Deputy Howlin has 25 minutes left.
Private Members' Business. - Services for the Mentally Handicapped: Motion (Resumed).
The following motion was moved by Deputy Yates on 5 December 1989:
That Dáil Éireann deplores the lack of Government planning and provision of adequate services for mentally handicapped persons; calls on the Minister for Health to provide adequate residential, day-care and community care facilities for all age groups of mental handicap and to bring forward legislative proposals to give specific legal rights to such disabled persons.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
"commends the efforts of the Minister for Health to improve the level of services available to mentally handicapped persons despite the severe overall limitations on Exchquer resources and the intention to make further resources available for the development of these services as budgetary circumstances permit."
—(Minister for Health).
I indicated to the House last night, and the House agreed, that I could share a few minutes of my time with Deputy Garland. I trust that Deputy Garland will be in the House to follow.
At the commencement of my contribution last night I read into the record an addendum to this motion in the name of the Labour Party and all the Labour Party Deputies. The object of that addendum is to put flesh on the bones of the Fine Gael motion which the Labour Party wholeheartedly supports and to spell out some of the specifics of the crisis that faces people with a mental handicap. Quite clearly that crisis exists and it is of the utmost importance that the Minister recognises that and spells out clearly to the House the steps he proposes to take to deal with those who unfortunately have a mental handicap, and those carers who are trying to look after the people so striken, whether they be family members or others.
I am sorry the Minister for Health is not here because before dealing with the specifics I will refer briefly to the speech made by the Minister in this House last night. The Minister talked at some length about the money being spent on the services for the handicapped and sought to give the impression that a huge sum was already available to ensure that the right to a full life is being delivered to all afflicted with mental handicap. What the Minister did not say is that the sum of money he talked about included every penny spent on services for the physically handicapped as well as for the mentally handicapped, including people who are deaf, blind and handicapped in numerous other ways. The Minister did not say that the money included allowances paid to mothers who keep their children at home or that those mothers could have their allowances removed if their child or children had to spend a period in hospital. The Minister did not say that in many cases the payment of that allowance is dependent on an annual medical check to certify to the satisfaction of the Department that the mentally handicapped person in their care has not been cured — as if there was a cure for mental handicap. Neither did the Minister say that the money includes the disabled persons' maintenance allowance which is paid to all handicapped and disabled people, nor that they could lose that allowance if the sheltered workshop that employs them pays out more than around £10 a week. I am glad the Minister has arrived for the end of my comments on his speech last night. In short, as we have come to expect from this Minister, the figures he used were misleading and incomplete but, in a sense that does not matter. Whatever he is spending at the moment is not enough and there is ample evidence that that is a fact. The Minister knows that as well as any other Member of this House.
Last night I attended a meeting of the parents association for people with a mental handicap in the Mansion House, a few short yards from this building. It was attended by almost 1,000 people, including quite a few Members of this House. Those of us who were there could see the pain and hardship at first hand and we could see the anger that had driven mothers and fathers to the point where they are going to march on the streets of Dublin next Friday to demand their rights. We could see the shame that we who call ourselves a Christian people, who often refer to the mentally handicapped as being special, should reach a stage where this group of parents find themselves reduced to street tactics in the face of indifferent and intransigent policy makers. Words are not adequate to convey the pain and despair and the feeling of hopelessness that was expressed so eloquently by the carers and parents last night in the Mansion House. These people felt they were a forgotten people. In organising last night's meeting the parents' association issued a press release which summed up well the anger they feel. That press release should be read into the record and I propose to do just that. It reads as follows:
People with a mental handicap are often called special. Why? Is it because people with a mental handicap never complain, never protest, never march? Is it because the families of people with a mental handicap are prepared to carry whatever burden the State is unwilling to share? Is it because people with a mental handicap can be safely ignored whenever employment policy is being drawn up? Is it because the families of people with a mental handicap cannot afford to die, because there is no provision for their children — and even find it difficult to emigrate, because there are countries that don't want to let them in?
Everyone involved in the provision of services for people with a mental handicap recognises that a crisis now exists in the range and quality of service on offer to our sons and daughters. This crisis has been brought about by the failure of Government and the responsible agencies to provide and allocate the necessary financial resources to the services for our children. The absence of a planned and comprehensive programme has left us with no choice but to raise our voices in public protest. We are determined that our children's rights will become Government priorities.
Our children, who range in age from the very young to well into adulthood, face — and will continue to face — cutbacks in Education and Training, open and Sheltered Workshops, Breakaway and Crisis Intervention facilities and Residential Centres. We are demanding urgent action on behalf of our children — the needs of people with a mental handicap must become a priority. The Government must act now, to make available the funding necessary to end the waiting lists.
Parents are angry. We face a total lack of action — and even awareness — from our elected respresentatives. According to the most up-to-date figures available from the Eastern Health Board, a total of 328 residential places are needed now. In the years after 1990, a further 567 places will be needed.
And residential facilities are only a part of the problem. In the areas of training, education, and employment facilities, the crisis is growing. In all of these areas, the rights of people with a mental handicap have taken second place to the needs of Government book-keeping. Even now, when money is becoming available for Health, that money is being spent only in the country's general hospitals.
There is no evidence of any extra current money being made available in the 1990 Health Estimate just published; the capital allocation for Health has been reduced — and the demand for new residential places for people with a mental handicap will have to compete with all sorts of other demands for a share of that reduced money; the financial allocations made for Education include no provision for alleviating the growing crisis of staffing in special national schools for people with a mental handicap.
We are determined that all this must change. We aim to generate a climate where the hardship being suffered by people with a mental handicap, and their families, will no longer be tolerated. Our goal is to place the issue of mental handicap where it belongs — at the top of the political priority list. We won't settle for less.
That is more than a plea from the heart of concerned parents — it is a demand for rights, rights that are enshrined in a United Nations declaration but which have never been enshrined in any national legislation.
The Minister said last night that legislation to give specific rights to persons with a mental handicap is being considered. I hope the Minister will not linger long in his considerations and that finally we will have rights for mentally handicapped people enshrined in legislation.
Before going on to deal with those rights, it is necessary to spell out some of the specific problems that exist in this area and which, taken together, add up to the crisis that people with a mental handicap face.
The most worrying feature of the crisis in mental handicap is that there is little or no planning for the future. A great deal of lip service is paid to the concept of planning, but the reality is that the agencies and their staffs in the fields are too busy dealing with the crisis in current services, and worrying about next year's financial allocations, to be able to look ahead. The human hardship involved in mental handicap will get a good deal worse unless planning starts now, and the development of plans must take place in the knowledge that resources will become available.
That is why it is imperative that the Minister for Finance and the Government should commit themselves now, for a period of years, to improving the funding available in the area of mental handicap. In return, the agencies in the field should come together to ensure that all extra funding is spent in a rational, planned, and co-ordinated way, in addressing the following crisis points.
It has always been difficult up to now to establish exactly what the scale of the problem of residential places is. Estimates have varied, and data about waiting lists has been difficult to assemble. Because there is a high degree of overlap between waiting lists, the mentally handicapped person in Dublin who is seeking a residential place, for example, can be named on up to five different waiting lists. But now at last there is reliable information in the Eastern Health Board area, and while we wait for similar information to be available for the rest of the country, it is reasonable to calculate the scale of the problem by extrapolating from the Eastern Health Board area figures.
According to Estimates prepared by the Eastern Health Board, 328 residential places are required for persons with a mental handicap in the Eastern Health Board area alone, and they are needed immediately, with a further 567 places needed in the years after 1990; at least 1,000 residential places will be needed in the country as a whole.
Residential places are required in cases where the severity of the condition is such that the person is incapable of being cared for at home, or where parents are ill or aging. It may seem unbelievable in this day, but many hundreds of families in Dublin alone are in the position where they are afraid to become ill, for fear of what might happen to their child. There are now cases where mentally handicapped people are living alone; where mothers of 70 are trying to cope with 40 year old handicapped sons, where parents have not had an unbroken night's sleep in years.
These are only some examples. But what has happened in terms of the provision of new places? Last year, in the Dublin area, between ten and 20 additional residential places became available to cope with a demand that outstripped supply by a ratio of 50:1. One of the largest full-time residential centres in Dublin has been unable to admit a new patient for four years, and recently had to approach some of its parents asking them to take their children — aged from 12 to 40 — home for long weekends, to enable the institution to cut down on staffing costs. The last new centre built in Dublin was opened five years ago. If new places become available in the short term, the likelihood is that they will be used to transfer mentally handicapped people out of psychiatric institutions. Those in the community will continue to wait.
That is what is happening. If that is to be the future, then the future is very bleak. There is an imperative need for an investment programme in new residential places. Clearly, such centres must be purpose built, equipped and staffed to the highest levels. For the eastern region alone, a capital programme of £10 million a year for the next five years is the minimum that is essential.
A comprehensive range of services must be developed within catchment areas to deal with the needs of families who are under stress. Day care centres, crisis intervention facilities, "breakaway units" to enable families to take holidays are all desperately needed. It is a fallacy to believe that families can always cope with cases of mental handicap without any back-up from the community. Even though policy makers pay lip service to the need for back-up, any family who needs help finds it very difficult to find a place, even for a week.
In the eastern region alone, there are 6,000 mentally handicapped people living in the community. By and large, that means that there are 6,000 families coping with degrees of stress ranging from mild to profound. The Eastern Health Board have outlined, for each community care area, the staffing and capital requirements necessary. They estimated, for instance, that in 1987 a capital outlay of £8 million extra would be required to put essential mental handicap services in place. Qualified extra staff, at an extra cost of £1 million, would be needed also. In fact, nothing extra was spent in 1987, 1988 or 1989, and so far, nothing extra has been provided for 1990.
Special schools for the mentally handicapped are staffed by teachers and teachers aides whose salaries are paid, in the main, by the Department of Education. No distinction has been made between these schools and ordinary national schools when it came to the educational cutbacks. The consequence has been that in many if not most special schools there are now staff shortages. Teachers and teachers aides who have left, were not replaced.
The extra demands involved in teaching mentally handicapped young people to help them to maximise their potential, has given rise to the appalling possibility that many special schools are in danger of becoming child minding centres with teachers under too much stress to be able to devote the time needed to get the best from their pupils. Surely no-one would deny that a special case can be made for protecting special schools from cutbacks? Why are they called special, and why must special people bear the same burden of financial rectitude as the rest of the community?
A domiciliary care allowance is paid to the mother of a mentally handicapped child living at home up to the age of 16. That allowance, at present £79 a month, is intended to compensate her for the full-time care she gives her child. Surely in this day and age it is possible to improve on this meagre and inadequate allowance. I am anxious to give some time to Deputy Garland so I will bring my own contribution to a rapid conclusion, although I have much more to say.
I have listed some of the entirely legitimate demands of the community of families who serve the mentally handicapped. None of them is outrageous or unreasonable. If we call ourselves a civilised society we will recognise that people with a mental handicap have the same rights as anybody else, even if it costs more to ensure that these rights are properly delivered.
I tell the Minister the parents' association for people with a mental handicap have chosen a theme, a slogan, which is "Unlock their rights." The Minister has in his hand the key to unlock the rights of those mentally handicapped people and their families and I urge him tonight to use that key and unlock those rights.
Acting Chairman
It was agreed that Deputy Garland would get five minutes of the Deputy's time.
It was agreed last night.
Acting Chairman
Deputy Garland, you have five minutes.
I would like to express my broad support for this motion and for the Labour Party amendment. The Green Party, Comhaontas Glas, place great emphasis on community health with community participation, and in this regard mental health is no different. We need strong Government commitment, planning and funding together with vital community involvement.
I am satisfied from talking with the parents' association for people with a mental handicap that the level of State services in this area is totally inadequate to provide a reasonable standard of care for the mentally handicapped. Everyone in this House is aware of the need for restraint in the area of Government spending, nevertheless I am satisfied that the parents' association have an unanswerable case for increased State spending in this area. After all, have they not paid their taxes over the years? I submit that, having paid these taxes, they are entitled to reasonable services in this area.
The main reason sufficient money is not readily available is the scandalous profligacy displayed by successive Governments over the last 20 years or so. Apart from anything else, there are many examples of waste, inefficiency and feather-bedding in the Estimates for Public Services for 1990, just published. For example, the IDA are to receive £108 million for next year. A large proportion of this enormous sum will be used to attract many totally unsuitable projects to this country. If a small fraction of this amount were to be reallocated from the Department of Industry and Commerce to the Department of Health this problem could, to a large extent, be solved.
Wexford county provides us with a good role model for the rest of the country where services for the mentally handicapped are comprehensive and co-ordinated and nearly adequate, community participation and community help being at the core of their success. The single most important concern is for a national plan to take cognisance of the need for appropriate care. While recognising the need for an increase in funding provided, we feel vast amounts of money are not necessarily what is required but what moneys are available should be targeted for the appropriate services, an investment in people rather than in buildings and technology.
The latest report on the handicapped services shows that more than 2,000 people cared for in the community need residential care and a similar number of people in residential care could be cared for within the community if the community services were adequately developed. A large institution with its accompanying clinical environment is not the most suitable place for these people. People with a mental handicap have a right to normal patterns of life in the community as far as is possible. They need to participate in and be respected as members of society. They need to be cared for in their own homes or in substitute family type homes.
Acting Chairman
The Deputy has one minute.
They need to mix and socialise with other members of a community and have access to common facilities.
I call on the Minister for Health to facilitate the relatives of mentally handicapped persons who wish to care for them at home, by providing more respite beds and promoting break-away service. Where residential care is required it should be provided in small units within the community. We must recognise that the mentally handicapped are like ordinary people ——
Acting Chairman
You must conclude now.
—— with similar and special needs. We should allow them to articulate their own needs and we should take heed of what they say. Above all, we must recognise their vulnerability and respect them as human beings having a great potential.
Acting Chairman
I call the Minister of State, Deputy Frank Fahey. I understand he has agreed to give five minutes of his time to Deputy Máirín Quill and five minutes to Deputy Dermot Fitzpatrick. Does the House agree to that arrangement? Agreed.
I would like to express my appreciation of an opportunity to contribute to this debate and to compliment Deputy Howlin on a very forceful speech, much of which we would all agree with. However, perhaps it is a little unfair to be so critical of the performance of the present Government, especially the present Minister for Health, in regard to treatment of the mentally handicapped. Unlike probably any other area of administration in the State, the Minister for Health has succeeded in ensuring that cutbacks which applied all over the place did not apply to the area of mental handicap. He is to be complimented on that. Perhaps it did not come across in Deputy Howlin's speech.
I would like to correct Deputy Howlin. He said the Minister had misled the House last night. This was wrong. The £130 million is for services for mentally handicapped persons and does not include the physically handicapped or allowances for handicapped persons. I would like to stitch that into the record.
I think it is fair to say that everyone, especially the Minister for Health and the Minister for Education who are charged with this responsibility, would agree that we would all like to see more resources. Of all the areas of care probably mental handicap is one where the maximum resources possible should be provided. All politicians would agree that it touches the heart and consequently deserves the maximum possible support. Within all the constraints this Government, and especially those two Ministers, have tried to ensure that all possible resources have been made available for the mentally handicapped. Deputy Howlin produced a nice little phrase asking the Minister to use the key to unlock the rights of the mentally handicapped. Let me make the point that in the education area we have to look around for quite some time to find the key following on a four-year period of the Deputy's party being in Government. I will give some examples of that in a few minutes. It is wrong for Deputy Howlin to come in here this evening and make a speech without reference to his own party's period in Government.
The Minister's party are responsible. They have been in for three years.
Acting Chairman
Deputy Howlin, allow the Minister to continue.
I will give examples of what I am talking about in a moment.
They are responsible now and have been for three years.
I am pointing out that the speech he made was very honourable but he totally forgot about the period when he himself had an opportunity to do something about the things he talked about.
My Department reject the suggestion that they provide inadequately for the education needs of the mentally handicapped. Special schools and special classes in ordinary national schools in which mentally handicapped pupils are enrolled, are generously staffed and funded. The total expenditure by my Department for the provision of teachers, equipment, school transport and other services is about £15.6 million per annum.
The Department recognise three different categories of mental handicap from an education point of view. Firstly, there are pupils who are termed mildly mentally handicapped and are often referred to as slow learners. Secondly, there are moderately mentally handicapped children and thirdly, the severely mentally handicapped pupils. Obviously, the fundamental education needs of each category vary. This is reflected in the curricula and the pupil-teacher ratio pertaining to each category. The Department rely on a recent psychologist's report in order to establish the needs of any mentally handicapped child.
Until quite recently the provision for all categories of handicapped children was made predominantly in special national schools. As a result mentally handicapped children, like other categories of handicapped pupils, were for the most part, educated in isolation from their peers and some aspects of their social development suffered as a result. Bearing this in mind and taking cognisance of the most recent findings, policy orientation has shifted towards catering for these pupils in ordinary national schools as far as possible. The number of children in each special class is very much smaller than in the ordinary classes in primary schools. This reflects the additional individual attention needed by mentally handicapped children in general.
The current pupil-teacher ratio pertaining to mildly mentally handicapped pupils is 16 pupils to one teacher and for moderately and severely handicapped 12 children to one teacher. However, I must stress that the pupil-teacher ratios relating to the mentally handicapped are not as rigorously enforced as those in the ordinary national schools because of the special needs of this category of pupils. It can be appreciated readily by the House that the ability of levels of mentally handicapped children varies considerably. This factor demands that there be flexibility in order to provide facilities to cater appropriately for the individual needs of every mentally handicapped pupil. Notwithstanding the strong policy bias that will apply in future towards integration of mentally handicapped pupils in ordinary national schools, there will always be a need for specialist educational facilities to be provided in central establishments, particularly for children with severe handicap who require a particularly large investment in staff and equipment.
Submissions have been made in recent times to the Department regarding the issue, and promoting the idea, that there should be full integration of handicapped children into the mainstream of ordinary national schools. My Department are favourably disposed towards the general trend in favour of integration and believe that the same attitude is shared by the vast majority of teachers and boards of management of ordinary national schools.
I now propose to give some details on the existing facilities being provided by my Department to children with mild, moderate and severe mental handicap, to refer to the extensive school transport service which is provided and, finally, to conclude with some analysis of the finances devoted by my Department to their education. As previously stated, the pupils who are mildly mentally handicapped are often referred to, in everyday terms, as slow learners. Generally, these pupils would have attained an intelligence quotient in the range of 70 to 100 when psychologically assessed. There are currently 32 special schools employing over 250 teachers, located nationwide, catering for 3,840 pupils. These schools were established when centralised education for the mentally handicapped was in vogue. In addition to this and with a view to integration, my Department have established 154 special classes, employing 154 special teachers attached to ordinary national schools — 90 of the latter are situated in Dublin, while Munster accounts for 22, Ulster 14, Connacht six and the rest of Leinster, 22. We would readily accept that there is a requirement for many more such special classes.
When pupils are geographically dispersed, greater difficulties arise in establishing a special class because of transportation cost and logistics. Special classes in ordinary national schools cater for 1,850 children. Therefore, for the total population of 5,700 mildly mentally handicapped pupils, we can note with satisfaction that 48 per cent, or nearly half, are partly integrated into ordinary primary school facilities.
The moderately mental handicap children tend to have an intelligence quotient in the range of 50 to 70. The Department have sanctioned 33 special schools catering for 2,250 children. As might be expected the degree of integration into the ordinary schools has been slower than that observed in the case of mildly mental handicap pupils as witnessed by the small number of special classes — nine have been established nationwide. Only 2.6 per cent of the moderately handicapped pupils, therefore, have achieved anything like integration into the ordinary national school system. The curriculum review board are expected to report shortly on the feasibility of achieving a greater degree of integration. In respect of moderately handicapped pupils, my Department recently completed a curriculum specially to cater for the needs of these people.
With regard to severe mental handicap in 1985 a detailed report called, The Education and Training of Severely and Profoundly Mentally Handicapped Children in Ireland 1983, my Department established ten special classes to cater for pupils who are severely and profoundly mentally handicapped. This was a very progressive step and placed us in the vanguard of educational provision for these children. There are 17 classes in existence at present. These are attached, for administrative purposes, to special schools. However, some of these are physically located in local health centres.
School transport for the mentally handicapped is another area where we have attached significant attention. The geographical and dispersion aspect results in the average cost of providing transport for a mentally handicapped child to his or her nearest school to be significantly higher than for ordinary pupils. On average it is about three times as expensive to transport a pupil to a special school or class as it is to transport an ordinary pupil to school. In keeping with my Department's policy in favouring day school rather than residential facilities, every effort is made to provide daily transport, despite the long and costly distances involved. The extra costs involved are reflected in the disproportionate amount of money on transporting mentally handicapped pupils in relation to the total allocation for school transport. For instance, in 1988 out of £28 million allocated for school transport, over £3 million was spent on the transportation of mentally handicapped pupils.
The full impact of the magnitude of this expenditure can be appreciated when it is realised that whereas the mentally handicapped receiving transport account for 11 per cent of total expenditure on the service, they only account for 4 per cent of the number of pupils in receipt of that transport.
Finance for education of the mentally handicapped is, indeed, relatively strong and some general analysis is as follows. The special provision made by my Department in favour of children with any form of mental handicap is clearly illustrated by the expenditure levels on their education at primary level in 1988. The following clearly illustrates this point. My Department spent over £10 million on full-time teachers in special classes and in special schools. In addition, £1.5 million was spent on various part-time teacher services in the special schools. My Department incurred expenditure of £3 million approximately in transporting pupils to special schools and classes. My Department spent nearly £400,000 in the provision of child care assistants in special schools. These child care assistants assist the special school teachers. Despite all this, I am the first to admit that we would be much happier to be in a position to put more money into this area. We are constantly under pressure from people and from parents of children to respond to demands for more resources. We are particularly keen to try to provide for more child care assistants which we accept are needed in the special schools.
We are particularly anxious to provide for a more comprehensive transport system than that provided. We are conscious of a considerable amount of hardship suffered by parents of mentally handicapped children who have to travel many miles to pick up points in order to catch the special transport that is made available. I am conscious of sad individual cases throughout the country where parents have to travel five and six miles to catch a bus and travel back in the evening to collect the child.
I should like to inform the House that we are endeavouring to provide a transport system which will, as far as possible, accommodate the needs of those children and make travelling more appropriate to their needs. This is a huge problem because of the dispersed nature of the transport. Often a bus can travel up to 100 miles collecting children in a very dispersed area. However, we are reviewing this whole area and looking for further initiatives where we can be of greater assistance to parents who are under a considerable amount of pressure.
In regard to the school building programme, we have laid special emphasis in the past two years on the provision of improved accommodation at our special schools. I do not want to hark back to Deputy Howlin, but I should like to mention the example to which I referred when I talked about trying to find the key. A special school, St. Joseph's, Galway, made up of prefabricated classrooms should have been demolished at least five years ago as it was in a diabolical condition, but we are only now getting round to providing a new school there because of the lack of planning or progress in that regard. It would not be fair to lay all the blame for the existing difficulties at the door of the Government, the Minister or myself. We inherited some difficulties but I assure the House that we will continue to tackle those difficulties and give priority to the improvement of accommodation in special schools and to the development of more special schools where they are required.
As I mentioned previously, in excess of £15.6 million of non-capital funds was expended on the mentally handicapped under all headings at primary school level during 1988. My Department also made special teacher provision for the education of mildly mentally handicapped pupils in some secondary, vocational, community and comprehensive schools at a cost of £1 million. The educational needs of mentally handicapped pupils are comprehensively and generously provided for by my Department and we are determined to do more. Furthermore, the Department will continually review the present arrangements for the delivery of that educational service over future years to ensure its cost effectiveness and suitability in the light of the most up to date policies directed at assisting handicapped persons to derive the maximum benefit for their own personal development in the educational system.
On the initiative of the Minister for Education, for the first time we have put major money into sport for the mentally handicapped in the last two years. The greatest increase in the amount of money from our sports budget in the past two years has been towards the provision of sports facilities and opportunities for the mentally handicapped, which is evidenced by the amount of money we have given to the Special Olympics in the last two years.
Acting Chairman
I now call on Deputy Fitzpatrick as the Minister agreed to share five minutes of his time with him.
I thank the Minister for allowing me five minutes of his time. I want to deal with one or two points which occurred to me as a general practitioner and a TD.
I should like the Minister and the House to consider the plight of parents of mentally handicapped people. I use the word "people" rather than "children" because, with advances in modern medicine, the life span of the mentally handicapped is comparable to that of the general population. Parents are worried about what will happen to their children when they pass on. There does not seem to be a mechanism in place which will satisfactorily resolve this problem. Their child has been brought up in a family setting and is used to the normal conduct of family life. He or she is accepted and becomes part of the normal family but the parents' worry is that when they are gone there will not be any support mechanisms or family, other than institutional care, for their child.
It is a difficult question to deal with because you are talking about very personal problems of care, property disposal, etc. Will the Minister set up a working party or some other mechanism to look at the problems which will become more acute and numerous in future? To take any person — not alone a mentally handicapped person — out of their home after 40 years or so and put them into an institution can cause them grave upset and retard their development. This problem should be looked at with a view to leaving the mentally handicapped child in the home in which he or she was brought up and providing support services. It is not an easy question and it will require sophistication and sensitivity in dealing with it. I look forward to hearing the comments of Members on this point.
The Minister mentioned my constituency and I join him in praising the nuns in St. Vincent's who manage the best home in the country for the mentally handicapped. They have managed, with care and sensitivity, to move many children and adults to the community and provide support services for them.
I ask the board of Cheeverstown Hospital to kindly get down to business and resolve the problem which is denying care to mentally handicapped children. It is becoming a scandal, not alone in the Eastern Health Board area, but nationally.
I thank Minister Fahey for giving me five minutes of his time, it is appreciated. Proper development of services for the mentally handicapped have seen very little growth since 1980. Accordingly, we now have to confront the fall-out of a decade of scandalous neglect, but confront it we must.
In the field of human suffering nothing can equal the anguish of middle-aged parents struggling with the problems of a mentally handicapped child, and very often left without help or hope. They do not know where to turn or what the future holds for their child when they have passed away. This nightmare cannot be allowed to continue. In many instances the health boards have failed to play their part. I will give an example in my own area. A little over two years ago, when it became obvious to everybody that Our Lady's Hospital, Lee Road, was no longer fit for human habitation the Brothers at Upton offered to take 30 psychiatric patients and look after them in a civilised environment. However, the health board did not provide the money to make that transfer possible. That is a sad indictment of the priorities of some of our health boards. Indeed, it can be rightly said but for the extraordinary efforts of groups like the Cope Foundation, Cork, which grew out of Cork Polio, the Brothers of Charity at Lota, those who run St. Francis' Training Centre and the many excellent rehabilitation centres throughout the country, the plight of people suffering mental handicap and their parents would be infinitely worse than it is today. It is only fit and proper that we pay tribute to those groups this evening. Our task is not to decry what has happened in the past but to chart a course for the future. The training for open employment is funded mainly from the EC Social Funds for a limited three year period, but despite the trojan efforts on the parts of the staff of the rehabilitation centres, it has failed to achieve its task. Despite the best efforts of the placement officers, work is not available for the trainees of these centres and they are finding it impossible to cope with the large numbers of people who are looking for jobs in the open market.
We will have to place an increased emphasis on the provision of additional sheltered workshop places for handicapped persons. I appeal to the Minister to address this task urgently. In addition, there is a need for a large number of places in residential care. I would ask the Minister to ensure that provision is made for mentally handicapped persons to have short stays in residential care so as to enable their exhausted parents to get a break now and then. If the mentally handicapped people could take a break away from home for a week or so, this would be an enormous benefit to their mothers. This could be provided without a huge charge on the Exchequer.
Education has a major role to play in the care of the handicapped, and in this respect I am glad to see that the Minister of State at the Department of Education is present. I want to remind him again, although he has adverted to this fact himself, that the embargo on recruitment in the public service has led to the loss of a number of day care assistants in day care centres, and people who left on retirement, voluntary redundancy or whatever were not replaced. The Minister for Education will have to make an exception of this group and ask the Minister for Finance to lift the embargo in this instance, because an adequate number of day care assistants is vital in providing a minimum level of care in day care centres. Equally, we need to provide more speech therapists and physiotherapists in the existing centres and in the centres that will be provided. I know that this costs a great deal of money but I do not think we can walk away from our responsibilities any longer. Certainly I will be urging the Ministers from my own party to lend their support at the Cabinet table to the Minister for Health and Education in their efforts to secure an increased budget in order to provide a minimum decent level of service for the mentally handicapped so that the nineties do not parallel the eighties in regard to the neglect to which these people have been exposed.
I commend the Minister for what he has said. I urge both Minister to intensify their efforts to make proper and adequate care for mentally handicapped people a priority within the Departments of Health and Education in the decade ahead. I am quite sure they will get support for that and I am confident that they will respond to that support.
Deputy Callely rose.
With your permission, Sir, I will share my time with Deputies Eric Byrne and Austin Currie.
Acting Chairman
I understand that the Minister has said that there are two minutes of Government time remaining and Deputy Callely wishes to speak for those two minutes.
It is 7.55 p.m.
Acting Chairman
The Government's time expires at 7.55 p.m. but there are two minutes remaining.
I gave two minutes of my time to the Government side.
Acting Chairman
Is it agreed that we give Deputy Callely two minutes? Agreed.
I am fully aware of the Minister's concern for the families of the mentally handicapped. I, too, am concerned about the facilities provided and the services available to the mentally handicapped. I would like to compliment all the statutory and voluntary agencies involved in the delivery of services to the handicapped but I want to note on the record my disappointment with the services being delivered by Cheeverstown House. I was delighted to note in the Minister's speech that he, too, is dissatisfied and that he has initiated a course of action to deal with this situation.
Acting Chairman
I am afraid the Deputy's time is up.
With your permission, Sir, I intend to share my time with Deputies Eric Byrne and Austin Currie. I understand that I have been allocated 20 minutes. I will take about ten and I will give seven minutes to Deputy Byrne and three minutes to Deputy Currie.
Acting Chairman
Does the House agree to Deputy Sherlock sharing his time with Deputy Eric Byrne and Deputy Austin Currie? Agreed.
The hallmark of any civilised society is the way in which it treats the weakest and most vulnerable members — the old, the very young, the ill, the infirm and the handicapped. Judged against this yardstick, the policies of cutbacks in the health area pursued by successive Governments in recent years cast grave doubt over our right to describe ourselves as a civilised society, because it is these categories of people who have suffered most from Government economic policies. For the past two years the Fianna Fáil Government have been listening to the economists, the stockbrokers and the bankers. The media commentators have lavished praise on them for pruning the health budget.
It is hard to think of a more vulnerable and defenceless group in society than the mentally handicapped, who are generally not in a position to defend themselves or to fight for better conditions or for medical care. It is to our eternal shame as a society that not even the mentally handicapped have been spared from the lash of the cutbacks.
We are happy to support the Fine Gael motion and, indeed, the Labour Party addendum which set out the extent of the problem and offer some suggestions for solutions. We believe that the Government amendment, which speaks of the development of services for the mentally handicapped "as budgetary circumstances permit", should be treated with utter contempt. The message conveyed by the Government to the handicapped in this amendment is that they must wait for adequate treatment and adequate services and that as far as the Fianna Fáil-Progressive Democrats administration is concerned, the demands of the internal bankers will take priority over the rights of the disabled. The fact that mentally handicapped people have not suffered even more has been largely due to the love and care lavished on them by their families and the trojan work done by the many voluntary organisations active in the area. What angers and frustrates those involved voluntarily in the care of the handicapped, whether families or groups, is that the more work they do, the harder they try, the more content the Government seem to be to wash their hands of their obligations and load even more work and responsibility onto families or the voluntary sector. The reality is, of course, that the extent of the problem is so great that families or voluntary organisations alone simply do not have the capacity or the resources to deal with the problem. The level of handicap suffered by some people is just so severe that institutional care will always be required. Of course, the costs involved in caring for the handicapped and ensuring they get the treatment they need is enormous and requires substantial central funding.
The census of mental handicap undertaken in 1981 gives some indication of the extent of the problem. According to that census there were 12,304 persons suffering from mental handicap, ranging from moderate to profound. In addition, there were found to be some 9,400 borderline or mildly mentally handicapped people. What is of most concern is that, according to that census, more than 9,000, or three-quarters of the handicapped, were aged 34 or under. The fact is that, with the improvement in medical science, people with mental handicap thankfully are living longer. In turn that means they need care longer. It is likely that that pattern has continued since that census was taken.
Thankfully, as understanding of mental illness and mental handicap have improved, we have moved away from 19th century attitudes which saw such people as a public threat who should be locked up. The whole trend in recent years has been away from institutional care, where such is possible and practicable, toward care in the community. The Green Paper on Services for Disabled People —Towards a Full Life— published in 1984, described the broad objective of services for those with physical, mental or sensorial handicap as being “to equip them to realise their full potential and to participate to the greatest extent possible in the life of the community”.
A document published by the Eastern Health Board in 1986 entitled Specialist Services for the Mentally Handicapped put it this way: “a handicapped person should develop in an environment as normal as is practicable.” In this regard it is appropriate that mentally handicapped persons should be maintained in their homes as long as possible with appropriate support services and that facilities as near as possible to that domestic environment be available when handicapped persons can no longer be maintained at home.
Of course, progress in this direction is possible only if adequate funds and resources are provided for families and agencies endeavouring to cope with the effects of mental handicap. According to the Commission on Health Funding the majority of the 2,000 mentally handicapped persons at present in psychiatric hospitals are suitable for transfer to community hospitals and residential centres and approximately 1,900 of the 5,000 in special residential centres require only hostel accommodation or, in some cases, day care. What is happening is that the Government have been paying lip service to the principle of providing community care. Institutional care is being starved of resources while community care services are not being developed to compensate.
Of course, there will always be some patients who will require residential care. According to the parents association for people with a mental handicap, some 350 additional residential places are required in Dublin alone and an extra 800 places nationwide. In addition an extra 1,000 day places are needed throughout the country. The stark facts of their recent submission are very different from the rosy picture painted by the Minister for Health last evening and this evening by the Minister of State at the Department of Education. Some of the points of that parents' association submission are worth quoting, amongst which are money cutbacks every year since 1982, with services being stretched to the limit, staff numbers down, skilled personnel leaving the country while children with mental handicap cannot get services; waiting lists are getting longer while lip service only is paid to community based services, leading to regression and a custodial type service.
How long are the Government prepared to allow this appalling scenario to continue? There are many facets of the problem which might be dealt with. I want to refer specifically the lack of education for handicapped children due to insufficient places and staffing in special national schools. All of the scientific and educational evidence shows that, in many cases, the impact of mental handicap can be lessened by proper educational stimulation. Our Constitution contains much about education and the rights and obligations to the State to the family. For example, Article 42.4 states quite specifically that the State shall provide for free primary education — that means free primary education for all children; it does not exclude children with a mental handicap. In the case of the handicapped, education delayed is education denied. The State may well be in breach of its constitutional obligations by failing to provide proper educational facilities for mentally handicapped children.
A related area is the crucial need for adequate speech therapy for those with mental handicap. In many cases the effect of mental handicap is worsened by communication difficulties. This is an area crying out for urgent action. It has been estimated that approximately 20,000 people with mental handicap could benefit from speech therapy. Yet some people must wait up to two years even to secure an appointment with a speech therapist. To deal adequately with this problem alone would necessitate the appointment of some 400 speech therapists while the number available for such work with the handicapped is approximately 27.
If the Minister or other members of the Cabinet were unaware of the extent of the problem facing the mentally handicapped and their families, in the light of this debate they can no longer make that claim. The obligation is now clearly on the Government to act quickly and decisively. I have no doubt that if they do they will have the support of every Member of this House.
Last evening in the Mansion House — filled to capacity with over 800 people — a series of demands were made that the Department of Health must immediately take on board. It is a pity the Minister was not present to hear the barely restrained anger, frustration and fears of those mothers, fathers and carers of people with a mental handicap. It is impossible to recreate, in this austere Chamber, reading from a prepared script, the heartfelt pleas summed up by a mother with a handicapped child who spoke from the floor asking: is there anybody listening; will the politicians ever listen to our requests? I am here this evening to ensure that their pleas have been heard.
The Minister will have noted the litany of needs of people with a mental handicap. He will have heard Brother Lawrence Kearns of the Order of St. John of God and his Order's pleas on behalf of persons with a mental handicap. The Minister will have heard the pleas of the parents association for people with a mental handicap. He will have heard also from the Eastern Health Board who have drawn his attention to their need of 368 day service places and 328 residential service places. Indeed, the Minister himself confirmed in the course of his remarks last evening that he is aware of the crisis.
What the Order of St. John of God want to know, what the parents association for people with a mental handicap want to know, what the Eastern Health Board want to know and what I am demanding to know is, what is the Minister going to do about the crisis facing the mentally handicapped? He is insulting their intelligence and mine by asking us this evening to vote on his amendment to the motion which reads that we should commend the efforts of the Minister for Health to improve the level of services available to mentally handicapped people. Any person who has listened to this debate over the past two evenings who could vote to commend the Minister will be flying in the face of the demands of the carers and ignoring the plight of people with a mental handicap. Indeed, their plight is a living indictment of the neglect of successive Governments, including the Fine Gael/Labour Coalition Government, of their needs.
I ask the Minister and Cabinet to immediately address the whole range of their demands, including their educational requirements, the need for more and better training in both open and sheltered workshops, to assist, to fund and to develop breakaway and crisis intervention facilities and to ensure that people with a mental handicap are not placed in psychiatric hospitals. He should recognise that the needs of psychiatric patients are different from those of people with a mental handicap.
I cannot over-emphasise the need for respite care and short-term crisis relief residential places. The horrendous fears of parents who worry about pre-deceasing their handicapped children must be alleviated. The Minister must cease to exploit the generosity of voluntary agencies, families and community volunteers by injecting sufficient money into the service so that the fear and loneliness of many, including those who are ageing prematurely from strain and worry, are alleviated. The Minister must abolish waiting lists by providing adequate buildings and staff, estimated to cost £7 million in the Eastern Health Board area, alone, which represents one-third of our total population.
While nobody would refuse funds from whatever source for this cause I should like to make a point about national lottery money being allocated to the mentally handicapped. Adequate finance over the next three to five years to ensure the completion of the integrated development programmes I have outlined must be funded by the Exchequer, not based on the occasional crumbs from the sale of raffle tickets. Persons with a mental handicap have their rights; they are not begging for charity.
I shall sum up by saying that the Minister must introduce Supplementary Estimates in the next session, thus initiating the first step in the three to five year integrated development plan for people with a mental handicap. There can be no more arguments advanced about the necessary resources not being available. For example, if the Government can allocate Dublin Corporation money to build the Parnell Street section of road costing £32 million per mile, along with hundreds of millions of pounds for other dubious roads schemes, then £7 million can be diverted from the requirements of the motor car to the Eastern Health Board for the care of human beings.
In conclusion, I would like to record my personal thanks and appreciation to all the carers of people with a mental handicap, but particularly to the voluntary workers at the Walkinstown association for the handicapped who do tireless work on behalf of those with a mental and physical handicap. I must confess it was that group who introduced me initially to the plight of the mentally handicapped and I am forever grateful. I am delighted to take this opportunity of representing their case in the Dáil.
We now have five minutes left before the Fine Gael spokesman concludes and I understand there are two Deputies hoping to share in the five minutes.
I am going to make a few basic points. Firstly, this should not be a party political matter. This is a party political forum but an issue of this nature should not be party political. I knew the Minister for a long time before I came into politics in this State. I know him to be a humane man and I know he will deal with this matter in a way that indicates his humanity. Secondly, I went to last night's meeting in the Mansion House attended by over 1,000 people. I was very impressed by their restraint and their responsibility and also by their anger and militancy. When listening to them, I understood why that was the case. They were telling this House to do something about this issue about which they feel so impatient and so angry and I hope that message is getting across.
A number of basic points were made at that meeting about the obvious concern of parents, particularly the parents of a handicapped child, as to what is to happen to that child in the future. I share that concern as, I am sure, we all do. The people at the meeting emphasised the importance of some statutory rights for their children and I underline that. They talked about the fact that no education or assistance is available for their children to learn to read and write. They pointed to the cutbacks and in particular illustrated that two and a half years had passed since one child had seen a speech therapist.
It was said that the mark of a civilised society is looking after the less well off, the poor and the deprived in that community. Traditionally I believe that this country, North and South, has much to answer for because its attitude to mental handicap has not been civilised, it has not been Catholic, it has not been Christian and it certainly has not been humane. This is not a poor country. It is a matter of distributing the wealth that is available, and it is a matter of priorities. The Minister should take it that Deputies on all sides of the House consider this matter to be a priority and he should act accordingly.
I would like to raise the matter of mentally handicapped adults. Quite a few of these people are cared for by their parents but the situation will arise, and in many cases sooner rather than later, where parents, due to age and infirmity, will no longer be able to care for them. Who then will take on this task? That is the question the Minister and his Department should ask themselves. The prospect is bleak under the present setup and until the Minister provides facilities to care for the handicapped this situation will get worse.
I come from a county that has one of the finest schools and care centres in the country. Twenty-five years ago Mrs. Sylvia Dawson and other volunteers set up a committee in Longford and since then a lot of hard work and effort has gone into helping the mentally handicapped. I am glad to say that Mrs. Dawson is still involved as secretary of the Association for the Mentally Handicapped in the county.
The withdrawal of a child care assistant at the primary school, St. Christopher's, Leamore Park, is an example of the cutbacks in this area. I call on the Minister for Education to immediately appoint a child care assistant at this school. The facilities provided in Leamore Park are excellent. Many voluntary committees throughout County Longford have raised funds over the years to help out St. Christopher's and many new facilities have been introduced. However, unless funding is providing on an ongoing basis, these facilities will be unable to develop. Let the Government show they care. Let them now, as a matter of urgency, provide the necessary funds to deal with these problems.
Surely those members of our society who cannot care for themselves must now get further recognition from the State. Friends and families of the mentally handicapped throughout the country have now in public demonstrations come together to highlight the needs of those who cannot shout for themselves. However, they cannot continue to carry unaided the burden and stress of this task.
Figures and budgets mean very little to the mentally handicapped. I know the Minister has to work within certain financial guidelines in his Department, but the will must be there at the outset in order to achieve the results we all want to see.
I attended the Annual General Meeting recently of the County Longford Association for the Mentally Handicapped. At that meeting the message was clear. I pass on that message here tonight. Urgent action is needed. Let the Members of Dáil Éireann now speak out for those who cannot speak for themselves and I say to the Minister, this is the time to show we care.
I propose to share five minutes of my time with Deputy Nuala Fennell, with the agreement of the House.
I am very happy to support the motion in the name of Deputy Yates and the amendments in the name of my colleague, Deputy Brendan Howlin. This is one more shameful debate in the health area, an indication of the erosion of essential services for a most vulnerable sector. I really should not say it is an erosion because that suggests that there was a structure there to erode. It is a total equivocation of the needs of mentally handicapped children and young people. It has become abundantly clear to me that the experience of parents of mentally handicapped children and young people is a sad and sorry one. Instead of recognising the valiant role these parents play in loving and caring for their families, unfortunately they are penalised, overlooked and, above all, not listened to.
As has already been referred to, last night for many of us that position was more than redressed. We went to a meeting in the Mansion House held by the parents' association of the mentally handicapped. There we listened to the very real difficulties of parents coping with the total care of their children, many of whom are well into adulthood. It was not just a meeting of complaints and moaning; it was a presentation of facts — like the need for 328 places for mentally handicapped people in the Eastern Health Board area alone, there are no speech therapy facilities, no physiotherapy facilities, few training facilities, no crisis care and many old age pensioners are attempting to care for their middle-aged, seriously handicapped offspring.
There were many people in the Mansion House for what was a very well organised, well run conference. Most of us were invited and TDs of all parties attended. One of the newly elected backbenchers was the sole representative for Fianna Fáil. He attempted — and full marks to him for trying — to defend the position of the Minister and the Government in the face of considerable hostility. Do not imagine for one moment that those of us in Opposition who attended could feel any sense of virtue or bask in any sense of relief, because we could not. It is a poor reflection on all politicians and on previous Ministers for Health that these parents have to take the present action of bringing their handicapped children on to the streets to show how deplorable their situation is.
I did not find a grain of comfort in the Minister's speech last night, or indeed in the speech of the Minister of State tonight, that would give any hope. If that is the best that can be done, it is not good enough. I say, please go back to your books and make a start towards the justifiable requests of this group. The one thing which is happening here, to what extent I do not know, is that some parents who can afford it are sending their children to residential care in Northern Ireland. This can only be done out of a sense of total frustration.
The Minister mentioned the problems in regard to Cheeverstown and I think they were also mentioned tonight. In the face of the crucial needs in this area, the petty political wrangling over board membership or whatever, is very sick. The Minister should bring forward legislation which will open the doors of this unique custom built complex. The Minister has responsibility for this and he can take that power.
Finally, I want to make two requests. The Minister should take account of the voices of parents and parental representative bodies. They have the perspective and insight into the real community, educational and residential needs of the handicapped and the Minister cannot continue to ignore them. They not only deserve to be considered but they have a right to be considered. Of course, the stress is great on both parents but I have to say that mothers bear a considerable amount of the stress and strain. I want to quote from a thesis by Nuala Molony called The Myth of Community Care in which she takes on the perspective of mothers of mentally handicapped children. She states:
When talking to the mother community care is actually care by the mother who gives of her whole life to look after the mentally handicapped person. In many cases it means that the mother has to neglect the rest of her family to look after the handicapped child, also the cost to the mother of keeping this mentally handicapped person at home with them was very high in terms of their physical and mental health. Some of the mothers in fact considered "ending it all" because of the burden this child had placed on their lives. Mothers up until recently felt there was some relief available in institutions if things got too bad, now this option is not there.
The Minister's attention has been drawn to the need for respite beds to provide care for stressed and exhausted parents to enable them to have a break, go on holiday or even to attend a wedding or a funeral. I ask the Minister to please make this a priority. Such respite beds existed five years ago but because of the cutbacks they have been absorbed into the total bed allocation.
Every TD will have received phone calls today from consitutents seeking support for tonight's motion. I appeal to the Minister not to let this motion go to a vote. We should not be divided on something so patently urgent and so deserving of right and justice. This campaign will not go away. The people organising it and their supporters are very serious and energetic. I ask the Minister to concede to my request not because of last night's public meeting, the phone calls or letters and his own embarrassment, though that might go some of the way, but because it is a just and right cause which calls for our action and our co-operation.
Firstly, I should like to thank all the Deputies who contributed to this informative debate. It has accurately reflected, so far as this side of the House is concerned, the anger and frustration which is mounting on this issue. I should like to say at the outset that we will be supporting the Labour addendum to our motion and we appreciate the support of The Workers' Party for both our motion and the addendum.
The Minister's speech last night was very disappointing. Leaving aside the fact that he decided to devote four out of 11 pages of his speech to continue the public argument, which is tantamount to one washing dirty linen in public, in relation to the Cheeverstown residential centre — I do not wish to comment on the rights and wrongs of this — it is wholly inappropriate when we are seeking to try to take a major initiative which will gurantee the rights and services for the handicapped that the Minister should in turn launch a major offensive on the people who have given a lifetime of service to the care of the mentally handicapped. I share the Minister's view that this problem should be resolved but it was totally inopportune to use this debate to launch such a vicious attack on them and it was totally out of place.
Hear, hear.
The most telling point which has recurred in this debate is the position of geriatric parents who have a mentally handicapped adult son or daughter whom they have cared for all their lives but who will go to their graves with the fear and anxiety of wondering who will care for them after their death. What did the Minister say in page seven of his speech? He said they should contact their family doctor if there is a problem. This is unacceptable.
There is an acknowledged need — whether we take the Central Review Committee's figures of the Eastern Health Board or the nationally established figures, given that by and large the Eastern Health Board provide better services than the other health boards — for 800 such residential places. Every year there are an extra 850 mentally handicapped adults but there is inadequate provision for them and they have had to depend on the crumbs from the national lottery to date.
The quality of life for those people of all ages who are mentally handicapped and living our their lives in communities is inadequate. I am talking about the 6,000 mentally handicapped people who are living with their families in the Eastern Health Board area. What do they have to fulfil their lives or to give them extra dignity? They face a waiting list for non-existing day care centres and community workshops which are overburdened and cannot cope. There is an urgent need for the Minister to put in place a national scheme with an investment plan not alone for residential centres but for day care centres so that when professional counsellors break the news to parents that their child is mentally handicapped they will know that for the rest of their natural lives their mentally handicapped child can look forward to the basic right to be educated in a special school and to be transported to that school. I consider what the Minister of State said tonight as the most appalling whitewash of the problem.
We all know that the ratio of 12 pupils to one teacher in special schools has been augmented in the past by attendants and special care officers but they have disappeared and teachers are now in an impossible situation in their classrooms. We know that there are no transport facilities in rural areas and there are no back-up essential services for speech therapy. We know of people who started speech therapy but had it stopped for the past two years. Parents are bewildered as to why basic speech therapy and physiotherapy facilities are provided on a stop-go basis.
I listened carefully tonight to the contributions of Deputies Fitzpatrick, Calleary and Quinn. We have a saying in my part of the country — this is the simplest way in which to sum up my comments on their contributions — that talk is cheap. At 8.30 tonight there will be a vote whereby we can actually do something as opposed to commending the Minister. This is the opportunity for this House to take the initiative. The Minister could see fit during the recent debate on the dental motion to make a paltry contribution of £300,000 for orthodontics but I regret very much that he could take no initiative whatsoever in this debate other than to put forward a self-congratulatory amendment which seeks to avoid all the crunch issues.
There is no proper assessment or monitoring of the services for mentally handicapped people. Once they reach 18 years of age they are let back into their families and the community without proper support services. Only last night the case of an unfortunate widower who is in his eighties came to my attention. Unfortunately, this man is without both his lower limbs and is aging. He is faced with the problem that he does not know what care his mentally handicapped son will receive after he has died. This is not good enough. We need to establish rights for handicapped people and the regrettable failure of this debate is that the parents, friends and associates of the mentally handicapped have had to take to the streets. As a substitute for the real politics of this House we have street politics to deal with the problems of the mentally handicapped. This is unacceptable in a modern society. What we want is a major initiative which will give a proper system of guardianship for mentally handicapped adults whose parents have predeceased them, a proper system of education which will guarantee the specialist needs of the handicapped and genetic counselling services for parents on a regional basis. We must ensure that those who are sufficiently mildly or moderately handicapped will have a real chance to participate in society by having proper European social funding for sheltered employment.
This is not an issue of my creation and it is not a party-political issue. This issue is gaining momentum and is an issue about people who have suffered for a long time in a silent, voiceless and vulnerable way and who have put up with their lot. However, they now see that extra money is being allocated to the health service — an extra £111 million will be allocated next year — but the Minister did not see fit to make proper provision for the 23,000 people who are handicapped. Until the Minister makes proper provision the issue will not go away. This is a predictable and inevitable need. Those people live in the community and they need to be cared for.
I should like to call on those Deputies who in the privacy of their clinics and at constituency meetings have given soothing words of comfort to different associations who work for the handicapped to show their true colours when the division bells ring. They should show that they are prepared to put the handicapped before their party and vote for the motion.
Amendment put.
The Dáil divided: Tá, 69; Níl, 67.
Tá
- Ahern, Bertie.
- Ahern, Dermot.
- Ahern, Michael.
- Andrews, David.
- Aylward, Liam.
- Barrett, Michael.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Mattie.
- Brennan, Séamus.
- Briscoe, Ben.
- Browne, John (Wexford).
- Calleary, Seán.
- Callely, Ivor.
- Clohessy, Peadar.
- Collins, Gerard.
- Connolly, Ger.
- Coughlan, Mary Theresa.
- Cowen, Brian.
- Cullimore, Séamus.
- Daly, Brendan.
- Davern, Noel.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Ellis, John.
- Fahey, Frank.
- Fitzgerald, Liam Joseph.
- O'Dea, Willie.
- O'Donoghue, John.
- O'Hanlon, Rory.
- O'Keeffe, Ned.
- O'Leary, John.
- Power, Seán.
- Quill, Máirín.
- Fitzpatrick, Dermot.
- Flood, Chris.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Harney, Mary.
- Hillery, Brian.
- Hilliard, Colm.
- Hyland, Liam.
- Jacob, Joe.
- Kelly, Laurence.
- Kenneally, Brendan.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leyden, Terry.
- Lyons, Denis.
- Martin, Micheál.
- McCreevy, Charlie.
- McDaid, Jim.
- McEllistrim, Tom.
- Molloy, Robert.
- Morley, P. J.
- Nolan, M. J.
- Noonan, Michael J. (Limerick West).
- Roche, Dick.
- Smith, Michael.
- Stafford, John.
- Tunney, Jim.
- Wallace, Dan.
- Wallace, Mary.
- Wyse, Pearse.
Níl
- Allen, Bernard.
- Barry, Peter.
- Bell, Michael.
- Belton, Louis J.
- Bradford, Paul.
- Bruton, Richard.
- Byrne, Eric.
- Carey, Donal.
- Connaughton, Paul.
- Cosgrave, Michael Joe.
- Cotter, Bill.
- Creed, Michael.
- Crowley, Frank.
- Currie, Austin.
- D'Arcy, Michael.
- Deasy, Austin.
- Deenihan, Jimmy.
- De Rossa, Proinsias.
- Durkan, Bernard.
- Enright, Thomas W.
- Farrelly, John V.
- Fennell, Nuala.
- Ferris, Michael.
- Finucane, Michael.
- Flaherty, Mary.
- Flanagan, Charles.
- Garland, Roger.
- Gilmore, Eamon.
- Gregory, Tony.
- Harte, Paddy.
- Higgins, Jim.
- Higgins, Michael D.
- Hogan, Philip.
- Howlin, Brendan.
- Kavanagh, Liam.
- Kemmy, Jim.
- Kenny, Enda.
- Lee, Pat.
- Lowry, Michael.
- McCartan, Pat.
- McCormack, Pádraic.
- McGahon, Brendan.
- Mac Giolla, Tomás.
- McGrath, Paul.
- Mitchell, Jim.
- Moynihan, Michael.
- Nealon, Ted.
- Noonan, Michael. (Limerick East)
- O'Brien, Fregus.
- O'Keeffe, Jim.
- O'Shea, Brian.
- O'Sullivan, Gerry.
- O'Sullivan, Toddy.
- Owen, Naro.
- Pattison, Séamus.
- Quinn, Ruairí.
- Rabbitte, Pat.
- Ryan, Seán.
- Shatter, Alam.
- Sheehan, Patrick J.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emment.
- Taylor, Mervyn.
- Taylor-Quinn, Madeleine
- Timmins, Godfrey.
- Yates, Ivan.
Tellers: Tá, Deputies V. Brady and Clohessy; Níl, Deputies J. Higgins and Bradford.
Question declared carried.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided: Tá, 69; Níl, 67.
Tá
- Ahern, Bertie.
- Ahern, Dermot.
- Ahern, Michael.
- Andrews, David.
- Aylward, Liam.
- Barrett, Michael.
- Brady, Gerard.
- Brady, Vincent.
- Connolly, Ger.
- Coughlan, Mary Theresa.
- Cowen, Brian.
- Cullimore, Séamus.
- Daly, Brendan.
- Davern, Noel.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Ellis, John.
- Fahey, Frank.
- Fitzgerald, Liam Joseph.
- Fitzpatrick, Dermot.
- Flood, Chris.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Harney, Mary.
- Hillery, Brian.
- Hilliard, Colm.
- Hyland, Liam.
- Jacob, Joe.
- Kelly, Laurence.
- Kenneally, Brendan.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Brennan, Mattie.
- Brennan, Séamus.
- Briscoe, Ben.
- Browne, John (Wexford).
- Calleary, Seán.
- Callely, Ivor.
- Clohessy, Peadar.
- Collins, Gerard.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leyden, Terry.
- Lyons, Denis.
- Martin, Micheál.
- McCreevy, Charlie.
- McDaid, Jim.
- McEllistrim, Tom.
- Molloy, Robert.
- Morley, P.J.
- Nolan, M. J.
- Noonan, Michael J. (Limerick East).
- O'Dea, Whillie.
- O'Donoghue, John.
- O'Hanlon, Rory.
- O'Keeffe, Ned.
- O'Leary, John.
- Power, Seán.
- Quill, Máirín.
- Roche, Dick.
- Smith, Micheal.
- Stafford, John.
- Tunney, Jim.
- Wallace, Dan.
- Wallace, Mary.
- Wyse, Pearse.
Níl
- Allen, Bernard.
- Bell, Michael.
- Belton, Louis J.
- Bradford, Paul.
- Bruton, Richard.
- Byrne, Eric.
- Carey, Donal.
- Connaughton, Paul.
- Cosgrave, Michael Joe.
- Cotter, Bill.
- Creed, Michael.
- Crowley, Frank.
- Currie, Austin.
- D'Arcy, Michael.
- Deasy, Austin.
- Deenihan, Jimmy.
- De Rossa, Proinsias.
- Durkan, Bernard.
- Enright, Thomas W.
- Farrelly, John V.
- Fennell, Nuala.
- Ferris, Michael.
- Finucane, Michael.
- FitzGerald, Garret.
- Flaherty, Mary.
- Flanagan, Charles.
- Garland, Roger.
- Gilmore, Eamon.
- Gregory, Tony.
- Harte, Paddy.
- Higgins, Jim.
- Higgins, Michael D.
- Hogan, Philip.
- Howlin, Brendan.
- Kavanagh, Liam.
- Kemmy, Jim.
- Kenny, Enda.
- Lee, Pat.
- Lowry, Michael.
- McCartan, Pat.
- McCormack, Pádraic.
- McGahon, Brendan.
- Mac Giolla, Tomás.
- McGrath, Paul.
- Mitchell, Jim.
- Moynihan, Michael.
- Nealon, Ted.
- Noonan, Michael. (Limerick East).
- O'Brien, Fergus.
- O'Keeffe, Jim.
- O'Shea, Brian.
- O'Sullivan, Gerry.
- O'Sullivan, Today.
- Owen, Nora.
- Pattison, Séamus.
- Quinn, Ruairí.
- Rabbitte, pat.
- Ryan, Seán.
- Shatter. Alan.
- Sheehan, Patrick J.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emmet.
- Taylor, Mervyn.
- Taylor-Quinn, Madeleline
- Timminus, Godfrey.
- Yates, Ivan.
Tellers: Tá, Deputies V. Brady and Clohessy; Níl, Deputies J. Higgins and Bradford.
Question declared carried.