Caít Keane (Fine Gael)
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I welcome the Minister of State, Deputy Kathleen Lynch. The purpose of the motion this evening is to bring to her attention the situation concerning the Dyspraxia Association of Ireland, which is this country's only charity providing vital support for people with dyspraxia. That is in the absence of any unified position from the HSE. The association depends heavily on volunteers, with the exception of one part-time member of staff, namely, the development officer. The retention of this part-time position is vital for the continuation of the service. Due to the depleted financial situation of the association, the development officer will be made redundant on 15 November, in two days’ time. The fantastic service that has been provided by the development officer and the volunteers will no longer exist.

Could the Minister of State indicate what could be put in place to assist the Dyspraxia Association of Ireland so that it can continue to provide this vital service? As she is aware, dyspraxia is a lifelong neurological disorder which affects cognitive ability and causes difficulty in planning and carrying out sensory motor tasks. It affects up to 6% of the population, which is a considerable amount, up to 2% of them severely. A total of 5% to 6% of children aged between five years and 12 years are affected by dyspraxia. Boys are three times more likely to be affected than girls. It can affect all areas of development – intellectual, emotional, physical, language, social and sensory - and impairs a person’s normal process of learning. Some of those children are very intelligent but because of the effects of the condition they are hindered.

The condition is formally recognised by international organisations, including the World Health Organization. Occupational therapists, psychotherapists and the provision of extra help at school can all help a child with dyspraxia to cope and overcome many difficulties. Awareness of the condition in this country is extremely poor, which means that people with dyspraxia and their parents or carers struggle to get the condition identified in the first instance and they find it very difficult to access the help and support they require. There is no cure, but early intervention, in particular, is important. Could the Minister of State indicate why the HSE does not refer people to the Dyspraxia Association of Ireland so that early intervention can take place? The association addresses the problem, raises awareness and provides a telephone helpline to people who are left out on a limb due to long waiting lists. In some cases people have had to wait for two years without any help or contact. The Dyspraxia Association of Ireland can step in and provide support, mostly on a voluntary basis, and increase awareness. The HSE provides a direct therapy service and there is currently a long waiting list of 18 months to two years for any intervention or occupational therapy. A study by Dr. Madeleine Portwood in 1997 at the Deerbolt Young Offenders' Institute showed that 61% of juvenile prisoners showed symptoms of dyspraxia ranging from mild to severe. She concluded that early identification would reduce the number of young people who have become school failures and feel that life has nothing left to offer them.

Early identification, as the Minister of State knows, is of key importance. We must identify and then help the people concerned. The doubly disadvantaged study concluded that children, young people and adults with dyspraxia were significantly at risk of becoming socially excluded. We all know the problems that such social exclusion can bring. In that context, I ask the Minister of State why the HSE does not, as a matter of course, interlink with the Dyspraxia Association of Ireland? The association cannot do all of the necessary work on its own and people cannot be left for one year or 18 months without help. I ask the Minister of State to set up a meeting with the association in order that it can show her evidence of what it has achieved to date with very little funding. The association is dependent on corporate and individual donations and has set up an online donations facility to try to deal with its depleted financial resources. Services will no longer be provided by the association in two days time. I, therefore, ask the Minister of State to intervene. I am aware that the HSE in County Louth, working with the association, intervened recently on behalf of 40 people with dyspraxia. That could be used as a template for the future. The association is not looking for much funding. A sum of €70,000 or €80,000 would help considerably. I know that there is some national lottery funding in HSE coffers and perhaps some of it might be used. My plea is urgent and I ask the Minister of State to intervene.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator for raising this matter. I am in no doubt about the seriousness of the current pressures on the health service. We are still in the process of developing a service plan. However, notwithstanding the financial pressures, the Government is fully committed to ensuring the ongoing delivery of vital services and supports to people with disabilities within the confines of the resources available to us. The HSE has been provided with funding in the order of €1.4 billion to fund its 2013 disability services programme for children and adults with disabilities. This represents approximately 11.5% of overall health expenditure. As the Senator probably knows, the majority of this funding is distributed through non-statutory agencies which deliver over 80% of all disability services. There are in the region of 300 such agencies across the country which provide a significant and broad range of services for children and adults with disabilities in partnership with and on behalf of the HSE. It is worth remembering that many children and adults with disabilities can be supported very effectively within mainstream child and adult services.

Dyspraxia is a developmental co-ordination disorder that affects movement and co-ordination. It can affect the learning capacity of some children and for this reason, such children may require additional supports in the school setting to keep up with their peers. I understand a comprehensive range of supports are in place in the school system to support these children.

From a health perspective, there are a number of therapies that can make it easier for people with dyspraxia to cope. These include speech and language therapy to improve speech and communication skills and occupational therapy to find ways for people to remain independent and complete everyday tasks. Such therapy services do not necessarily have to be delivered through specialist disability providers and are frequently accessed through primary care teams and community therapy services.

I am very aware of the excellent work being carried out by the Dyspraxia Association of Ireland on behalf of children and adults across the country with dyspraxia. I also know that the association is not in receipt of a core grant from the HSE and must rely entirely on membership subscriptions, donations and its own fundraising efforts in order to finance its activities. It is not alone in this situation. Numerous organisations around the country which are providing supports for specific diagnostic groups do not receive HSE funding. The funding of these organisations is an issue that is under active and ongoing consideration by the HSE. Pending the completion of the HSE's national service plan for 2014, it is not possible to predict the service levels and funding to be provided next year for the disability sector.

I again thank the Senator for raising this issue.

Caít Keane (Fine Gael)
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The Minister of State has said additional supports are available in schools, but supports are needed before children start school. She has also maintained that therapy services are available through primary care teams, but, in reality, primary care teams are not present on the ground. The Minister of State has said the funding of organisations such as the Dyspraxia Association of Ireland is under active and ongoing consideration. In that context, I ask her to commit to meeting the association in the context of the service plan for 2014. It is out on a limb and receives no official support. It is providing a great service and taking a lot of pressure off the Department of Health and the HSE. The fact that a considerable number of people with dyspraxia end up in prison is significant in the context of preventive health care. Having said that, some members of the Dyspraxia Association of Ireland are among the most intelligent people in Ireland and all they need is a little help and early intervention.

Kathleen Lynch (Cork North Central, Labour)
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I will find out who is the best person for the Dyspraxia Association of Ireland to meet because it might not be me. Perhaps the new HSE director of social care might be the best person. I will investigate that issue further.

As part of the negotiations on the HSE's service plan, we are seeking a particular sum of money for services for those under 18 years. We must start to deliver services before there is a diagnosis. Children with dyspraxia often have co-ordination difficulties and their clumsiness has been recognised. Speech therapy, physiotherapy and occupational therapy services must be provided alongside the supports available in schools. While a diagnosis is important at some stage, particularly if someone needs more specialised interventions, service delivery should not be conditional on a diagnosis. The Dyspraxia Association of Ireland does an extraordinary job. It has worked in a space that was not occupied by any other service providers and has developed a high level of expertise based on the lived experiences of its members. We must try to co-ordinate the activities of all of the groups providing services and to cut out as much of the duplication of effort as possible. These issues are all being examined.