John Whelan (Labour)
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I am glad to welcome the Minister of State, Deputy Kathleen Lynch, to the House, and I am pleased that she is taking this matter on behalf of the Minister for Health. Over the past two years we have raised many issues in the House, particularly health and social matters, and none can really be classed as more important than another. Nevertheless, I am convinced that I have raised nothing more important than this case. I am not abusing privilege or protocol as it is a matter of public record and I have the permission of the family as I do not want to speak around the issue. The person affected is Mr. Michael Malone, Shanahoe, Abbeyleix, who for 14 years-----

Marie Moloney (Labour)
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The Senator should not name individuals in the House but he can give the details to the Minister of State afterwards.

John Whelan (Labour)
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I take the point and I do not mean any disrespect in that regard. The case pertains to a man to whom I can relate in a personal capacity as he is only 48 years old, which I would regard as very young. For him to be confined to a nursing home for the past 14 years is distressing to me and his family. He has a caring and loving family and his siblings do everything possible for him, although both parents have, unfortunately, passed away. The man has a rare disorder called Kjellin syndrome, which is complicated by a number of other related conditions. The man has been wheelchair-bound since he was 23, and he suffers from deafness and other complications arising from the condition.

The Minister of State will agree that we have a duty of care and responsibility to our citizens. We spend much time here and elsewhere talking about depression, social inclusion, independent living and the importance of people having fulfilled lives, where possible. In this regard I am desperately reaching out and raising this matter as a last resort on the floor of the Seanad. I do not like doing it with individual cases but the family has, unfortunately, hit a dead end in their interaction with the HSE, which is being obstinate in the extreme. It is taking a poor position, to say the least, in this case.

It is clear that this man can live a fulfilled life with peers but he must be transferred urgently to the St. Joseph's home for the deaf in Stillorgan, which has capacity. That has been confirmed by the facility. It would be an ideal location for the man to make a recovery and live an engaging life, as he would be safe among peers with a good quality of life and independence. Otherwise, I fear his condition will deteriorate and he will slide back into needing further care and assistance. It is inappropriate to say that at 48, the man is in a nursing home. I hope the Minister of State will give me and the family some hope for optimism in her reply on behalf of the Department.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for raising the issue, although I am not certain we can resolve it today. I am sure it will not be the end of it. I know the Senator is referring to the circumstances of a particular case and I am informed that the HSE is in discussion with the individual and family to identify the services best suited to his particular needs. At Abbeyleix community nursing home, the individual's medical and nursing needs are supported and his case is reviewed every three months by the local doctor, or more regularly if required.

The individual's social inclusion in the local community is also facilitated. In early 2013, the family requested the possibility of a transfer from Abbeyleix Community Nursing Home to St. Joseph's House, Stillorgan, citing its more specialist services and more appropriate age profile. A meeting was facilitated between the individual, his family and local HSE staff to consider the options.

There are a number of factors for consideration before any transfer can be progressed. These include clarification of the individual's needs, the availability of necessary resources within the local midlands social care budget allocation and ongoing discussions between the HSE and St Joseph's House, Stillorgan as to its future service model, in the context of the congregated setting report. Local staff within the HSE continue to engage and be available to the family for liaison and update as to ongoing options for this individual.

There has been a strong move by the State over many years to ensure people with disabilities have choices and options. In response to public policy and investment, the number of people in congregated settings, or settings with ten or more people living together, has been declining. A number of centres have already made arrangements to enable persons with a disability to move to the community. The United Nations Convention on the Rights of Persons with Disabilities also sets out clearly, in Article 19, that people with disabilities should be supported to live in the community rather than institutional settings or segregated from the mainstream of the community.

In 2011 the Health Service Executive, HSE, following extensive consultation and international research, launched a new model of residential supports for people with disabilities. The report, entitled Time to Move on from Congregated Settings, found that, notwithstanding the commitment and initiative of dedicated staff and management, a significant number of people were still experiencing institutional living conditions where they lacked basic privacy and dignity and lived their lives apart from their communities and families. The report outlines a strategy for community inclusion which is in line with national and international policy. The HSE proposes to work with agencies such as St. Joseph's House over the coming years to deliver this new policy. Decisions on future admissions to St. Joseph's House will be made within this context. In the case of this individual we will contact the HSE in that area and I am sure a solution can be found.

John Whelan (Labour)
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I thank the Minister of State for her reply. I am a little heartened that she went off script because up to that it was the standard HSE position, which sets the alarm bells ringing for St. Joseph's House and which seems to be on the way to being phased out. I understand the policy. It would be great if everybody could be cared for in their own homes and in a non-institutional setting. With no disrespect to anybody, nobody can tell me a nursing home anywhere, no matter how good it is - and the nursing home in Abbeyleix is good - is a place for the last 14 years for a wheelchair-bound 48 year old man who has a lot to offer and a lot of living left to do.

The Minister of State is correct that this is not the end of it. I am taking this as a special case and will hold the HSE responsible for the neglect of this man if it does not intervene and take heed of the Minister of State's intervention. I welcome the Minister of State's commitment that a solution suitable to this man and his family can be found. Otherwise we are looking at a life sentence in institutionalised care which is inappropriate to his condition, needs, entitlement and right to a healthy, long and fruitful life which can be as independent as possible and with as much fulfilment and growth as possible. His condition is declining and regressing due to the inappropriate setting. He needs to be among his peers in a setting of special care which can address his condition, the syndrome he has and his deafness.

I am grateful, as always, for the personal input from the Minister of State and the compassion she indicates. I urge her to intervene and bring forward her own input to this with the HSE so this man can look forward to the coming weeks, months and years ahead with some optimism. Despair surrounds him, languishing as he is in an inappropriate setting of a nursing home at this young age.

Kathleen Lynch (Cork North Central, Labour)
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The solution that will be found may not be in St. Joseph's House. Any solution that will be found will be with the help of the HSE. They are the people at ground level who deal with this on a day-to-day basis. Maybe there is a different solution but I will definitely talk to them.