I propose to take Questions Nos. 59, 109, 228, 229 and 233 together.
I want to assure Deputies that the improvement of services to people with mental handicap is one of my main priorities. I am determined to improve these services and my predecessor outlined details of the Government's commitment in this regard in her statement to the Dáil on 11 December and in the statement issued following the announcement of the Estimates.
The report of the review group — Needs and Abilities — which has been accepted in principle by the Government, sets out the framework for the development of services for persons with a mental handicap and the Government are committed to the improvement and expansion of these services under the Programme for Economic and Social Progress and the Programme for Government. The Programme for Economic and Social Progress envisages a seven-year implementation period and in the past three years an extra £9 million has been allocated for the development of these services.
With the extra £6 million provided this year significant improvements in services will be put in place in 1992. Of the £6 million allocated, £1 million will be allocated to support the capital costs of the new services. When the increases in the allocations to the health board and mental handicap agencies are taken into account, the total increase in cash terms in 1992 over 1991 is £10 million.
Of the £5 million available for additional revenue costs, £1.12 million has been allocated to provide an extra 80 residential places and £1.2 million has been allocated to provide 300 day places for those most in need of such services.
A further 41 respite places will be developed at a cost of £590,000 in a full year. This will mean that about 500 additional families will be able to have a respite break of one month in the year. This is a very significant provision and will provide valuable relief to families and carers. These additional places will be spread over the entire country in proportion to need.
A home care or outreach programme is being developed at a cost of £1.21 million to meet the needs of families with a mentally handicapped member. It is my intention that this scheme will work in a flexible way. The scheme should provide a service for up to 1,000 families and will be targeted specifically at those persons who have no service at present or for whom services are inadequate.
There is a particular need to have an effective and immediate response when crises arise in families with a mentally handicapped member. A sum of £400,000 has been allocated to provide 20 places in the Dublin area to ensure that emergencies can be responded to when they arise. There is also the need to cater for those persons with mental handicap who are also disturbed. The service for these people is being improved and expanded. An additional six places are being put in place in Dublin area at a cost of £150,000 and Unit B, St. Loman's Hospital, Lucan, County Dublin, will be replaced.
Preventive and early intervention services play a significant role in reducing the level and severity of handicap in our society and will receive particular attention this year. A specialist genetic counselling service will be initiated in Our Lady's Hospital, Crumlin, as soon as possible. A separate sum of £250,000 has been allocated for this purpose in 1992. Services for children will be expanded by the provision of three extra early intervention teams and 55 places in child education and development centres at a cost of £220,000 and £280,000 in a full year, respectively. The precise operational details of the additional services to be provided, the staffing requirements, and the people to benefit have been agreed by the mental handicap co-ordinating committees in each health board area.
These developments are a major step forward and will result in a considerable improvement in service provision. I also do accept that more needs to be done but I want to assure Deputies that the service will be maintained at this higher level and it is my intention that this will be built on and further improved in future years.
I recognise the understandable fears of parents who have a son or daughter with a mental handicap. I hope that the special measures being put in place this year will allay their fears to some extent but I accept that they will not be fully satisfied until they are assured of a place for their son or daughter. I hope that the service improvements which are taking place and which are planned as I have outlined will assure them that this Government are determined to resolve this issue.
It is estimated that approximately 1,000 additional residential places are required to meet existing needs among the mental handicap population. The report of the Review Group on Mental Handicap Services Needs and Abilities estimated that there was an annual requirement of 40 additional residential places to meet emerging needs. In the longer term the review group predicted a "break even" situation would not be reached until after 2010. While it is not possible to estimate the likely waiting time for a person in need of a residential place, I wish to assure the Deputy that respite care, which is an integral part of service provision, is available throughout the country and emergency situations are dealt with speedily and effectively. As I have already indicated significant improvements in these services are being put in place this year.