Deputy Rabbitte has been given permission to raise the crisis in regard to the provision of services for the mentally handicapped with specific reference to the Dublin area. The Deputy has five minutes.
Adjournment Debate. - Mental Handicap Services.
I thank the Chair for permitting me to raise the urgent question of the crisis in our mental handicap services, the persistent neglect by the Government and particularly the Minister of the expanding need in this area and, most scandalously, the Minister's efforts to conceal the extent of current need. Although the Minister for Health has, on his desk since last summer, a major report on mental handicap he has refused to publish this report or to make it available to Members of this House. It is disgraceful that his Department have published no figures on the extent of need in the community and that despairing parents, who have been driven to protest on the streets and outside of this House, have been compelled to use their own knowledge and resources to compile statistics and identify service requirements.
The Minister's claim, in the midst of cuts in the health services, to have protected these services sounds very hollow indeed to the distraught, despairing, parents who are obliged Sunday and Monday, Saturday and Tuesday, every day of the week, every hour of the day, summer and winter, to cope within their own resources with the care of handicapped sons and daughters and relatives. There is scarcely a Member of this House who could be unaware at this stage of the heart-rending and harrowing experiences of those parents who despair of the Minister's neglect. I can supply the Minister with details of a recent case in my constituency where a mother, driven beyond the bounds of human endurance, attempted to take her own life. Sadly and tragically she is not an isolated case.
The parents' association for people with a mental handicap — PAM — have attempted to construct a profile of need in the Eastern Health Board area. This shows that there are 642 people wait-listed for service in 1991. Of these 642 people, 220 have no service at present while 440 require a service adjustment. There are 422 people on the waiting list for residential placement this year and because of the population bulge, and because handicapped people nowadays have virtually a normal life expectation, it is estimated that this figure will rise to 1,500 by 1995.
I believe a report going to the next meeting of the Eastern Health Board will broadly confirm those figures. Surely the Minister acknowledges that services for people with a mental handicap have dramatically failed to keep pace with the numbers demanding those services. How can the Minister plan for the provision of services for the mentally handicapped when we do not even have official figures on the service requirement? I do not know, and the Minister does not know, unless he is concealing the information, the precise situation outside the Eastern Health Board area. What we do know is that because of demographic trends and medical progress the need is expanding.
In the Eastern Health Board area alone it is estimated that the additional day and residential facilities would require a current commitment of almost £8 million and a capital commitment of almost £4 million. This cannot be met without a specific significant improvement in next year's budget and the lifting of the staff embargo in respect of care, education and training in the mental handicap area. The Minister does not appear to acknowledge, a Leas-Cheann Comhairle, that handicapped people have the same rights to realise their human potential as the rest of us. If one's five year old child does not attend school the Department of Education wants to know why. If a mentally handicapped school-going child of any age does not attend school nobody, and no Department, seems to care. At Question Time today, for example, the Minister refused to tell the House the parameters of the formula agreed for the utilisation of the 60 vacant places at Cheeverstown and when those 60 places, that have been disgracefully lying idle since the construction of Cheeverstown, will be fully utilised.
This, a Leas-Cheann Comhairle, is a crisis. It is a term I use advisedly and accurately in respect of the services for the mentally handicapped. It is one dimension of the health services where the Minister has not managed to protect the service and where parents are driven now to marching on the streets, to protesting outside this House because they cannot even get requisite information from the Minister on when a planned programme for the care of the mentally handicapped is likely to be devised.
I am pleased to have an opportunity of coming into the House again, today, to respond to this debate. This year approximately £140 million will be spent on the provision of services to people with mental handicap of which about £40 million will be spent on services in the eastern region. About 11,000 people received day or residential services last year. Four and a half thousand of these places were located in the east. This does not include services provided by the Department of Education.
I am aware of the difficulties which exist in our mental handicap services at present. For this reason regional mental handicap co-ordinating committees were reactivated by the Minister for Health throughout the health boards to produce multi-annual plans for the developmet of the service in a prioritised and coordinated way. These committees have been in operation now for some time and are already making a difference.
This year an additional £2 million was allocated to meet the immediate priority needs identified by the co-ordinating committees. This extra allocation enabled 149 residential places, 442 day places, 21 respite care places to provide breaks to about 200 people to be provided. It was also possible to approve 25 extra staff for other supports.
Because of the particularly serious situation which existed in the Dublin area, £1 million of the £2 million extra allocation was allocated to provide an extra 91 residential places, 184 day places and an expanded family support service for 66 clients.
I must also point out that allocations to voluntary mental handicap agencies funded by my Department have been protected since 1986 in real terms in recognition of the vital service they provide. I feel, therefore, that this Government's record shows a commitment to mental handicap services, and an understanding that this area should be regarded as a high priority.
The Eastern Health Board have submitted their priority requirements for service developments in 1991. These are being considered by my Department at present and will be incorporated with the plans from the other health board regions into a national programme for the development of mental handicap services.
I am determined that the priority needs established in this national programme will be dealt with, in line with the funds made available to the health service in 1991 and future years.
We have nothing to hide. We conceal nothing. We stand on our record of maintaining in real terms the level of funding being provided, of having provided extra funds this year and, in co-operation with the statutory bodies and the voluntary agencies we will continue to give the priority that the services for the mentally handicapped deserve.
What about the parents outside the gate?
The Deputy is giving them encouragement.
Good encouragement.