Tuesday, 29 November 2011
This is a case with which I am very familiar. It concerns a seven year old boy with intellectual disabilities who requires attention and intervention. He was attending the autism unit in Inagh national school, north County Clare, which unit has a proud reputation for achieving a lot in early intervention and ensuring children can be in the mainstream as much as possible. The boy in question had made significant progress since attending the unit and was in the mainstream classes for maths and English. Teachers were extremely pleased with his development, as were his parents, family, friends and neighbours. I know him and could see the improvement. Unfortunately, in recent months he has taken a significant step backwards. His behaviour is out of character compared to how he had been for a number of years. Something is fundamentally wrong. His family is at the end of its tether; his behaviour is so bad that, for health and safety reasons, he has had to be moved from school to home. He has had to return home on a number of occasions. His behaviour is inexplicable. The problem is that in recent years he has had not sessions with an occupational therapist. In spite of the family and the school principal ringing two or three times a day for the past month, the early intervention service based in Ennis has failed to provide for an assessment or send an occupational therapist to identify the root cause of his inexplicable behaviour.
The Minister of State has a proud record in this area. Children are extremely important and the Government has appointed a Minister for Children and Youth Affairs. Its commitment to this area is clear, but it seems there is a blockage. I would not have taken the unusual step of submitting a matter for discussion on the Adjournment unless I had reached the end of my tether in seeking to resolving the matter for the family. It needs urgent attention. I plead with the Minister of State to ensure the systems of State do not let this boy down.
I am taking this Adjournment matter on behalf of my colleague, the Minister for Health, Deputy James Reilly, and thank the Senator for raising it. I am pleased to take the opportunity to outline the current position on the staffing of occupational therapy posts in County Clare.
Under the Health Act 2004, responsibility for the management and delivery of health related services to individuals, including governance issues about the allocation and expenditure of funding for disability services, was vested in the HSE which is allocated funding directly from the Exchequer annually to fund the various health related services to individuals. Therefore, it is a matter for it to prioritise where this funding is allocated. It must manage the many demands on its services against the level of funding that can be made available. It cannot, however, guarantee that funding will be available for the type and location of every service requested.
On the Senator's question regarding the individual mentioned, the HSE has advised me that he is attending Clare school services and that the team, including the occupational therapist, is aware of the issues identified by the family in recent weeks, particularly his deteriorating behaviour in school. I have been assured that the HSE is in contact with the child's mother. It will engage with the team to seek a further update and ensure the services required are provided.
Expenditure on health services for people with a disability will be approximately €1.5 billion in 2011. Special consideration was given to disability and mental health services in budget 2011 through a maximum reduction of just 1.8% in the allocation for the two sectors. The relatively low reduction of 1.8%, compared to other areas of the health budget that saw reductions of up to 5%, recognises that these services are provided for vulnerable groups and to ensure existing services are maintained and that priority is given to the delivery of front-line services. An additional €10 million was also provided as demography funding in 2011. However, despite this substantial amount, the Government acknowledges the significant demand for new services and that there is a growing requirement to enhance existing services. This demand is driven by a combination of the growth in numbers of people with disabilities seeking services and the fact that people with disabilities are living longer, thankfully, owing to improvements in medical treatments and standards of care. This has led to a situation where demand for disability services always exceeds supply in any given year.
Services have been developed over time by individual service providers or former health boards and reflect the individual experiences and expertise of providers in meeting local needs. This has led to variations in the way services are configured and, in the provision of supports for children with disabilities, the HSE has recognised the need to enhance the level of consistency and standardisation in the way early intervention services and services for school-aged children with disabilities are delivered. The reconfiguration of existing therapy resources to geographic based teams for children and young people has been identified as a priority and is a key result area in the HSE's national service plan 2011. National, regional and local level structures are being put in place to progress this initiative which will have a positive impact on the assessment process for children with disabilities and the provision of appropriate clinical services and supports for them.
I thank the Minister of State for her comprehensive reply on behalf of the Minister for Health. The fact remains, however, that the child's mother has reached the end of her tether. The Minister has been in contact with the HSE and realises, through the school and the family, that there are issues that need urgent attention. This issue must be dealt with urgently. I know that resources are very tight, but the position is very serious. I, therefore, ask the Minister, through the Minister of State, to notify me when the child will receive a visit from an occupational therapist. This must happen within a number of days, not weeks, because the family is extremely concerned about the boy's safety.
I will endeavour to find that information for the Senator. I take it from his contribution that the boy is only starting to display this behaviour. The important point is that it be dealt with as urgently as possible because allowing such behaviour to become embedded causes difficulty. I am sure his parents are very distressed at this turn of events and I hope intervention by me and the Minister for Health will mean we will be able to progress the issue as quickly as possible.