Paul Coghlan (Fine Gael)
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I welcome the Minister of State.

Colette Kelleher (Independent)
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I welcome the Minister of State. I would like to share time with my colleagues, Senators Devine, Swanick and Humphreys. I know it is unusual, but we wish to outline a cross-party approach to the matter. We are all members of the all-party Oireachtas group on dementia. I thank Senator-----

Kevin Humphreys (Labour)
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It was submitted in all our names.

Paul Coghlan (Fine Gael)
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I regret that no notice was given of this intention.

Colette Kelleher (Independent)
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It was submitted in all our names.

Paul Coghlan (Fine Gael)
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I am advised it was not.

Colette Kelleher (Independent)
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Yes, it was.

Paul Coghlan (Fine Gael)
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It is a Commencement matter, not a motion.

Kevin Humphreys (Labour)
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However, it was submitted in all our names.

Colette Kelleher (Independent)
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It was submitted in all our names.

Paul Coghlan (Fine Gael)
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It is in Senator Kelleher's name only.

Colette Kelleher (Independent)
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However, I submitted it in all of our names.

Paul Coghlan (Fine Gael)
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The Senator cannot submit a Commencement matter on behalf of other Senators. She could do so for a motion, but not for-----

Colette Kelleher (Independent)
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I will speak on behalf of everybody else, but we all signed and it was an idea that came from the group.

Paul Coghlan (Fine Gael)
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I am advised that in the circumstances, I could give a minute to each of the others.

Colette Kelleher (Independent)
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We have it worked that way.

Paul Coghlan (Fine Gael)
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Senator Kelleher can take two minutes and I will give the others a minute each.

Maire Devine (Sinn Fein)
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The Leas-Chathaoirleach is very generous.

Paul Coghlan (Fine Gael)
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However, there is no arrangement. I am totally reliant on the advice I receive, as Senators will understand.

Colette Kelleher (Independent)
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We appreciate the Leas-Chathaoirleach's largesse.

Paul Coghlan (Fine Gael)
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It is an unusual situation. We will allow it. Senator Kelleher has two minutes and the other Senators have a minute each.

Colette Kelleher (Independent)
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I thank the Leas-Chathaoirleach and the Clerk of the Seanad for allowing us the opportunity to raise this important issue. I welcome the Minister of State, Deputy Jim Daly, to the House. Dementia is an issue that affects every community throughout Ireland. An estimated 55,000 people live with the condition with this figure expected to more than double in the next 20 years. People with dementia need a wide range of community services to support them from the moment of diagnosis and throughout their journey. We are all aware of the significant gaps in these vital services and supports in every county.

Maire Devine (Sinn Fein)
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We have worked hard together as a group. Today we made a decision to focus on the estimated 4,000 people who develop dementia each year. That is at least 11 people per day. Those are not my estimates; they come from the HSE's Understand Together information campaign. Each one of these 11 people and their families need access to a dementia adviser to support them as they embark on their journey with dementia, which can last years or even decades. Many of us in the group have medical backgrounds and we have had hands-on involvement with the frightening terror when somebody is given that diagnosis.

A dementia adviser works with people with dementia and their families, providing a highly responsive and individualised support to the person with dementia from the moment of diagnosis onwards, and includes their carers. They help people to connect with dementia supports and services in their areas. However, there are only eight such advisers throughout Ireland. Access is on the basis of a postcode lottery.

Paul Coghlan (Fine Gael)
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The Senator's time is up.

Maire Devine (Sinn Fein)
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As a member of the all-party Oireachtas group, I am acutely aware of the lack of equity. Sinn Féin's budget submission strongly advised the Government to provide funding for an increased allocation for dementia advice.

Keith Swanick (Fianna Fail)
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I thank Senator Kelleher for sharing time. A recently published independent report, Evaluation of The Alzheimer Society of Ireland Dementia Adviser Service Report, by UCC, which was commissioned by the HSE's national dementia office as part of the implementation of the national dementia strategy, highly recommended an increase in the number of dementia advisers to meet the increasing demand as a result of increasing prevalence of dementia in Ireland. The report also recommends the development of the service to achieve national coverage.

This independent evaluation is the first external evaluation of the dementia adviser service in Ireland and it has provided evidence of overall high levels of satisfaction with the service. People living with dementia, their carers, and health and social care professionals reported satisfaction with the information, advice, peer group and signposting of services provided by the service. The report found challenges with equity of access to the dementia adviser service across the country and a large number of people with dementia, including some in counties Roscommon and Mayo, and their families simply cannot access a dementia adviser because of where they live.

Kevin Humphreys (Labour)
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This is a vital support for people suffering from dementia and their families.Will he ensure that funding for an increase in the number of dementia advisers will be included in the upcoming 2019 HSE service plan? Nothing less is needed for these families. Will the Minister also commit to building up a national network of dementia advisers in order that there is one in every primary care unit in the country? We have seen the changes at first hand and how a dementia adviser can help families and sufferers. It is vital we provide this service throughout the country. Will he ensure the funding is put in place in the 2019 HSE service plan to ensure dementia advisers are easily accessible for people diagnosed with dementia?

Jim Daly (Cork South West, Fine Gael)
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I thank the Senators for raising the issues. As a response to the challenges facing people with dementia and their families and carers, the national dementia strategy was launched in December 2014. It contains 35 priority and additional actions and its implementation is led by the national dementia office in the HSE. Plans are progressing to further implement the dementia strategy through the national dementia office, including in the area of diagnosis, post-diagnostic supports and care pathways.

In 2016 and 2017, the national dementia office partnered with the Alzheimer Society of Ireland on a project to map dementia-specific community-based services and supports. It provides a useful snapshot and baseline study into what, where and when dementia services are offered. The study was also used to inform a service finder hosted on the national dementia office’s website, which allows people to search for dementia-specific community services in their area.

There are gaps in access to services and a large variance in what services are provided across the country. The national dementia office met with senior HSE officials in each community healthcare organisation region to highlight gaps in each area and develop local action plans to improve service provision. The national dementia office also developed a needs analysis framework to support local dementia service planning and development. This framework is a mechanism to help the office direct time, energy and resources into dementia care that most appropriately meets the needs of people with dementia. It will be used to make dementia service development more responsive and consistent around the country.

The national dementia strategy calls for the HSE to consider the provision of dementia advisers, based on the experience of demonstrator sites. There are nine dementia advisers in the country, eight of whom are hired by the Alzheimer Society of Ireland. The HSE contributed €400,000 to the service in both 2017 and 2018. An evaluation of the dementia adviser service was published on 26 September and recommended the continuation and expansion of the service to ensure equity of access country-wide. The Government welcomes the positive results of the evaluation and will continue to work to improve service delivery for people with dementia.

Dementia advisers are not the only community support being given to people with dementia and their families and carers. The Department of Health secured funding through the Dormant Accounts Fund for numerous projects to improve care and supports for people with dementia, including the delivery of post-diagnostic supports, a dementia diagnostic service for people with intellectual disability, a national network of memory technology resource rooms, the development of a national dementia registry, the national roll-out of a dementia training programme for HSE home care staff, the development of dementia resource centres, funding for a dementia community activation co-ordinator and community support projects for people with dementia. On the Senator’s request to increase the number of dementia advisers, the quantum of services to be provided by the HSE is being considered as part of the HSE’s 2019 national service plan.

Colette Kelleher (Independent)
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I am disappointed that all the Minister of State can say is that dementia advisers are being "considered" rather than committed to. This is after several budget submissions on our behalf and a clear evaluation by University College Cork. The national dementia strategy is welcome but it does not go far or fast enough. It is time for the Government to make good on dementia commitments and recognise the emergency that faces people with dementia and their carers in Ireland. People feel that while they may be heard by the Government and sympathetic Members, hearing and listening are not being matched with real money and public investment for real supports and services for which people with dementia and their carers are crying out. There is strong cross-party support for supports and services such as a national network of dementia advisers, a real uplift in dementia-specific home care, day supports, Alzheimer's cafes and the range of supports that are needed in every county.

As the Minister of State will know, in Cork, where we are both from, according to the Alzheimer's Society of Ireland, ASI, there are approximately 4,000 people with dementia, who are cared for by 12,000 people, and an additional €500,000 is needed in 2019 to bring it up to the minimum level. That is why ASI is holding an emergency dementia summit next Wednesday to be followed by an AV room briefing by the all-party group on dementia. This is an emergency on which there is an urgency to act, and I am disappointed by the Minister of State's response.

Jim Daly (Cork South West, Fine Gael)
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I regret the Senator's disappointment but the HSE's service plan is in the gift of the HSE and has not yet been passed back to Government. It is up to the HSE as the Minister does not write the service plan. It must examine all areas and divide up its budget and present it to the Minister, which I expect will happen by the end of the month.

In the interim, I cannot start part-writing it nor make part-commitments on the floor of the House, which might box in the HSE. We must wait and see what the HSE will decide. While I had numerous discussions with the HSE before its preparation about what I would like to see in it, it must revert with its plans and, therefore, I will not prescribe anything here. It is not within my gift to do so until the service plan is presented to me at the end of the month when I will be in a position to comment further.