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Dáil Éireann debate -
Wednesday, 28 Nov 2012

Vol. 784 No. 3

Leaders' Questions

The past 12 months have not been good for people with disabilities. It has been a year of cutbacks, fear, anxiety, worry, frustration and anger. The anger is mainly directed at the Government and those in authority who do not seem to realise the impact of cuts on the ground for people with disabilities. We are hearing this loud and clear from parents across the country on a continuing basis. There are several areas I wish to highlight where this is being felt the most.

Across the country, despite official rhetoric, special needs assistance has been cut from schools and children have lost their special needs assistants. For young people with disabilities who leave school, there is no guarantee of placement for them at the end of this year and there was none last year. About 700 people with disabilities came out of school last year and it will be the same figure this year. It is a sad indictment on our society-----

It is a sad indictment on Fianna Fáil and its years in power.

-----that the only children who cannot be guaranteed a place coming out of school are young people with disabilities.

It was Fianna Fáil that was in power.

The Deputy without interruption.

Yes, when we were in power there was continuing demographic-----

Fianna Fáil created the chaos. Deputy Martin has some neck.

The Deputy without interruption.

What provision did Fianna Fáil make for this area when it was in power?

There was provision. That is the point. Demographic funding was an ongoing provision for young people leaving school with special needs. They were provided a place which in total came to €20 million per annum. The Health Service Executive, HSE, has confirmed that such funding has been gotten rid of.

I want to take the case of Emma, a young woman, 19 years of age, with severe autism and severe epilepsy. She needs a full-time residential placement. The officials in the HSE could not help the mother or the family in this case.

Thank you, Deputy.

The HSE officials told the mother that they were not in a position to provide additional funding for school leavers in 2012. The Minister confirmed that to me in writing.

Because Fianna Fáil bankrupted the country.

It will be getting worse in the next couple of weeks.

There has been a ruthless review of the domiciliary care allowance, particularly in so far as it applies to children with autism. Up to 60% of all applications for domiciliary care allowance in the first six months of this year were refused. Up to half of applications for children with autism were refused. I want to cite a case of a young child called Alex-----

No, Deputy, you cannot. It is Leaders’ Questions. Would you please put a question?

This is an important point.

I know that but you are over time.

I will finish it quickly. His is a case of severe social impairment, challenging behaviour, speech delay, he has been described as a flight risk and requires constant supervision. The Department of Social Protection stated this child is not entitled to a domiciliary care allowance. Will the Taoiseach accept there was a lack of basic funding in last year’s budget for people with disabilities, particularly young people with disabilities?

Thank you, Deputy.

Will he ensure adequate funding for school placements next year?

No, I do not accept that. The Minister of State, Deputy Kathleen Lynch, has pointed out that €1.4 billion is provided in this area. I make the point to Deputy Martin that we should be very grateful to the service providers who do an extraordinary job with limited circumstances. There has never been a guarantee like he speaks of for children in this area. I do not know the case of the young person with autism to which he is referring.

There will be lots more.

One can always find cases like this that are individual, sensitive and important. The Deputy should let me have the details of this case.

There were 3,000 parents protesting outside Leinster House last week.

I must point out to Deputy Martin, however, that there was never a guarantee for placements in these cases. Up to €1.4 billion is provided in this health area. The service providers in this area do an extraordinary job and are proving they can do so much more with less. If Deputy Martin so wishes, he can send the details of this particular case of an autistic young person to the Minister directly and we will see the response. I listened to a case this morning of a claim that grants for a particular school had been terminated completely when in fact there are many options open to the school to deal with this.

With the greatest respect, the system knows this case very well. I did not raise it this morning so that the Taoiseach could take another file from me just to process it back around again. This is a familiar response from the Taoiseach when we are raising issues of systemic importance.

Do you want me to solve it?

It is a merry-go-round.

Mattie, you were part of ruining the country.

Do you want it solved or not?

The issue here is a decision by the Government to get rid of the annual demographic funding that was provided for young people with special needs who left school. In the case to which I referred, the HSE representatives stated they had not received any demographic funding for new residential places in 2011 and 2012 and, therefore, they were not in a position to fund a full-time residential placement or shared care placements at the present time.

Can we have a supplementary question, please?

That is the root of the issue. It was summed up by a parent who wrote to me on this. Parents of children with disabilities are angry because normally at age 18 all students from------

I must remind the Deputy again that this is Question Time. Will you please put your question?

-----the school go on to placements. Children without special needs can move on to placement. It is the children with special needs who seem to have the largest problem getting placements. This can be dealt with and resolved.

Thank you, Deputy.

Last year, the Minister of State, Deputy Kathleen Lynch, was boasting that she got rid of the demographic funding and the service providers were in a position to cope.

I was not boasting.

The service providers are not in a position to cope.

Thank you, Deputy.

They are telling people and every Member this. We know it from the parents of the children who are coming to talk to us.

Deputy, will you please adhere to the Chair and put your question?

I am asking the Taoiseach to sort out the broader problem and issues so as to avoid this targeting of people with special needs both in school placements and the application of the domiciliary care allowance. The most dreaded word for parents of children with disabilities is "review". Once they see that word-----

Deputy, I will not ask a third time. Will you please resume your seat?

-----they get very angry and fearful because it means special and ruthless targeting of people with special needs.

Resume your seat, Deputy.

This is all because of the bank guarantee.

Deputy Martin should review how we got here.

If Fianna Fáil had not messed up the country-----

Deputies, there is a time limit on this debate.

(Interruptions).

Deputies, thank you.

(Interruptions).

The Deputies opposite need to take a bit of responsibility. They are cutting services.

Deputy Finian McGrath supported the last Government.

Deputy Finian McGrath was part of the support mechanism.

Will the Deputy, please, allow the Taoiseach to finish? This is Leaders' Questions, not statements.

In fairness, Deputy Finian McGrath jumped ship.

The Minister is getting shifty, too.

Deputy Micheál Martin speaks about targeting people individually. He has raised the case of an autistic child who needs a placement. If he wants that problem to be solved or investigated properly, I invite him to send me the details.

I sent the details to the Minister.

The Deputy should note that €1 million has been allocated from the disability budget for autism services, specifically those dealing with these cases. He tells us that we should not target people, yet he raises a particular case in the House.

The Minister of State, Deputy Kathleen Lynch, knows that they do not have the money.

If the Deputy wants to have that case examined, I invite him to send us the details to we see what can be done.

I want the system to be changed and it can be.

Persons with a disability, despite the economic circumstances we face, have been better protected than any other sector. There are always cases.

The fund was wiped out in its entirety.

The Deputy seems to assume that he is the only one who has access to the people concerned. I am told their stories every day of the week, as everyone else here knows.

Unfortunately, these cases are the fallout from the bank guarantee and the legacy with which we have to deal.

That is rubbish. The Taoiseach got rid of demographic bodies.

In this case the Minister of State at the Department of Health, Deputy Kathleen Lynch, has €1 million from the disability budget to deal with autistic cases alone. The Deputy is well aware that an independent review is being carried out of the service providers dealing with the case he mentioned.

That is frightening.

The Government is cutting the disability budget.

We might take away the allowance of €42,000.

We are over time. I call Deputy Pearse Doherty on behalf of Sinn Féin.

(Interruptions).

The Minister of State is cutting the disability budget. She is doing it.

Will the Deputy, please, respect the Chair? I have called Deputy Pearse Doherty.

The Minister of State is cutting services for people with disability who have a right to them.

The Deputy will be leaving the Chamber in one minute.

I am not accepting it.

Will the Deputy, please, resume his seat?

No way, a Cheann Comhairle. I am not accepting it.

The Deputy will leave the House.

This is not a real republic because the Government is slashing services.

The Deputy will leave the House.

No, a Cheann Comhairle, I will not, not until the Minister puts it right.

I told the Deputy to leave the House.

I am defending the rights of people with a disability against the cuts. The Labour Party is against me.

I am asking the Deputy again to leave the House. Out, please. Any more messing and the same treatment will apply. This has become a total sham.

Make sure that you are fair with it.

The Deputy will be next if he is not careful. Deputy Pearse Doherty to continue, without interruption.

Next week the Government will introduce a budget in which it will heap additional hardship on low and middle income families throughout the State.

Will the Deputy circulate his script?

At the centre of the budget-----

(Interruptions).

Please, Deputies.

Next week the Government will introduce a budget-----

This is live on television. Will Deputies, please, give some example to the rest of the community watching?

For the third time, next week the Government will introduce a budget which will impact heavily on those on low and middle incomes. A central part of the budget proposals will be a property tax, a charge on the family home. We know that many people will simply be unable to afford to pay this charge.

A Deputy

It will be like being in Belfast.

Last week the Minister for Finance, Deputy Michael Noonan, indicated or announced to me in a reply to a parliamentary question that 13 Ministers had claimed a second home tax break known as the dual abode allowance. The Taoiseach will be aware that this tax break is exclusively for Ministers and officeholders. Those from outside Dublin are allowed to write off €6,500 against their income tax bill if they have a second home in Dublin without having to provide a single receipt. If they do not have a second home in Dublin and stay in a hotel, they can write off against their income tax bill €3,500 for having their laundry done and without having to provide a single receipt.

When the Taoiseach was in opposition and Deputy Micheál Martin and his gang were availing of this lavish tax break, the Taoiseach promised to abolish it. Since he has taken office, far from abolishing it, we have seen the cost increase by 30% to €112,000.

Will the Deputy, please, put his question?

Is the Taoiseach one of the 13 Ministers availing of this tax break? Which of his ministerial colleagues are availing of it? How can he justify it to people at home who fear the introduction of the Government's property tax on their family home when 13 of his Cabinet colleagues are writing off against their income tax bill the cost of a second home in Dublin?

(Interruptions).

The fact of the matter is that the Deputy claims the overnight allowances to which he is entitled. They are a multiple of what any Minister who does not receive overnight allowances would claim. Most Ministers are in Dublin four or five nights a week, depending on their schedule or duties. The matters mentioned by the Deputy are part of what the Government is considering in respect of the budget which, as he is aware, that will be presented by the Minister for Finance next week.

First, this is not an allowance. Ministers must write to the Revenue Commissioners to ask that their income tax bill be written down by an amount that can be up to €6,500 in unvouched expenses.

I will outline what it includes.

I am sorry, Deputy, this is Leaders' Questions. Will the Deputy, please, put a question?

This is my question. If a Minister decides to buy a house in Dublin, all of the mortgage interest will be written off against his or her income tax bill. His or her solicitor's fees will be written off against his or her income tax bill.

Will the Deputy, please, put his question?

His or her auctioneer's fees will be written off against his or her income tax bill. No one knows whether the Taoiseach is one of the 13 Ministers who have availed of this tax break. How many Ministers have availed of the €3,500 deduction for the purposes of having their laundry done because they stay in a hotel or guesthouse? The people deserve clarity and openness.

The Deputy claims expenses.

All of the expenses paid to Deputies are published on the Oireachtas website. At this point no one knows the 13 Ministers who are reducing their income tax bill by this scheme which the Taoiseach when in opposition promised to abolish when the other gang was availing of it.

(Interruptions).

I will not ask the Deputy again. Will he, please, stay quiet and stop shouting across the House? It is ridiculous. No one can hear what is going on. Will the Taoiseach try to reply, please?

Deputy Pearse Doherty has made a statement. Ministers are entitled to an allowance of €6,000 which they can claim at the 41% tax rate, which works out at approximately €3,500. As a rural Member, the Deputy is in a position to claim approximately €30,000 or more, depending on what his overnight allowance figures are.

It is more than that.

No Deputy is allowed to reduce his or her income tax bill.

(Interruptions).

I do not know what Deputy Martin Ferris is claiming, but Deputy Pearse Doherty is referring to two very different things.

Perhaps the Minister for Public Expenditure and Reform, Deputy Brendan Howlin, is availing of it.

I call Deputy Thomas Pringle.

Hands up those who are availing of it.

During the past year we have heard about hospitals in Dublin refusing treatment to patients nationwide because they are not from within the catchment area. At times the treatment sought is so specialised that it has not been available outside Dublin. We have also seen that services in hospitals are kept below a line running from Galway to Dublin. Citizens living to the north and north west are being forced to travel long distances to access treatment.

I wish to raise an issue which does not concern the provision of highly specialised treatment. For a modest investment the Government could make the lives of more than 100 children easier and save the health service multiples of the cost in the future. In September Diabetes Ireland submitted a business case to the HSE for the provision of insulin pump services for children at Letterkenny General Hospital. At an estimated cost of €95,000, insulin pump services could be provided for the 138 children who access diabetes care services in Letterkenny.

Currently, 20 families must travel to Dublin, which journey takes five to six hours, to access care. For many, the decision in terms of the logistics and costs involved in travelling to access treatment is a difficult one.

The priority of Government should be the provision of equal access to treatment for patients. Where one lives in the country should not be the deciding factor in whether one gets treatment. Some 50% of children with diabetes develop long-term complications. Properly controlling insulin levels in childhood can reduce the long-term effects of the condition. This investment will have long-term benefits for the health budget and will improve the quality of life of sufferers.

Does the Deputy intend asking a question?

Will the Taoiseach accept that this investment will save money in the long term through a reduction in the risk of complications from diabetes and will he ensure budget 2013 makes provision for insulin pump therapy for children in Donegal through Letterkenny General Hospital and in other regional areas identified by the expert advisory group?

The incidence of diabetes is of growing concern and importance. When listening to the proceedings of a recent meeting of the Joint Committee on Health and Children I heard the chief medical officer from the Department of Health say that the number of diabetics in this country will increase to 250,000 over the next couple of years and that this could be prevented through education, diet and activity. Deputy Pringle will have heard expressed this morning the growing concern about the levels of obesity here and the associated costs of addressing the consequences in that regard. There is no legal basis for treatment based on catchment areas. The Minister has advised all hospitals of this. I do not know the details of the facility in Letterkenny of which the Deputy speaks. However, as a result of action taken by the Minister and HSE there are now 800 fewer children on waiting lists, some of whom are in the category referred to by the Deputy. The new emergency department in Letterkenny General Hospital is now open and roll-out has commenced of a diabetes programme which involves the recruitment of 17 nurse practitioners, which will be of assistance in addressing this issue.

I acknowledge that it is difficult for parents to have to travel long distances to access treatment for their children. I have seen them in Our Lady's Children's Hospital in Crumlin over many years. It is hoped the recruitment of the 17 nurse practitioners will have an impact. As I said, the Minister has already informed all hospitals that there is no legal basis for confinement based on catchment area. I hope this will improve the position for the parents of the children of whom the Deputy speaks.

I thank the Taoiseach for his reply. This is not about catchment areas, rather it is about the making of a small investment in a regional hospital, which would save multiples of that invested in the future. It is also about budgeting within the HSE. Investment of a small amount of money now will result in large savings in the years to come. I believe the Government should be able to make this decision in the context of budget 2013. The Government needs to provide this funding which will ensure easy accessibility of services for people and will result in long-term health benefits. It would also contribute to a reduction of €1.1 billion in the cost of treatment of obesity, which issue was mentioned by the Taoiseach in his reply. These small investments need to be made to ensure services are provided and savings are achieved. In a budgetary context, this is what should be important and should be the consideration.

One of the issues that has arisen from the North-South Ministerial Council programme is the extent of cross-Border co-operation and activity in a range of areas, including transport, education, business and health. I know from the last meeting held in Armagh that the Minister, Deputy Reilly, has had a number of meetings with the Minister for Health, Social Services and Public Safety in Northern Ireland, Mr. Poots, MLA to discuss the effectiveness of cross-Border co-operation at a number of facilities, including between Altnagelvin hospital and Letterkenny General Hospital and the new South West Acute Hospital in Enniskillen with Sligo General Hospital.

I am not sure whether the Deputy is calling for the provision of a new facility or treatment area at a cost of €95,000 or whether that figure relates to personnel. The HSE programme may have a proposal in this regard, which may be enhanced by way of co-operation between the HSE and the authorities in Northern Ireland and between the Minister for Health, Deputy Reilly and Minister for Health, Social Services and Public Safety, Mr. Poots, MLA. I assume the matter raised by the Deputy can be followed through. The amount referred to by him is small. It may be that co-operation in terms of addressing the problem mentioned by the Deputy already exists or is under way. Perhaps Deputy Pringle would raise the issue directly with the Minister, who will be able to advise him what is happening in that regard or of the exact plans of the HSE to deal with the particular issue raised by him.

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