Dáil Éireann debate -
Thursday, 7 Oct 1993

Vol. 434 No. 3

Adjournment Debate. - Facilities for Handicapped Child.

Mr. J. Higgins

I thank you and the Ceann Comhairle for choosing this item and the Minister of State for coming into the House to listen to what I have to say.

Pauline will be 14 years old in December. She is mentally handicapped and emotionally disturbed. Since the age of five she was catered for on a daily basis by the Brothers of Charity, Boyle, County Roscommon. I pay tribute to the Brothers of Charity for the tremendous level of care provided for Pauline during the years and for their absolute devotion to her welfare. No words could adequately express the gratitude of Pauline's parents for the level of service provided for her and for the daily relief provided for them as the parents of a handicapped child.

However, approximately one and a half years ago Pauline's parents were notified by the Brothers of Charity that they could no longer cope with her, she was extremely strong, given to tantrums and they could no longer devote the physical resources on a daily basis to cope with her. An arrangement was made which, very kindly was paid for by the Brothers of Charity whereby two women were employed to take Pauline into their home on a Monday to Friday basis. This arrangement operated very satisfactorily and provided tremendous relief for the parents who took Pauline home each weekend. However, two weeks ago the two women caring for Pauline notified the Brothers of Charity and her parents that they could no longer provide custody and care for the child. She is now back home with her parents.

Pauline is literally uncontrollable. She has the strength of an adult and requires two people to contain and restrain her at times. Everything within reach is in danger; plates, implements and pieces of furniture regularly become missiles. Some tantrums can even lead to biting. The situation has to be seen to be believed and I have seen it. Everything I have said has been verified by the social worker.

These parents cannot cope. They have a social and constitutional right to a level of service for their child appropriate to her needs which are definite, well defined and, I admit, difficult. I consulted the social worker at length and without doubt, given her condition, the most appropriate institution for Pauline is Cregg House, Sligo. Unfortunately, Cregg House does not have the resources or the place at present. However, they have an application with the Department of Health for additional places. I ask that in the interim a place be created for her at Cregg House and that the necessary resources be made available to provide, first, this additional place and, second, the much required additional places which have already been the subject of an application to the Minister and his Department.

I appreciate there are major calls on the funding available to the Department of Health. However, this is an emergency and the position is out of control. The furrowed faces of Pauline's parents tell the story very graphically. I again urge the Minister to take a personal interest in the matter and intervene to ensure that proper institutional care is provided immediately.

Minister of State at the Department of Health (Mr. O'Dea)

I acknowledge that Deputy Higgins has taken a personal interest in this case and has done tremendous work for this unfortunate girl and her parents. The person referred to by the Deputy is a 13 year old child from County Mayo with autism, severe mental handicap and severe behavioural problems. I understand that the child in question had been provided with an intensive home care service by two care workers. The issue of residential care has now arisen because the care workers have recently left the area.

The provision of mental handicap services in County Mayo is the responsibility of the Western Health Board. Services for people with autism in the Western Health Board area are provided mainly by the Western Care Association on an agency basis for the Western Health Board. Current policy is that persons with a mental handicap should be treated as far as possible in their own health board area. The Deputy will appreciate that Cregg House serves the needs of clients in the North-Western Health Board area.

A case conference on this child was held on Thursday, 30 September 1993. The conference was attended by the health board's area medical officer and social worker as well as the child's parents and representatives of the Western Care Association. The association are currently considering placing the child in their new facility in Foxford which is currently being developed. In the meantime the Brothers of Charity are offering a limited crisis intervention service until the end of December.

As regards the child's long-term needs a further meeting between the Brothers of Charity and the Western Care Association was held at 3 p.m. today. I will communicate with Deputy Higgins concerning the outcome of this meeting.

I assure the Deputy that the Programme for a Partnership Government includes a commitment to the provision of additional funding to enable the implementation of the recommendations of the review group on mental handicap services to be accelerated.

In the budget this year the Government made available an additional £8 million for improving and strengthening health services to people with a disability and, in particular, those with a mental handicap. In addition to this £2 million is being made available from within the Estimates of the Department of Health to strengthen the funding base of some of the direct funded mental handicap agencies and to meet some essential service needs. A sum of £4 million has been allocated to the health board regions, of which £158,000 has been allocated to the western region, and this money is being used to provide additional residential respite emergency and day care services and to develop further early intervention in child education and developmental services.

The precise services to be provided in each region have been agreed by the regional mental handicap co-ordinating committees within the guidelines issued by the Department of Health and approved by the Minister for Health. These allocations were determined on the basis of the waiting lists for services and the current level of service provision in each area. Provision has also been made for the capital investment necessary to support the initiatives put in place this year. In all, the total amount being spent this year on services for people with mental handicap is £209 million.

However, I fully accept that much more needs to be done to meet fully the needs of all persons with a mental handicap who are on a waiting list and it is intended to build on the improvements already put in place in future years.