asked the Minister for Health the further progress that has been made since his Department arranged the seminar on mental handicap last January.
Ceisteanna—Questions. Oral Answers. - Mental Handicap.
2.
One of the main points emerging from the discussion during the seminar was the need to establish in many areas a service to counsel and support the parents of young mentally handicapped children living at home. Following the seminar I set aside some of the financial resources of my Department for that purpose and requested the health boards to let me have proposals for suitable schemes following consultation with local mental handicap interests. I have conveyed approval to proposals submitted by four health boards and I expect to receive proposals from the remaining boards shortly: these will receive immediate attention in my Department.
The other main topic touched on during the seminar was the shortage of residential places for the adult mentally handicapped. I have already made considerable provision for such places in this year's capital programme—750 residential and 250 day places—and I am considering at present what further projects can be provided for in the 1979 programme.
During the seminar views were expressed on a number of other facets of the mental handicap services—for example, the development of group homes and hostels and the relationship between the statutory and voluntary agencies. These are being borne in mind in the planning of the services.
In view of the invaluable nature of the seminars in question and the constant prospect of review of the programme, would the Minister consider arranging a further seminar next year at which the progress now being made could be reviewed? Many health board members have assured me that it provides them with a valuable opportunity of conveying their views to the Department and to the Minister.
That is a very constructive suggestion. We will keep it in mind. It might not be at the start of next year because we are awaiting another report.
3.
asked the Minister for Health if he intends to introduce a comprehensive national programme for the mentally handicapped.
A number of initiatives in relation to the mental handicap services have been taken as part of a comprehensive programme for the mentally handicapped.
In the community sphere a counselling service for the parents of young mentally handicapped children living at home has been initiated, the domiciliary care allowance which is paid to mothers caring for their handicapped children at home has been increased from £25 to £35 per month and certain other improvements have been made in the scheme. In addition, there have been two increases in the Disabled Persons Maintenance Allowance which is paid to needy handicapped persons over 16 residing at home.
In the provision of residential and day accommodation, schemes are in progress or in planning which, over the next few years, will improve existing facilities and provide some 2,000 extra places for children and adults at an estimated cost of over £23 million. Since August 1977 some 450 new posts have been approved for the mental handicap services which have considerably improved the range and quality of the services available throughout the country for our mentally handicapped.
As regards the planning of future services, I am at present awaiting the report of a special study group representative of my Department and other interests—that is the report I mentioned to Deputy Desmond—which will be making recommendations to me regarding the future development of our mental handicap services. On receipt of this report I will be considering what further initiatives might be taken in the continuing development of the service.
In other words, when that report is presented we would have the basis upon which a comprehensive programme might be detailed. While the improvements outlined are welcomed, the Minister will accept that they are really improvements on the existing service. The setting out of a comprehensive programme would appear to depend on the report that is awaited?
There is no real line of demarcation. We are going ahead with anything that appears to be immediately advantageous. As I said in reply to Deputy Barry Desmond, the home counselling service emerged from the seminar and there was no reason why it should not be embarked upon so we went-ahead with it. We do not necessarily have to wait for this other report to decide an initiative. The main thing is the provision of places and that is well under way.
In view of the enormous cost of capital and current expenditure on institutional care, particularly for mentally handicapped children, would the Minister undertake a special review of the £25 allowance in the context of next year's budget?
It is £35.
As the Minister is aware, this sum of money has not kept pace with inflation in the past five years. With that in mind, perhaps he would be in a position to encourage the parents of mentally handicapped children to devote more care to them in their own homes?
This is an important aspect of the matter. First, let me remind the Deputy that the level was at £25 for many year but we increased it to £35 in April this year. In addition, we made that £35 available to every child. We have also instituted the home counselling service. These are very important aspects of the domiciliary side. I agree with the Deputy that we must do everything possible within our resources to help those parents to keep their children at home. I will ensure that that aspect of the matter is prominent in the review.
I know the Minister is aware of the extremely high cost to parents of keeping mentally handicapped children at home. Whilst the £35 allowance is a help, would the Minister consider the possibility of having medical card cover issued in respect of the children, even in circumstances where the family income in general would not qualify the family for medical services? Would the Minister consider the idea of having medical card services so that the cost of local GP would be covered in respect of children kept at home?
Yes, a fair number of these families would have medical cards anyway for one reason or another but it is an idea.
A fair number do not have them.
(Cavan-Monaghan): Is the Minister aware that there is still great difficulty in finding suitable places in institutions for young people who cannot be kept at home and who badly need to be institutionalised? Is he aware of the problem arising when these young people who are being accommodated reach the age of 16 or 17 and are no longer kept in the institutions which cater for young people and a suitable alternative home or institution cannot be found? The parents go through great stress for perhaps a year under threat of having the child sent home to them when the child is not suitable for living at home.
Yes, I accept that. The bottleneck is in the provision of residential places for the adults. It works both ways. First, the accommodation is not there for the adult mentally handicapped person. Also, when some in-patients grow from childhood to adulthood they stay on in the institution and occupy a place which should be reserved for a child. So, the real need is for adult residential accommodation. That is why in our building programme we are concentrating on those. When the works began in 1978 are completed we shall have 700 extra places. At the moment we are planning a capital programme for 1979 and we shall almost certainly be giving priority to adult accommodation.
(Cavan-Monaghan): Could the Minister give any indication of when more places will be available?
They will be coming on stream next year and the year after. Probably by 1980 they will be all there.