Vol. 417 No. 7
5 Mr. Spring asked the Minister for Health if his attention has been drawn to the fact that the parents of 24 trainees in St. Michael's House Short-Term Training Centre have been told that no service can be guaranteed after June of this year; the steps he proposes to take to guarantee continuance of service; and if he will make a statement on the matter.
21 Mr. McCartan asked the Minister for Health his intentions and plans with regard to provision for the mentally handicapped in the Dublin area; whether the report Needs and Abilities will be acted upon; the timescale which is envisaged to meet the targets set by that report; the way the proposed restructuring of the Eastern Health Board will impact upon the proposals of the report and his plans; and if he will make a statement on the matter.
I propose to take Questions Nos. 5 and 21 together.
An allocation of £5 million revenue and £1 million capital has been made available for the development of additional mental handicap services throughout the country. Because of the particularly serious situation which exists in the Dublin area £2.65 million has been allocated for the development of an extra 45 residential places, 20 respite places to serve 240 people, 125 day care places, a home support service for 300-500 families, 20 emergency places, an improved and expanded service for people with mental handicap who are also disturbed and 15 day places for children. The operational details of the additional services to be provided and the people with mental handicap to benefit are being considered by the Mental Handicap Central Planning Committee of the Eastern Health Board. Their proposals are awaited.
The recommendations of the report Needs and Abilities have been accepted in principle by the Government. I would like to assure the House of my intention to develop services for persons with a mental handicap as set out in the Programme for Economic and Social Progress. Of course the speed with which this can be achieved will be determined by the availability of funds in the context of the State of the Exchequer's finances.
The reorganisation of the health services in the Eastern Health Board area will include a single new authority which will be responsible for all health and personal social services in the eastern region. It will take over the present function of the Eastern Health Board as well as some of the functions of the Department of Health and will ensure that health services in the region are delivered in an integrated and co-ordinated way. I am happy to say that in so far as mental handicap services are concerned there is already considerable co-ordination in health board areas because of the establishment of co-ordinating committees which are representative of the health board and the voluntary agencies in each area.
I share the Minister's concern for the mentally handicapped. However, Deputy Spring specifically asked about the 24 trainees at St. Michael's House — I am not sure if the Minister is aware of this — who were told last year by a placement officer that alternative places would be found for them in sheltered employment. They have now been told that there is no sheltered employment available for them and that their future cannot be guaranteed in this centre after June. We know there are changes in the European Fund which has been promoting training for these people, but we cannot just forget about people because they are handicapped. Is the Minister aware of what has happened and of the advice of the placement officer? The parents of these children need some assurance about their future.
St. Michael's House sought funding for 80 additional day centre places which, if agreed by the mental handicap central planning committee, would cater for some or all of the 24 students leaving level one training. It depends on the central planning committee, which comprises health board officials and representatives of voluntary agencies. We have to await their report and recommendations.
The person who advised the parents that these people would have no future after June is scaremongering or creating the wrong impression. The Minister should advise his officials to that effect.
I will. It causes serious concern and anxiety. I will have it checked up immediately and try to reassure the parents on this point.
Is the Minister aware of the difficulties and shortcomings in services for mentally handicapped people on the north side of the city? I raised these matters with the Minister's predecessor inside and outside the House. Has the Minister taken any steps to specifically address the shortcomings in services for mentally handicapped people on the north side of Dublin?
Long term training is provided for people with mental handicap in St. Michael's House centres. The number in Glasnevin is 77. The number in North Great Charles Street is 83 and 31 mentally handicapped people are catered for at Castle Industries in Coolock. These centres have spare capacity but they require additional revenue in order to take in more people. I hope the central planning committee will take this into consideration when making their decisions on their financial allocations.
Funding is primarily a matter for the Minister. One other aspect of the service that is particularly deficient in the north side relates to speech therapists. This lack was highlighted in the report. Will the Minister make any specific response with regard to the provision of proper speech therapists?
It is very important that the central planning committee should have a say in where the money goes. At the moment it is almost impossible to get speech therapists. I will ask the central planning committee to look into this question and to provide the necessary funds.
Does the Minister not accept that he is being a little bit disingenuous in expecting the central planning committee to deal with these questions when the Eastern Health Board have assessed their immediate priority needs as costing £11 million. They will only have a tiny fraction of that sum available. To suggest that they will be able to deal with the problems relating to this group of 24 people or other services in the Eastern Health Board is not to tell the truth to the public. Would the Minister not agree that the Needs and Ability document sponsored by the Government would in 1992 have required extra spending of £18 million on the current side and £5 million extra on the capital side to meet the needs identified?
I have not learnt to print money yet. The central planning committee is very important. The committee ensured that people with moderately severe and severe mental handicap obtained access to residential places. Before that it was usual for mildly mentally handicapped people to usurp all the available places. Mental handicap is a big problem to which we must apply ourselves. It was neglected by Governments over the years. As a result of the Programme for Economic and Social Progress it will be given priority. The Irish Congress of Trade Unions made it clear that we must look at this problem and agreed that there should be a seven year programme to help alleviate the problem. It cannot be solved overnight and if the Deputy was sitting here he would be giving me the same answer that I am giving him.
All I am saying is that the Minister has to accept responsibility and not pass it on to the committee.
I am accepting responsibility.
The Minister is blaming the mildly mentally handicapped people for the problems.
I never said that.
Deputy Carey should restrain himself. There is no need to heighten things here at all.
The Minister did say it.
The central planning committee have ensured that places are given to those who need them.
The Minister is now qualifying it.
No, I am not.
This kind of heckling must cease.
I worked in the area of mental handicap for a long time. The Deputy cannot tell me anything new. I saw injustices.
That is why we expected more from the Minister.
We have to recognise the importance of this and give those with mental handicap their proper place in society. We must all acknowledge that this deserves priority. We need a programme over the next few years which will ensure that those in need of residential care will get it. That can only be done through a proper integrated programme. I congratulate the Congress of Trade Unions on giving this the impetus it deserves.
Could we clear away this fog and curtain that is being thrown over this issue with money being spent by co-ordinating committees and so on. This question deals with the parents of 24 trainees who have been told that they cannot be guaranteed places after June. Does the Minister guarantee the parents of these 24 people in St. Michael's House short term training centre that their fears are unfounded and that the service will be continued on after June? Can we allay the fears of the parents of those unfortunate people?
A simple straightforward question demands a simple straightforward answer.
Let us have a simple straightforward answer.
The Minister would be wrong to interfere in the way this money is allocated. I will make a recommendation to the committee that this area should be looked at as a matter of urgency in view of the anxiety of the parents. This is a matter for the Eastern Health Board and voluntary agencies. This is something which warrants immediate attention. I will ask them to look at it but I cannot force them to.
I welcome the strong sentiments the Minister has expressed in favour of planned action in this area. I hope it will deliver on the badly needed places. The Minister in his reply indicated that, while the will is there to appoint speech therapists, they cannot be found. Can the Minister give an assurance that the difficulties in this area will be overcome and will he elaborate a little further on the difficulties?
We may have to seek speech therapists abroad if we cannot get them here. It is important that mental handicap be discussed in the House and elsewhere so that the care and attention needed will be given. I wish I could give the Deputy all the answers he wants but I cannot do so. I will make a recommendation that this case be looked at urgently and I will see what we can do about speech therapy. I understand that we cannot deal with the problem of providing speech therapists immediately because they are not available. There is a great opportunity for people to take up speech therapy as a career. If we are to have a seven-year programme we will have to recruit speech therapists, who will play an important role.
Most Members will welcome what has been said by the Minister. One speaker referred to the CPC committee of the Eastern Health Board. Recognition will have to be given to all concerned for the excellent manner in which they placed people in appropriate care who had hitherto been misplaced. That must be recognised. Those of us——
That is not a question; it is a speech.
That is a matter for the Chair, Deputy Carey.
Those of us who are working together as an ad hoc committee in this House have given due recognition to the CPC committee.
Deputy Callely, we must proceed. I want to assist Deputies to elicit information but we must proceed by way of supplementary question.
I could not let that misinformation go on the record without correction. I welcome the additional funding that has been made available for mental handicap this year. Is it possible for the Minister to undertake a "stepped care" approach to the whole area of mental handicap, with appropriate funds being made available over a period? Everybody recognises that the difficulties in this area cannot be dealt with in 12 months.
This question is too long.
Is the Minister prepared to take a "stepped care" approach over a five or seven-year period?
Yes, I will. I have explained that this can only be tackled over a period of seven years. I should like to see progress made every year so that it is not left until the seventh year to catch up.
