Patricia Stephenson (Social Democrats)
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I am here to speak about respite and care delivery. Respite is a crucial aspect of disability service provision and offers those with disabilities, elderly people and those who care for them critical and much-needed support. The role of respite service delivery within the disability policy has been labelled as a key priority for the Government and the HSE and improvements in this area in the latest programme for Government have included an action plan for disability services.However, like many other areas in our health service, respite delivery is experiencing severe strain and increased pressure. The respite investment plan announced by the former Minister of State, Anne Rabbitte last year, stated that a 40% increase in provision would be needed for known unmet need according to the disability capacity review.

Transparency is needed around HSE respite data too. In January the HSE could not provide explicit data on the average number of overnight respite beds. It noted that data on respite beds is not routinely compiled by disability services. We need to compile this data. It is simply not good enough to say it is not available. That same month, the HSE stated there was no centrally maintained waiting list for respite services regarding individuals whose respite has been refused. How can this be? How can we know the real need if we are not recording the actual requests that are being made?

While the disability support application management tool is welcome progress, greater transparency on the patient data and available respite resources must be ensured. The absence of a formal policy on respite is also unseemly. It is clear that many of the shortages in respite service delivery could possibly be mitigated against policy oversight. Skills, Opportunities, Success Kilkenny, known as SOS Kilkenny, is one example of a respite provider to adults with intellectual disabilities and autism across Kilkenny city and county. It is a fantastic organisation. This week marks its 50th anniversary and demonstrates its role as a cornerstone in the disability sector in Kilkenny. Its services include offering community-based day locations and a part-time short-break service to individuals. This gives people the opportunity to experience increased independence and build lifelong skills.

SOS Kilkenny provides respite care in one home but it is fully booked for this year and the only other respite it can provide is on an emergency basis. The respite it provides enables families to continue their care role while ensuring service users receive appropriate and dignified care. It is really unfair that families rely on respite. They face long waiting lists, reduced availability and the increased stress on their household that comes with that. Many care givers are completely exhausted and risk burnout. We have spoken many times to caregivers, particularly during the election campaign, many of whom are elderly themselves. They talk about how increasingly difficult it is to manage their care responsibilities. They have been calling out for more respite as a way to transition their loved ones from the family home to independent living.

SOS Kilkenny, in particular, needs a second home to be able to provide a more comprehensive respite service. Could the Minister of State give an update on funding for Sycamore House, a dedicated respite facility in Kilkenny? I am aware that SOS Kilkenny had been promised an extra €1.5 million in funding. Can the Minister of State speak on that? Today is its 50th anniversary so it would be nice to have confirmation that funding is on the way.

In this context, will the Minister of State update the House on the plans to improve respite services for adults with disabilities, older people and children’s disability services? Can he commit to better data collection so that we know the scale of need in respite? Without knowing those numbers, I doubt we will ever get to the stage where we are properly resourcing the services.

Niall Collins (Limerick County, Fianna Fail)
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The Minister would like to thank Senator Stephenson for raising this important issue and for offering her the opportunity to respond.

Respite is a key priority area for the Department and the HSE and we have seen significant investment in respite services. Respite services can play a crucial role in delaying and-or preventing moves into full-time residential placements, preserving the family unit and supporting family stability. There has been significant focus on respite provision in recent years, with additional funding to expand respite services provided in successive budgets. Between 2021 and 2024, €35.7 million in new development funding was provided to expand respite provision. This has resulted in the addition of tens of thousands of respite sessions for children and adults with disabilities.

The Department is aware that the demand for respite outweighs the current levels of provision and is committed to working towards meeting the high levels of demand. In the national service plan 2025, additional allocation has been provided to increase the occupancy of existing respite capacity where feasible and to increase alternative respite provision, including in-home respite support hours.

The Department and the HSE are working hard to ensure that respite provision expands around the country. Last year, the Department took the opportunity to examine in closer detail the level of respite provision and availability across CHO areas. The HSE data on the national distribution of respite has shown that there are significant variances in the levels of respite being supported across different areas. Consequently, a process has been initiated with the HSE to progressively move to a situation whereby respite services are more equitably distributed across the country. It is important to note that some areas may look to provide more respite and home support to maintain people with family, thereby delaying the pursuit of residential services, and vice versa.

The HSE is also committed, through the national service plan 2025, to undertaking an audit of respite services this year. This audit will provide further insight into how respite services are allocated and managed, allowing efforts to be focused where needed.

The HSE is operating in a very competitive global market for healthcare talent. There are significant shortages of qualified healthcare professionals across the globe. The HSE and specialist disability service providers are experiencing ongoing challenges recruiting and retaining staff across a range of disciplines and grades.

Ensuring that the disability sector is fully resourced is a key priority of the Government which has been reflected in the programme for Government. To address the high staff vacancy rate during 2025 across all disability services, the HSE is continuing to carry out sustained workforce recruitment and retention initiatives. These initiatives will support the HSE and service providers to ensure existing services are utilised to their fullest extent.

The Senator mentioned locations in Kilkenny. I do not know if she flagged when she put down this Commencement Matter that she required some detail. If she sends us an email about what exactly she is looking for, we will endeavour to get that for her.

Patricia Stephenson (Social Democrats)
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I recognise there are recruitment challenges. The Minister of State might go into a bit more detail on the efforts being made. His remarks were quite general about how recruitment challenges would be addressed. The Minister of State might not be able to answer now on data and I might ask that the Department come back to me on this. Can we get a commitment for an audit of services and need? Can we start collecting data on the number of rejected applications for respite so we have a sense of how many people are on the waiting list? Without that data on how many people are applying, how many have been rejected, how many have been on the waiting lists and how long they have been there, we cannot really map the extent of the issue.

I note that plans for service delivery are contained within government initiatives including the programme for Government. However, as far as I can see there is not very much information on Gov.ie of the tangible work being done to achieve these targets. It would be great to have that uploaded so there is some accountability.

The development of a formal policy on respite was listed in the action plan for disability services 2024-26 but it was not in the programme for Government. Will the Department commit to do so in the lifetime of this Government?

Niall Collins (Limerick County, Fianna Fail)
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The data the Senator wants to see flow from the audit is something we can alert the HSE on. There has been steady growth in respite since 2022 with 2024 seeing a significant increase in activity with nearly 10,000 additional overnight sessions and 20,000 day sessions delivered. This coincides with an increase in funding year-on-year. Great work is being done to identify the best use of our resources in the area of respite. New respite services are being commenced. Existing services are being expanded and gaps in provision are being identified. Respite can be delivered in so many different places and ways and what works best will differ from person to person and family to family, which I know the Senator will appreciate. We continue to increase the funding and prioritise respite service provision. That will increase comparatively. Expanded and additional respite supports are critically important to many individuals and families across the country. The importance of this service to the service users and those who support them cannot be overstated. As I stated, respite plays a key role in supporting people to stay in their own homes with their own families for longer. In the first three months of this year alone 6,600 people accessed some kind of respite service, a number higher than that of 2024 entirely. It is important to keep in mind this momentum. The HSE and the Department are working tirelessly to achieve that.