Denis O'Donovan (Fianna Fail)
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Given the Senator's knowledge of the situation, I would welcome it if he did not name the individual concerned. He has supplied the details to the Minister of State anyway.

Trevor Ó Clochartaigh (Sinn Fein)
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Go raibh míle maith agat a Chathaoirligh, céad fáilte romhat a Aire agus mar a fheiceann tú táim ag ardú ceist anseo maidir l'othar a bhfuil an galar néarón luadrach air atá insan ospidéal i nGaillimh le blian anuas.

I have raised this matter on many previous occasions and I know that the Minister of State has the details of the person to whom it relates. Motor neurone disease is incredibly debilitating and is absolutely life-changing for anybody who suffers from it. I was involved in a campaign with this person - he instigated that campaign on his own behalf - in order that he might have a tracheotomy operation, which he would see as a life-prolonging in nature. That campaign was very successful. A lot of fund-raising took place in the Galway area in order to support the person in question when he was released from hospital following the tracheotomy. The operation went very well and it was expected that afterward, once an agreed home care package was put in place and suitable nurses and carers were made available, that this person would come home and be able to spend the remainder of his years there. That has not happened unfortunately, even though the efforts of his family , particularly his wife, have been ongoing. It appears that there is a kind of stand-off between two parts of the HSE, namely, that which runs the hospital section and the primary care section. What will happen is that once this patient is allowed home from the high dependency unit, HDU, he will become a financial burden on the primary, community and continuing care, PCCC, system and the money will have to come out of it budget. The HSE has known about that for quite some time and it is time for a decision to be made.

The family has done a great deal of research. It is quite unusual for this to be done and I think it is to be welcomed that the operation took place because it certainly will help the patient in question and he is feeling better after it. Even though his physical ability is obviously deteriorating, his mind certainly is not and he is very much on top of the situation. His researched and costed potential care services that would be available to him in the Galway area. The PCCC in the HSE area initially estimated that it would cost something of the order of €750,000 to provide home care on a 24-7 basis. The family's research indicates that this could be done for a fraction of the money that was being asked, so they actually made a saving for the HSE in respect of the potential cost.

The person involved does not want to hold up a HDU bed as such beds are in short supply. There is pressure on University Hospital Galway but there is also pressure on the family to travel to from their home place to the hospital - it is quite a long round trip - each day in order to visit the patient. That is unacceptable. The person has young children of school-going age and he would like to be able to be with them on a daily basis.

I would like to find out what discussions have taken place between the Department of Health and HSE west. If discussions have not taken place, will the Minister of State intervene as quickly as possible in order to try to get the management at HSE west to sit down with the management of the hospital and of the PCCC? A decision must be made at some stage. Let it be made sooner rather than later so that the patient can go home and spend the rest of his life with his family in a proper care environment. This would also take the pressure off the family. I look forward to the Minister of State's response.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Ó Clochartaigh for raising this very important matter. I know that he is very passionate about health and disability services, particularly in his constituency in Galway but also nationally.

In the first instance, I wish to assure the Senator of the Government's commitment to providing services and supports to people with disabilities that will empower them to live independent lives, allow them greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in A Programme for a Partnership Government and is guided by two main principles: equality of opportunity and improving the quality of life of all people with disabilities. One way in which the HSE is working to improve the quality of life for people with disabilities is through the provision of home support hours. One of the Senator's concerns relates to that particular issue. In the context of its service plan for 2016, the HSE's priority was to provide 2.6 million home support hours for over 7,300 people with disabilities. In reality, the actual number of home support hours provided in 2016 was higher, at 2.9 million hours. This reflects the responsive nature of the service and takes account of the fluctuation of assessed need over time as the needs of individuals change.

This year, the HSE has committed to maximise the provision of health and personal-social services, including home support services, within available resources.This year, the HSE has committed to maximising the provision of health and personal social services, including home support services, within available resources. As provided for in its national service plan for 2017, the HSE expects to deliver 2.75 million home support hours to over 7,400 people with a disability, an increase of 150,000 hours over last year's target. The goal is to help as many people as possible. This is a positive development which we can build on in years to come. I accept the Senator's point that we must build on it.

With regard to the matter raised, I am sure the Senator will understand my reluctance to comment here in any great detail about the specifics of any one case given the personal nature and circumstances of the matter. However, that does not mean we are not going to do anything. As the issue raised by the Senator is a service matter, I have asked the Health Service Executive for a report on the case. The HSE has informed that the person concerned is in a high dependency unit in University Hospital Galway and is in need of 24-hour care. I understand from the HSE that it is in discussion with the family on the appropriate options for the person's discharge from the University Hospital Galway. The HSE community health care organisation for area 2, which covers Galway, Mayo and Roscommon, has assured me that it is actively engaging on an ongoing basis with the family with regard to the most suitable and appropriate care for the person.

Trevor Ó Clochartaigh (Sinn Fein)
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I thank the Minister of State for his response and I note his interest in the disability services in Galway to which, hopefully, we will be welcoming him soon. The HSE response on this matter is a nonsense. Discussions have been ongoing for well over a year. It was known in advance of the operation that this would be needed. It is time for decisions to be taken and for heads to be banged together. It is probably costing as much per annum to keep this patient in the high dependency unit as it would cost to provide services for him at home with his family. I ask the Minister of State to re-engage with the HSE on this matter, with a view to a meeting being held with the relevant stakeholders and a decision being reached on when this patient can be moved home. As I said, this matter has been going on for far too long. The Minister of State, when in Galway, might take that opportunity to meet with the relevant stakeholders and raise this issue with them.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Ó Clochartaigh for the invitation to visit the services in Galway during my next round of visits to services throughout the country. I disagree with the Senator that the HSE reply is a nonsense. I accept that there is a problem. During the discussions on the HSE social care plan additional home support hours were agreed. This particular case is a classic example of a person who should be benefitting in that regard. I will engage with various departments in the HSE and will put pressure on them to resolve this issue. What is going on is not acceptable, particularly for a person with motor neurone disease. I agree with the Senator that the situation is extremely difficult for the person concerned and for his family, particularly his young children. It is our duty to facilitate them. It has been stated that the cost of doing so would be approximately €775,000 per annum. With a little creativity and planning we can, hopefully, come up with a resolution.

I will make known to the HSE the Senator's views regarding the urgent need for resolution of this matter.