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Dáil Éireann debate -
Wednesday, 1 May 1991

Vol. 407 No. 7

Adjournment Debate. - Residential Accommodation for Mentally Handicapped.

I want to thank you, Sir, for having given me an opportunity to raise what is not a party political issue but rather a most pressing one in the public interest. It is an issue of public funding and accountability. Above all, it is one about the plight of the most vulnerable of our community, that of the mentally handicapped and, specifically, about the fact that, after more than five years, half of a purpose-built facility for the mentally handicapped, to which the State has contributed some £20 million, continues to remain vacant resulting from the inability of all patient effort to resolve the dispute at the heart of this matter.

The Minister for Health must act now because, after years of futile discussions and negotiations, it is evident we have failed to tackle effectively the scandal of 60 places continuing to remain vacant at Cheeverstown House despite the proven extent of need within the community.

I submit the stage has now been reached at which only legislation can effectively resolve the impasse that has continued for more than five years. Meanwhile, the 60 places to which I have referred are lying vacant while the need for more than 300 places has been established by the parents and friends of the mentally handicapped whose members were forced to take to the streets to air their grievance. Almost £20 million of taxpayers' money has gone towards the creation of this purpose-built facility. It cost £2 million roughly on an ongoing basis to fund it and the public agencies concerned — the Department of Health and the Eastern Health Board primarily — are impotent to resolve the problem and to at least meet on a part basis the pleas of the parents and the community for this very badly needed relief.

I raised the matter in the House on a number of occasions. As recently as 29 November on an Adjournment on the general plight of the mentally handicapped I referred specifically to Cheeverstown House and to a reply to a parliamentary question that day by the Minister for Health who said that a formula was now in place which he was happy, to the best of his expectations, would resolve the grievance. It is now clear that that formula has failed, that the dispute continues and that there is a desperate need in the community for these places. No longer can any party in the House justify our standing apart, notwithstanding how much we admire the voluntary sector. The role of the voluntary sector has, indeed, been invaluable and its partnership with the Eastern Health Board can be reinstated but only after the Minister intervenes decisively to assert some element of democratic accountability and public control over the utilisation of these beds. That is an urgent matter.

It is six months since that undertaking was given to the House and I believe it was given in good faith but it has not managed to resolve the problem. I do not think the problem will be resolved by negotiation and discussion at this stage. Consequently, this House has a responsibility to the taxpayer and, most of all, a responsibility to respond to the harrowing tales of woe one hears from parents who have children who are in need of the kind of respite that Cheeverstown House offers. While there is that need in the community half of this facility is lying idle. It is a shame. We cannot stand over it. The Minister has to act and all parties in the House will support that position. Deputy Roche wants to indicate his assent with this, if that is permissible.

I would like to thank and congratulate Deputy Rabbitte for raising this issue. He put it eloquently, and I do not think words are needed to add to what he said, that it is a scandal. The issue of Cheeverstown House has been dragging on far too long. Three hundred places are needed in the Eastern Health Board area. Those of us concerned with the health issue, or the health board, have listened to the plight of these people. A sum of £20 million of taxpayers' money has been put into that institution and it is costing of the order of £2 million to fund it. As Deputy Rabbitte said, it is not a party political issue but it is an issue about power and power, unfortunately, has blotted out compassion on it. It is a matter that will need rapid legislative and forceful action by the Minister at this stage. The Minister gave an undertaking six months ago in good faith. I realise that patient negotiations have now run out, the time for talking has ended and now we need to have decisive action. I thank Deputy Rabbitte for giving me the opportunity to speak on this issue.

I concur.

On Thursday, 18 April this House was informed of the current situation regarding Cheeverstown House and of the initiatives undertaken by or facilitated by the Minister for Health to resolve the difficulties between Cheeverstown House and the Eastern Health Board. The present initiative was undertaken during 1990 by representatives of the Federation of Voluntary Bodies providing services to people with mental handicap. As a result of this initiative, a formula was agreed in October 1990 for a positive working relationship between Cheeverstown House and with the Eastern Health Board. The agreement provided for a linked sequence of events over an 18 month period. It provided for the recruitment of a chief executive officer to Cheeverstown House. It included participation by Cheeverstown House on the mental handicap central planning committee of the Eastern Health Board. In so doing Cheeverstown House was provided with the opportunity to work in partnership with the health board and other voluntary mental handicap agencies to identify, agree and meet the urgent priority needs of the region.

Once these steps had been taken, the agreement provided that additional funds would be allocated to Cheeverstown in 1991 to open additional facilities. The role of Cheeverstown House in meeting the needs of the local catchment area was recognised in the agreement.

A senior and much respected representative of the federation agreed to act as mediator between the Eastern Health Board and Cheeverstown House to assist with the implementation of the agreement.

I am aware that difficulties have arisen in the implementation of this agreement. The federation mediator has withdrawn his services because in his view the board of Cheeverstown House was unwilling to abide by the terms of the agreement in relation to the recruitment of a chief executive officer which was central to the proper working of the agreement. The federation's initiative is not yet over. I understand that the federation has sought a meeting with the board of Cheeverstown House in an effort to convince the board of the importance of making the agreement work. One can only hope that the board will accede to this request.

Since coming into office, the Minister for Health has dealt patiently with the board of Cheeverstown House. He has allowed the various initiatives to resolve the difficulties between the board of Cheeverstown House and the Eastern Health Board ample time to be implemented.

The issue at the core of the dispute is the reluctance of the board of Cheeverstown House to agree to an admissions policy acceptable, at first to the Department of Health and subsequently, to the Eastern Health Board. It is essential that mental handicap services, funded from public funds, are provided for those whose needs are greatest. In the Eastern Health Board area, there is a mental handicap co-ordinating committee, chaired by the Eastern Health Board and with representatives of the main voluntary bodies in the region. They have agreed a common waiting list, based on need. It is essential that as places become available in mental handicap centres, they are filled by people on this list. As far as practicable, it is the policy of the committee that people will be placed in the centre closest to their home. This is the arrangement with which every other voluntary mental handicap agency in the Eastern Health Board agrees. Why, we must ask, is Cheeverstown House the only voluntary mental handicap agency in the region which does not have an excellent working relationship with the Eastern Health Board?

One must also ask whose interest Cheeverstown House is serving. Can it truly say that it is serving the needs of the mental handicap population of the catchment area or the families as provided for in the agreement. Cheeverstown House is situated on the doorstep of a densely populated area with families who have a great need for its facilities. On the basis of the agreement it was the intention to provide additional funding to Cheeverstown House to enable it to open additional places this year. I must express my deep personal disappointment with the unwillingness of the board, to date, to operate an agreement which was painstakingly and thoroughly formulated and which was in the best interests of people with mental handicap in the area.

I would like to reassure the House, and the families of people with mental handicap in South West Dublin, of one thing. The Eastern Health Board had hoped to honour their part of the agreement to fund additional places at Cheeverstown House this year. The funds remain available to provide additional places for people with mental handicap. The health board are not dependent on Cheeverstown House for these additional places. With the co-operation of the other voluntary mental handicap organisation, such as the St. John of God Brothers, the daughters of Charity, St. Michael's House, Stewart's Hospital, alternative residential places and day places can be provided for people on the priority waiting list of the Eastern Health Board this year. The funds which were earmarked for Cheeverstown House this year will be diverted to other voluntary agencies if Cheeverstown House refuses to work the agreement.

I want one message to go to Cheeverstown House from this House this evening; that is — operate the agreement to which it is a party. There is still time for Cheeverstown House to reconsider its position and an opportunity for Cheeverstown House itself to resolve the present difficulties. Failing this the Minister is determined to act. Reluctant as the Minister is to interfere with the autonomy of a voluntary agency, he is determined to ensure that the Cheeverstown facility which was provided by public funds is put into full use for the benefit of the people for whom it was built.

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