Mary Wallace
Question:8 Miss M. Wallace asked the Minister for Health the arrangements, if any, that are being undertaken or considered by his Department and bodies under his Department's aegis to extend the provision of respite care. [9355/95]
Ceisteanna—Questions. Oral Answers. - Respite Care Services.
(Limerick East): Respite care services are provided for persons with a mental handicap, for the elderly and for people with physical or sensory disability.
The provision of respite care for persons with a mental handicap is an integral part of service provision. Respite care is provided in a flexible manner through the use of a variety of service elements. These include dedicated respite places, the use of five day residential places at week-ends for respite purposes, holiday respite, host families and the home support services.
In the period 1990 to 1994 more than 780 additional places were provided for residential, emergency and respite services. In 1995 a total of £12 million has been made available for the development of services of which £8 million revenue and £2 million capital is for new services. These new services will include up to 189 additional residential and respite places and the further extension of the home support services.
When allocating additional funding over the past few years, health boards were instructed to ensure that the services were directed at those waitlisted for services. Particular emphasis was placed on the provision of appropriate support services such as home support and respite care. These support services, when taken in conjunction with the provision of appropriate day services, are vital in enabling families to continue to care for their family member with mental handicap.
Supporting dependent elderly people at home is a major objective of health policy. As Minister for Health I am very conscious of the contribution made by carers to the maintenance of dependent elderly people in their own homes. In recent years my Department has encouraged health boards to provide support services for the elderly and their carers whether by services in the home such as home help or by way of respite care in a hospital or nursing home. This year the sum of £7.5 million is being made available to improve further health and welfare services for the elderly and their carers, including respite care.
In the case of services for people with physical and sensory disability, the development of health care services, including the provision of respite care, is currently being examined by the Review Group on Services for people with Physical and Sensory Disability. The group's final report is expected within the coming months. The extension of respite care will be considered in the light of the review group's report. However, even in advance of the report, my Department has, from development funds allocated in 1993 and 1994 for physical and sensory disability services, provided approximately £250,000 for the extension and improvement of respite care facilities.
As the Deputy will be aware the respite care fund of £500,000 which was formally administered by the Department of Social Welfare has been transferred to my Department. I will be making an announcement shortly on the allocation of this fund.
As the Deputy can see from my reply, the provision of appropriate support services for carers and, in particular, the provision of respite care is an issue which is very much to the forefront of the Government's policy in the development of community based services for the elderly and for persons with a disability.
The Minister mentioned that 89 additional places will be provided during 1995 for persons who are mentally handicapped. Will he clarify how many additional places will be provided for the elderly and those with physical and sensory disabilities? Is he aware that of the 30,000 carers throughout the country only 2,500 are in receipt of the carer's allowance? The remainder receive little recognition for their considerable work within the community. While there has been much talk about moving from institutional to community care the necessary back-up services are not being provided.
(Limerick East): I appreciate the Deputy's concern. While the carer's allowance has been helpful it is restrictive in its application. I intend later this year to re-examine a range of services for the elderly and will take this matter into account. On the question of places, the number is divided between the health boards but this year an additional £7.5 million is being made available to improve health and welfare services for the elderly. This is in line with the commitments in the policy document The Years Ahead — A Policy for the Elderly.
On the question of funding for respite care, I am concerned about the geographical spread. Caring for the elderly, particularly those suffering from Alzheimer's disease, places enormous demands on carers. I am concerned that insufficient respite care beds are available. There should be an onus on the health boards to ensure that additional beds are provided from the additional £7.5 million over and above the figure of 89 additional places mentioned by the Minister, that these are spread evenly throughout the country and that emphasis is placed on patients suffering for Alzheimer's disease.
(Limerick East): It is difficult to ensure an even spread when funding is provided by way of a block allocation to health boards which have discretion in deciding how it should be spent. Sometimes they give priority to one area of activity rather than another but as a matter of general policy I would like to see more places provided for persons suffering from Alzheimer's disease and greater attention paid to those who care for them. It is almost a cliché now to say that we could easily end up with two patients if we are not careful.
Will the Minister agree that one will not get better value for money than by providing respite care facilities? Most health boards are now in a position to appoint geriatricians who will not allow patients to be placed in institutions as has been the case heretofore. There is a great need to provide respite care beds to give those caring for elderly relatives at home time off.
(Limerick East): I agree that greater priority must be given to the provisions of respite care beds. The elderly have different needs. It is not true that being old is synonymous with being ill. Most of the elderly are in great form, in good health and enjoying life. The policy is to ensure that as many of them as possible remain at home and active within the community. As they have more needs the role of carers is vital. The interests of carers as well as the interests of the people for whom they care have to be taken into account.