Nessa Cosgrove (Labour)
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I raise the ongoing issue of the absence of a community worker for MS services in counties Sligo and Leitrim. The north west has the highest instance of MS in the country, but alarmingly there is no dedicated MS community worker in Sligo or Leitrim. They are the only counties that do not have a dedicated community worker. MS Ireland put together a business proposal and submitted it to the Department of Health. It is looking to be treated like everywhere else in the country. There are 19 community workers employed throughout the country. They play a vital role for anyone who has MS. It is a condition that affects people differently.

The community worker is there to offer case management, support to families and to act as an advocate to look at finance and training. They are a voice for people who have been diagnosed with MS. There were a lot of Government TDs and local representatives from across parties and none at the business proposal meeting. They listened to stories from Sligo and Leitrim people with MS who do not have access to the services that we should have access to. MS Ireland put forward a business case and it is looking for just short of €73,000 to employ a community worker, which in the grand scheme of things is a drop in the ocean.

Some 300 people have been diagnosed with MS in Sligo and Leitrim. There should two community workers. I worked as a community worker with the Irish Wheelchair Association. Trying to manage a caseload of 300 people would be astronomical. I would put forward the case that there should be two. I ask the Minister to look favourably on this. We have continued on in the north west. There is a wonderful MS therapy centre. They have to raise €100,000 a year to keep it operating and it has been such a support for people living with MS and their families. The idea of having a community worker has been overlooked because the centre has been such a success in the north west.

I am going to quote Mary who was at the meeting I mentioned:

When I was diagnosed with MS in 2006, there was no dedicated community worker in Sligo. Almost two decades later the situation remains unchanged. Upon diagnosis I was provided with medication options by her urologist and left to navigate the rest on my own. The MS nurse gave her advice on how to take the medication but beyond that there was no structured support. I had no access to information on how to connect with other people living with MS, no guidance on what her future could look like if I had to stop working and no knowledge of the financial supports available. There was direction on how to access homecare should I require it nor any mention of MS Ireland or the resources they offer.

Sláintecare contains a dedicated commitment to an integrated approach to healthcare. If a community worker was employed, €73,000 is a drop in the ocean in the context of the Department of Health's spending budget. It would support social workers' case management and the management team in the support services sector around MS. I would like the Minister of State to reply that the people living with MS in the north west are not going to be treated like second-class citizens anymore.

Noel Grealish (Galway West, Independent)
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This Commencement matter was submitted to the Department of Health and then forwarded over to the Minister, Deputy Foley who I answer it on behalf of.

I thank the Senator for raising this important issue and for offering me the opportunity to respond. HSE disability services has allocated funding on an annual basis to provide a range of services throughout the country. Funding is spent in line with nationally agreed policy for disability services, while at the same time endeavouring to maximise value. Services include residential and respite services, day services, PA and home support services, and therapeutic supports. Disability services are provided based on the presenting needs of an individual rather than by the diagnosis of the individual or the actual type of disability or service required. Services are provided following individual assessment according to the persons individual requirements and care needs.

The HSE works in partnership with organisations including section 38, section 39, out-of-State and for-profit organisations to ensure the best level of service possible is provided to people with a disability, and their families within the available resources.The majority of specialised disability provision, which is 80%, is delivered through non-statutory sector service providers. The Multiple Sclerosis Society of Ireland, MS Ireland, provides a range of services and resources to the whole MS community: those with MS, family members, employers and health professionals.

Of the circa 850,000 people living with a neurological condition in Ireland, it is estimated that approximately 9,000 people are living with MS. Through its regional community workers, MS Ireland organises a range of living with MS programmes, workshops and activities throughout the country that are targeted at various groups such as those newly diagnosed, carers, children of parents with MS and health professionals. Programmes include physical therapies, symptom management, and information and education seminars. MS Ireland provides services at a local and national level. Locally, its team of regional workers provide one-to-one and group support and its 39 voluntary branches provide opportunities to socialise, share experiences and avail of services.

MS Ireland also operates a confidential helpline that provides immediate information and support to those affected by MS. MS Ireland receives funding from the HSE under section 39 of the Health Act 2004. In 2023, MS Ireland received more than €3 million from the HSE to support its services. The funding is governed by a number of service arrangements in seven of the nine former CHO areas, which identify service delivery provided by the agency in return for the money being provided to it.

Nessa Cosgrove (Labour)
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There was no indication there that there is going to be any commitment to delivering MS services in the north west. I thank the Minister of State for outlining the amazing work MS Ireland and section 39 workers provide and I know that. Could the Minister of State bring it back to the Minister, and it would be really appreciated by the people in the north west, that this has been going on for decades, particularly when there is the highest instance in the north west of people with MS and we do not have the basic services that other counties do?

The Minister of State spoke about the role of disability reviews and that in 2018, the HSE disability capacity review stated that community workers were listed as the most used in multidisciplinary teams within disabilities. While these roles are available, people with disabilities can be enabled to access mainstream activities and services, slowing down or reducing the uptake on more traditional disability services. It is a cost-saving measure to introduce community workers and it avoids a duplication of work. Community workers do their job and people living with MS thereby get the supports they are entitled to because they are being signposted in the right direction. It cuts down and is a cost-saving measure in the long run.

Noel Grealish (Galway West, Independent)
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I once again thank the Senator. The HSE recognises the value of MS Ireland and MS care centre support and services to people with multiple sclerosis. Each year the HSE participates in the Estimates process with the Department of Health and the Department of Children, Disability and Equality and makes a submission for additional moneys to meet the health and social care needs of the population it serves. The disability services make submissions for additional funding for day, residential, respite and home support, with PA hours, multidisciplinary posts and neurorehab moneys as a key element of its submission. Any new funding secured is allocated to the integrated healthcare areas to provide service to those with the greatest need on a priority basis.

The HSE confirms it has received submissions from MS Ireland. These are being considered as part of the 2026 Estimates process. I will bring the particular issue the Senator raised here today back to the Minister and ask her to report back directly to the Senator.