Seanad debates

Wednesday, 2 May 2018

Commencement Matters

Services for People with Disabilities

10:30 am

Photo of Aodhán Ó RíordáinAodhán Ó Ríordáin (Labour)
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I thank the Minister of State for attending. I am raising the issue of access to St. Michael's House in Dublin 9 for day service users. These people are having difficulty accessing transport. The Department is well aware of this issue. In a presentation made to me last week, however, I was told that it had 788 adult service users who are transported to day services every day, of whom 200 are supported by St. Michael's House drivers and escorts, 120 are transported by Vantastic, 96 are transported by residential house staff and bus, 41 are transported by day service staff and bus, 35 are transported by contract taxis, 38 are transported by family members - with 18 such arrangements being unsustainable - and 258 are transported by public transport, some with support. A total of 435 of these individuals live with residential supports from St. Michael's House. The Minister of State will appreciate that these are very vulnerable users of the service for whom transport is essential. If they do not have transport, the service will not be accessible to them.

I will outline some of their concerns and some of the deficiencies relating to the service. A total of eight service users who live at home cannot access the service because they have no transport. This is a serious situation for these eight individuals. A total of 38 individuals are being transported by family members and, as already stated, 18 of these arrangements are not sustainable. An issue of equity arises here. St. Michael's House also supports an ageing group of people with increasingly complex needs. The average age of primary care givers there is also increasing. Twenty individuals supported in St. Michael's House residential services are on a waiting list for transport, which impacts on residential service staff. A total of 325.5 staff hours could be released from the roster if an effective transport service was delivered.

The issue of transport to and from St. Michael's House to allow individuals to access its services has been ongoing for quite a number of years. There is no cheap solution and providing transport is expensive. What is even more expensive, however, is the compounded vulnerability, isolation, loneliness and sense of despair experienced by the families who need these services for their loved ones. The sense of isolation because of a lack of transport is quite acute. While I know the Minister of State and his Department will be looking at both the cost and the bottom line, I contend that the cost of not taking action will be quite profound.

I want to be constructive. I know there are no easy solutions that the Minister of State can offer today but I would ask that he and other Ministers, who I know have been in contact with and have met representatives from St. Michael's House, can try to find an equitable and sustainable solution. A number of people clearly need this service and cannot access it because of the lack of transport to which I refer. The families of the eight individuals I mentioned will be impacted upon as well because of the range of challenges their loved ones face. I plead with the Minister of State to look at the situation and provide transport for these individuals. They are very vulnerable and need the service and to be able to access it. Without transport, they will continue to be isolated. We are in a much better financial position than previously and we have the resources to do things we were unable to do in the past. I ask the Minister of State and the Department to prioritise this issue.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I thank the Senator for raising the issue of transport for people with disabilities attending HSE-funded day services, particularly St. Michael’s House. I welcome the opportunity to outline the current position in this regard.

The HSE funds St. Michael's House to provide healthcare services on its behalf to those with intellectual disabilities. St. Michael's House provides a range of community-based day, respite, residential and early services for people with intellectual disabilities. The services provided by the organisation cover all ages from young children to older persons. Clinical support services include psychiatry, medical, nursing, occupational therapy, physiotherapy, speech and language therapy, social work, psychology and nutrition services. Services are located both on the north side and south side of Dublin and in 2007, the service extended to provide residential care for children in Navan, County Meath. St. Michael's House provides these services on behalf of the HSE to clients based on individual assessed clinical need and healthcare is provided in the most appropriate setting to meet the client’s individual needs. The HSE is providing €87.8 million in funding to St. Michael's House in 2018.

In general, the provision of transport services is not part of core services within disability services. As a general rule, public transport should be used in all circumstances where it is an option. This is in keeping with the principle of mainstreaming, with a clear focus on ensuring that persons with disabilities have access to the normal range of services and participate in community life as far as possible. It must be noted that in general, day service users are in receipt of disability allowance and are automatically entitled to the free travel pass so there should be no additional cost burden at an individual level. The HSE intends to liaise with the National Transport Authority and disability service providers to explore ways in which the authority's services could assist people with disabilities. The HSE plans to explore the opportunities these units may provide to people with disabilities to access day services and participate in the social, educational and economic life of their local communities. St. Michael's House is aware of the transport issues affecting a number of their service users. However, funding is not provided for the transportation of young people to and from day services. When all other options are exhausted and a person cannot avail of a day service because the or she does not have transport to attend, the service provider is advised to use some of the service money to cover the transport costs. This usually results in the provision of a reduced quantum of service.

In regard to developments to meet the day service needs of school leavers each year, all new service locations under development are located as close as possible to where people reside in order to reduce the travel time for each person and enable him or her to be more connected with his or her local community. I trust that this clarifies the position.

Photo of Aodhán Ó RíordáinAodhán Ó Ríordáin (Labour)
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With the greatest respect, it does not really do much, particularly for the eight service users who are at home and cannot access the service because they have no transport or the 18 individuals who are transported by family members, something which St. Michael's House has indicated is not sustainable. I ask the Minister of State to reconsider the answer he has provided, particularly in the context of these service users, who are isolated and who cannot use the service. I understand the constraints the Minister of State is under when he comes to the House with a script but we have a service for vulnerable people, a number of whom are at home and cannot access it because of lack of transport. The Minister of State's answer does not really give me, St. Michael's House or the families of these eight people and the 18 individuals whose current transport arrangements are made by family members and are unsustainable any comfort. Can the Department not meet representatives from St. Michael's House and find sustainable transport solutions for those 26 individuals?

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I accept the Senator's frustration and the fact that there is nothing concrete in my reply to give him or the people in St. Michael's House any solace. With regard to the specific request made by the Senator, which was for funding for transport for people availing of day services, this is an issue not just for St. Michael's House but for a number of different centres where transport is an issue and is not funded.When it goes back to the service provider to fund it, we can reduce the overall quantum of services available, which proves to be a difficulty. It is an issue we will have to address in the collective. I will convey the Senator's request to my officials and the HSE to re-examine the case of St. Michael's House. However, it is a wider issue and we will have to examine it nationwide.