the solution is. Unfortunately, I am putting it back on the shoulders of the Minister of State. In the case to which I referred, it is difficult to think that 25 years on, every time a new issue arises with her child the mother has to go and fight it. Money is being wasted in court. We must find a better way.

From the telephone calls and emails I have received it seems there is a lack of communication and clarity as to what is or is not available. The one thing worse than knowing one is not getting it, is not knowing what one is getting or when one is getting it. That adds another level of stress. I seek clarity specifically on when the services will be reinstated in County Clare. If there is a difficulty for service providers, is it due to staff shortages or Covid restrictions? If that is the case, how will we establish these services?In such situations, why has the HSE not stepped in to fill the breach with emergency staff if it needs to be done? We have seen that this has happened in nursing homes. Similarly, if the premises is not available to deliver a service due to Covid-19 restrictions, why are home care packages not created and put in place?

This issue comes up a lot with the disability sector. It is not just about empowering the individual - this is to do with empowering the families. If there are moneys available for the service providers and they cannot provide the service, should the money not then be available to the family itself to find carers? This has come up before for people who are adults and are capable of managing things themselves. It is a hand-up, not a handout. It is good for people to be empowered. If the service cannot be provided, maybe the family can be resourceful with the money that is there. The Minister of State has inherited a huge issue in this area but if any woman can sort it, she could be the one.

I would like to mention another aspect of this matter while the Minister of State is present and we are talking about disability. In my previous job, I worked for 14 years to get people out of cars and to promote sustainable transport. However, there is a huge issue around accessibility for people with disabilities who seek to move around our villages and towns independently. A lot of people with disabilities have the same needs as all the rest of us and they want to be independent. Sometimes they are really restricted due to a lack of pedestrian crossings, or because steps are too high, there are no ramps for wheelchair users or paths are too narrow.

I urge the Minister of State to consider that there may be a need for the Department of Health to engage with the Department of Transport. Engineers are great but they are thinking about cars and roads a lot of the time. People in the disability section of the Department would be able to reprioritise that and look for universal access. The designs have to include that. Lots of people with disabilities cannot drive but they can walk. However, they can only do so if they have safe infrastructure. There are some cases where the pedestrian crossings could be 1 km apart within a town. Disabled people cannot cross the road so they are restricted and they cannot go anywhere unless they get a lift. They are the same as the rest of us and they want to be independent. It would be great if there could be cross-departmental work on that issue.

I wish the Minister of State the best of luck and I thank her for all the work she has done so far. She is not in her job long but I have faith in her and I hope we can provide the best services in Ireland. I will support the Minister of State in any way I can to help her.