Seanad debates
Tuesday, 4 March 2003
Adjournment Matter. - Community Services.
2:30 pm
Michael McCarthy (Labour)
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I thank the Minister of State for Finance, Deputy Tom Parlon, for remaining here until this unearthly hour. The issue I wish to raise is one with wide-ranging consequences. It relates to CoAction West Cork, an organisation which for several years has provided sterling service to people with special needs and adults with learning dificulties, and their families, in the West Cork region.
At issue is the core funding deficit which now exists in CoAction. I stress that this is not an issue of general funding. The core funding deficit in CoAction has arisen because it has never received permanent funding for four services that it provides. These services affect 21 children and adults and have been operating for between five and seven years. For the past four years, CoAction has had to use over €1 million raised voluntarily to subsidise the day-to-day running costs of services to children and adults with learning disabilities. The Minister for Health and Children, Deputy Martin, acknowledged, in reply to a question in the Dáil on 27 February last, that voluntary fundraising has been necessary to meet needs identified in existing services which have suffered through Government under-funding of their core budgets.
This year the CoAction deficit will be much larger than in recent years, due to increased costs to match national pay scales. For reasons beyond CoAction's control, in previous years a number of positions remained unfilled. In its 1997 document Enhancing the Partnership, the Department of Health and Children undertook to deal with core funding deficits in agencies like CoAction. It did this for Cork city based agencies such as the Cope Foundation and the Brothers of Charity in 1998, and it is fair to assume that the large service providers in this area mopped up the initial funding.
After a three year delay an independent consultant conducted an evaluation in September 2001. His report highlighted the ongoing core funding deficit for the services provided by CoAction and confirmed the necessity of continuing these services and the need to maintain existing staffing levels, although he recommended additional staffing. He also informed the Department of Health and Children that CoAction expected a deficit of over €500,000 in 2002, yet the Department provided only an additional €63,500 to add to the organisation's budget.
The services provided by CoAction, in particular those for which it receives no funding, have been developed and maintained only by the extraordinary fundraising efforts of parents and voluntary members. I am sure that many voluntary organisations can pay the same tribute to their members but, given the financial constraints on this organisation, it is particularly inspiring that the parents of these children, and others closely associated with it, have felt obliged to engage in this type of fundraising activity. The financial crisis faced by CoAction is demoralising for its members and could have a negative effect on fundraising efforts. In 2003, it is not acceptable that almost 20% of the funds required by CoAction has to be raised voluntarily.
On 24 February 2003, due to lack of core funding from the Department of Health and Children, CoAction was forced to announce service reductions, service closures and staff redundancies. The services affected include the Bakehouse, a premises which CoAction acquired in Bantry town and which will close at the end of March. Reendonegan Group Home will operate on a five day basis instead of its usual seven day basis and respite weekends for children and adults will be reduced by 75%, a loss of over 1,000 respite nights. Summer camps, which have traditionally been funded by CoAction, will now be provided on a pay-per-cost basis. It is also widely believed that in eight months time CoAction will run out of funds.
The argument has been made, quite unfairly, on some sides that CoAction spread its wings too wide. CoAction would not have embarked on these services if there was no need for them. It is dealing with the most vulnerable members of society. This brings home the reality of the budgetary cuts and it is distressing for the people involved that this issue has resulted in redundancies, restriction of service and closure of some units. I stress again that this is a core funding deficit issue which is not generally acknowledged in terms of funding the organisation.
I appeal to the Minister to look favourably on the idea that €1.5 million per annum would be appropriate to address the core financial deficit. This is not a large sum of money in the context of the Book of Estimates and would be of major benefit to people with disabilities. I appeal to the Government urgently to address the core funding deficit in CoAction.
Tom Parlon (Laois-Offaly, Progressive Democrats)
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On behalf of my colleague, Deputy Martin, Minister for Health and Children, I thank the Senator for raising this matter and giving me the opportunity to outline the Department's position on this issue.
In recent years the Department of Health and Children has provided funding to meet identified needs in existing services. It has also provided funding to put in place new service developments to meet needs in residential, respite, day and other support services. These needs arise from the changing profile of persons with an intellectual disability or those with autism which has increased the number of older and medically fragile people availing of these services, in particular residential services. They also relate to issues such as underfunding of base budgets, including the need to consolidate elements of services previously funded from sources such as fundraising. The Department has sought to address these issues as resources have permitted.
It was agreed that this process should continue, albeit through new, more appropriate mechanisms, as outlined in the report Enhancing the Partnership, which dealt with the framework supporting the transfer of responsibility for funding intellectual disabilitv service providers to the health boards. These providers had been funded directly by the Department. A second report, Widening the Partnership, dealt with the application of that framework to voluntary service providers for those with an intellectual disability, such as CoAction West Cork, funded by the health boards. Between 1998 and 2002, additional funding amounting to €27.2 million was allocated to services for persons with an intellectual disability and those with autism to meet identified needs in existing services.
The overall economic position in 2003 has had implications for all aspects of public investment and this is reflected in the Estimates and budget adopted by the Government for 2003. Within this overall framework, however, some two thirds of the additional funding available for non-capital investment in services has been allocated to the health services. This funding is being applied largely to maintaining existing levels of service across all programmes, including services for people with an intellectual disability. Between 1997 and 2002, an extra €188 million in revenue and €139 million in capital funding has been provided, making a total additional investment of €327 million for the maintenance and development of services to persons with an intellectual disability and those with autism.
This year, the Department has allocated additional funding of €13.3 million to services for persons with an intellectual disability or autism to meet the full year cost of the 2002 developments and to further enhance the health related support services to children with an intellectual disability or autism. This funding brings the total extra investment in these services to €340 million over seven years. Of this amount, over €200 million has been built into the ongoing budget base.
This funding has brought about very significant and unprecedented developments in the services. Between 1997 and 2002, around 1,700 extra residential places were provided, most of them based in the community. This figure includes new residential respite places which were developed in 1997 and 1998. Between 1999 and 2002, about 465 dedicated respite places were also provided. In addition, around 2,950 new day places were provided between 1997 and 2002.
Despite this very significant investment over recent years, demographic factors are contributing to growing waiting lists, particularly for residential services, even though the number of people in receipt of such services, including full-time residential services, continues to increase. The increased birth rate in the 1960s and 1970s has resulted in large numbers of adults in their late 20s and 30s requiring full-time residential services. In addition, people with intellectual disabilities are living longer than previously, adding to the need for services compared to previous generations. This has also been the international experience in service provision to this section of the population.