Dáil Éireann debate -
Wednesday, 11 Nov 1998

Vol. 496 No. 4

Private Members' Business. - Mental Handicap Services: Motion (Resumed).

The following motion was moved by Deputy Theresa Ahearn on Tuesday, 10 November 1998:

That Dáil Éireann, conscious of the fact that people with mental handicap continue to live at the outer margins of society, and that their families frequently suffer great stress and hardship as a result of the denial of basic rights; aware, from Government-commissioned reports, that more than 1,000 people with a mental handicap live in completely inappropriate surroundings, and that thousands more are on waiting lists for essential services; believing there is a continuing and growing crisis in the legitimate demands of people with a mental handicap for residential services, respite care, training, education and employment; conscious that the Government and Dáil Éireann have welcomed the publication of a number of critical reports in this area, notably the Strategy for Equality, which contains 402 recommendations about the rights of people with disabilities, and Services to Persons with a Mental Handicap — An Assessment of Needs, which establishes a scientific database illustrating the gravity of the problem facing thousands of families; aware that the Programme for Government and Partnership 2000 both accord significant priority to the needs and rights of people with a disability; believing that the current strong state of the Exchequer finances provides a unique and unanswerable opportunity to make significant inroads into the unacceptable waiting lists; calls on the Government to mount a front-loaded assault on the problems in the context of this year's budget, and, in particular, to allocate a minimum of £30 million in capital funding to enable the residential and respite care crisis to be addressed, with a further amount of at least £30 million in revenue funding for new services and places in education, training and sheltered and supported employment.

Debate resumed on amendment No. 1:

To delete all words after "That" and substitute the following:

"Dáil Éireann recognises the need for the further development of services to persons with a mental handicap and approves both the Government's commitment to put in place an enhanced level of service provision in line with the commitments outlined in the programme for Government and Partnership 2000 and the actions taken by the Government to date in meeting these commitments which include:

—the provision of additional funding of £25 million;

—a £30 million National Capital Programme, over four years, to put in place appropriate infrastructure to support the services."

— (Minister for Health and Children).

Mr. Stagg

I want to share my time with Deputy O'Sullivan.

The way we treat the weakest among us is a measure of the civilisation of our society. Our treatment of mentally handicapped children and adults, in a time of plenty, is a damning indictment of our form of civilisation and a contradiction of our claim to be a Christian society. I have no doubt the Minister for Health and Children, Deputy Cowen, has Christian concern for the continuing under-resourcing of services for the mentally handicapped but Christian charity is not acceptable.

As a socialist, I declare the right of the mentally handicapped to the best services we can provide in residential places, day care services, special educational services, safe and adequate travel and in-home services to ensure they enjoy the highest standards achievable and that their dignity as citizens is ensured.

This matter was examined in detail by the previous Government and greatly increased funding was provided to meet the detailed and recognised needs of the mentally handicapped. That was a beginning and not an end to tackling the problem, but this Government has frozen that progressive approach.

We call on the Government tonight, particularly the Minister, Deputy Cowen, and the holder of the purse, the Minister for Finance, Deputy McCreevy — whose purse is overflowing with taxpayers' money — to provide the necessary funds for a decent level of services for the mentally handicapped.

The Minister, Deputy Cowen, came to my constituency before the last election and in the St. John of God school in Celbridge he made specific promises to the well-organised media audience. He promised that the area of mental illness and learning disability would no longer be the Cinderella of the health service, even if this meant reductions in other areas of expenditure. He stated: "If I am Minister for Health any work I do will be in the area of mental handicap and learning disability". The Minister failed to deliver on his promises to the weakest and most vulnerable in our society.

On 30 October, parents in that St. John of God school were informed that respite services were discontinued. I want to read a letter to the Minister written by one of the parents concerned. It states:

My son James is 32 years old. He is profoundly handicapped i.e. doubly incontinent, has to be fed, washed, lifted and requires 24 hour care. James is wheelchair bound and recently diagnosed with cancer of his stomach. He is also an epileptic since birth.

James has had brief respite care over recent years as both of us parents have serious heart problems. I, his father have serious heart trouble and currently have to see my doctor regularly. His mother has had serious heart surgery and is also under strict doctors instructions not to overdo her workload — some chance of that in our circumstances.

We have looked after James ourselves for 32 years and saved the State a fortune. On receiving this letter from Br. Gregory last week we just sat down and cried all day — we asked ourselves — just what is happening in the Dept. of Health that will allow this nightmare for us.

Now we have no break at all.

That is not the whole story from St. Raphael's. There are 30 children in day care who should be in full residential care. Ten of those are in the acute category and there is a waiting list for both day and residential services.

Apart from St. Raphael's in Celbridge, the other organisation providing services for the mentally handicapped in County Kildare is CARE. This voluntary organisation is grossly underfunded and needs an additional £270,000 for day to day expenditure in 1998 to prevent it going into liquidation. If this pittance is not provided by the Minister now, CARE will be legally obliged to close down and discontinue day services to 380 people and residential services to 18 others. This deficit arose because the Minister did not provide any funding this year for 40 people in day services in Kildare.

The Minister made a political football of the mentally handicapped before the election. If he fails to deliver to them now, he will be long remembered for that failure.

Ms O'Sullivan

I welcome the increase for the Department of Health and Children in the Estimates published today and hope the Minister will be in a position to tell us that an adequate amount of money has been provided to implement in full the terms of this motion concerning services for people with a mental handicap.

If we were to ask the public in a referendum if they wanted the basic needs of people with a mental or physical handicap provided for, I have no doubt it would be passed with 100 per cent support, yet funding for that most vulnerable sector of our society continues to be insufficient. How can we value ourselves as a caring and inclusive society when at least 1,300 mentally handicapped people are waiting for a residential place and another 1,000 are living in totally unsuitable conditions for their needs?

This is a basic human rights issue which must be addressed as such. People with a mental or physical handicap should have suitable services as of right. We must make this fundamental shift in attitude and now is the time to do that. We have the research and data, we know the level and cost of need in our community and now, more than at any other time, we have the money. We need this shift to a rights-based approach. The documents Services to People with a Mental Handicap — An Assessment of Need 1997-2001, the Strategy for Equality and Towards an Independent Future identified the needs in this area and there is no reason not to fund them.

Last night the Minister indicated that funding must be provided for the emergency cases that arise. Funding capital and revenue must be provided to meet the full extent of that need and ongoing data must be collated so that the calculation of need accurately reflects those requiring an appropriate service. Waiting lists must be eliminated and nothing less is good enough.

There would not be any question of telling a person they cannot get their pension because there is not sufficient money in the social welfare budget, or telling a five year old child he or she cannot go to school because there is not enough money in the education budget. However, that is what we are doing to people with a mental handicap. We need public policy that is based on right. It exists in other areas and it should apply in relation to disability.

We need particular provision for respite care. We should also consider people with mild mental handicap, many of whom are not even included in the data that have been assessed. We must also provide for the elderly mentally handicapped in our society whose numbers are growing. This is a rights-based issue and now is the time to fund it appropriately.

Mr. B. Lenihan

I understand I am sharing my time with Deputies Callely, Wright, Batt O'Keeffe, Hanafin and Conor Lenihan.

We cannot provide sufficiently for this group of people. I share the philosophy that, at a time when the wealth of the nation is so augmented, we must do everything in our power to provide for this group. We may have had excuses in the past because of the transitional nature of our economic development, but at this stage in our progress as a nation there is no excuse for us not providing all we can provide for those who are impaired by a mental handicap. I know from my discussions with the Minister that he has put this issue at the top of his priorities.

He has done so notwithstanding the fact that there are many lobby groups in the health and medical fields which are far more vocal, which receive far more money from the Exchequer and which wield much more political muscle than this group. I congratulate those who have made an effort to set about organising this interest and securing all the assistance they can from the public purse.

I was disappointed to hear Deputy Stagg introduce party politics. The Government of which he was part did have one major achievement in the major exercise of the assessment of need. That document, Services to Persons with a Mental Handicap/Intellectual Disability — An Assessment of Need 1997 — 2001, was an important intellectual exercise in assessing the extent of the problem. It drew something to our attention that we instinctively knew from our constituencies — that the problem was far more extensive than the official statistics indicated.

That publication was an intellectual exercise. What lies before this Minister is a very practical exercise, which is to facilitate funding and expenditure that will ensure that the requirements set out in the assessment are met. That lies before the Minister, and I know the Government has made a definite commitment to implement these additional services set out in that document. The total funding allocated by the Minister this year is £25 million for services to persons with a mental handicap. That figure is far in excess of the £12 million provided by the previous Administration. I do not make that point out of political partisanship. I know that that Government was completing this major intellectual exercise with the assessment of needs document. When I raised this matter while in Opposition, the assessment of needs document was produced as the reason urgent action was not being taken. I congratulate the Minister on the extent to which he has moved on this issue. I urge him to continue on that road and to find all the money he can for this group.

Mr. Callely

I preface my contribution by expressing my admiration and respect for and congratulations to all of the dedicated personnel involved in the delivery of services to those with a mental handicap. I support the further development of services to persons with a mental handicap. I have a long track record of deep concern and commitment to addressing the serious difficulties that prevail in the provision of services to people with a mental handicap.

I listened to Deputy Stagg, a former Minister of State, and I am appalled by the politicians who signed this Private Members' motion, hypocrites who, only a few months ago, were in a position to deliver, but who failed.

Mr. Sargent

That is not correct.

Mr. Callely

I said those politicians who signed and who were in a position to deliver. I accept Deputy Sargent was not.

The rainbow coalition was totally devoid of political balance and judgment on this issue. That Government was more interested in looking after family and friends as spin doctors, in consultancies and in travel and putting advertisements in their own journals for staff in their leaders' office on the taxpayer's money than in providing services to people in need.

Mr. M. Higgins

This is disgraceful.

Ms. O'Sullivan

Deputy Callely should address the issue.

Mr. Callely

I will give a flavour of my parliamentary questions on the provision, and more importantly, the development, of services for those with a mental handicap. I will quote some answers.

I put down a parliamentary question to Deputy Howlin when he was Minister for Health asking the number of people with a mental handicap who were misplaced in psychiatric hospitals. His answer was that persons with a mental handicap continued to be cared for in psychiatric hospitals either because they were not suitable for transfer or because transfer could not be arranged at the time. He was not in a position to give details of developments which might be put in place, as the then level of funding made available for such a development was budgeted.

Mr. Neville

What was the date?

Ms O'Sullivan

What was the date?

Mr. Callely

I asked the next Minister for Health, Deputy Noonan, about the inadequate level of services for people with a mental handicap and those who were being denied a service. The bottom line to his answer was that he was aware that more needed to be done if the needs of those waiting for services were to be met.

Ms. O'Sullivan

What was the date?

Mr. Callely

I could go on, but that gives a flavour of those who signed the Private Members' motion. They were in a position to deliver but failed to do so. I do not want to make a political football out of this, but Deputy Stagg spoke tonight about what he would do if he were in a position to deliver. He was in that position, but he failed, as did others who signed this motion.

It is obvious that successive Governments have failed to deliver on this. The credibility of all political parties and individuals is at stake.

Mr. M. Higgins

We will see how Deputy Callely votes tonight.

Mr. Callely

All political parties should examine their actions, performance and records carefully and responsibly. I ask Deputy Higgins to do so genuinely.

Mr. M. Higgins

Yes. We will see how Deputy Callely votes tonight.

Mr. Callely

I have visited nearly every service provider and Eastern Health Board facility to get a handle on the provision of services to people with a mental handicap. I have fought hard for the improvement and delivery of services in my constituency. I was surprised to learn on visiting a service provider that it was not offering residential placement. I am pleased that since pursuing the provider's needs it is able to offer residential placement. The difficulties and backlog caused — not necessarily due to lack of Government commitment and funding — can be imagined. There are a lot of issues to be acknowledged here.

As Deputy Higgins has said, we should move forward with a positive, planned process. An overriding priority must be to tip the balance in favour of the clearly acknowledged need for services. The document Services to Persons with a Mental Handicap/Intellectual Disability — An Assessment of Need 1997 — 2001 was initiated by the previous Administration for the period in question, and that programme was given an injection of £12 million in 1997. When this Government came to office it adopted that document and accelerated the provision of services with £25 million instead of £12 million. However, let us not complicate matters by scoring political points. We know the priorities — the provision of appropriate residential places, the provision of required day care places including education, training and a sheltered environment and improved, extended respite services.

Let us send a clear message to all on our commitment to this issue. I ask every party and Deputy to consider this matter individually. Let us reach agreement in unity to move forward positively in the best interest of those with a mental handicap. Let us not be divisive. The money is available and the assessment is there. It is a matter of agreeing to move forward positively.

Mr. Wright

Within two months of the present Minister for Health and Children's appointment I was summoned to his office to discuss the situation in St. Ita's, Portrane. He made it clear to me that he intended to ensure that something was done in relation to the situation there. He made a private visit there in November and was able to see the appalling conditions at first hand. Having covered every part of the complex, he stated that he intended to do something about the situation in the not too distant future.

Following that private visit and having consulted with the Eastern Health Board and asked for an immediate plan in relation to a particular section, as well as an overall plan, the Minister announced, this week, a £13 million allocation for St. Ita's, Portrane. He has been able to ensure that extra funding was allocated. The Minister's response has at last given hope to the staff and parents associated with St. Ita's. In his first 18 months in office, he has allocated substantial funding to St. Ita's which for many years was crying out for some Minister to respond to its needs. Some £200,000 has been provided by the Eastern Health Board and the Minister for a holiday home for the clients, parents and friends of St. Ita's. The response to the announcement from the hospital staff and all associated with it has been extremely positive. It is part and parcel of an overall plan which the Minister has taken on board to improve the deplorable conditions he witnessed on the occasion of his visit.

The announcement by the Minister for Education and Science last week of a £4 million initiative for special education services shows the Government has an overall coherent plan. This is an area that may have been neglected in the past. There is no Deputy in the House who, either on a daily or weekly basis, does not have a constituent who is not in need of some of these services. In the space of a week the Minister for Health and Children and the Minister for Education and Science have responded. The five year plan set out in the programme for Government has been adhered to and the funding needed for these projects has been delivered.

In my constituency and in many other constituencies the great work being undertaken by many voluntary organisations which should be done by other services is being responded to by the Minister. In my constituency of Dublin North fantastic work is being done by voluntary organisations in Fingal workshop and, for the past ten years, in the Arts Club in Portmarnock. I hope in the not too distant future the Minister will provide the necessary capital funding for these people to carry out their work. That would be for the betterment of those being cared for.

Mr. B. O'Keeffe

I am pleased to contribute to this debate and to welcome the visitors in the gallery who are associated with those suffering from mental handicap. They are welcome to participate in this debate. They afford us the opportunity to indicate to them our sincerity in dealing with an extremely important service, the delivery of a comprehensive service to those with a mental disability.

When the Government was formed it was evident there was an interest in and a focus on improving the overall service. The Minister with special responsibility in this area has decided that during his term of office he will ensure a proper service is in place for that section of society that has been denied proper funding for many years.

It is interesting that in the lead up to this debate no consultant said that patients would die as a result of a poor service. There was not a whimper from that section that anything would happen to those with a mental handicap because the service is inadequate. These people did not knock down the door of the Minister for Health and Children asking him to provide additional funding for the service. In terms of delivering psychiatric services every health board will be within its budget. Generally this is because those who are in the service go about their job quietly and do it in a professional manner. On top of that the parents, families and friends of those suffering from mental handicap are so involved and totally engrossed with the member of their family who suffers from mental handicap that they have not had the time to protest. Therefore, it behoves us in the House and those of us on health boards to speak up for this category and to stop dancing to the consultant tune.

I refer the House to the statement by the representative of the consultants when he exhorted chief executive officers in health boards to break the law. The same individual did not ask his own consultants if they would break the law. Maybe it would have been more appropriate for that representative to look inwardly rather than outwardly and to ask whether his members could save more money for the health board to ensure that at budget time we can make more money available for the delivery of this type of service. He could have asked whether it was possible for consultants to perform more operations on public patients vis-á-vis private practice.

The Minister for Health and Children may be gruff at times but behind the exterior he has a heart when it comes to the delivery of a proper and comprehensive service to those suffering from mental handicap. As chairman of the Committee on Health and Children I am aware from my discussions with him over a long period that he has taken it upon himself to ensure a lessening of the burden, particularly for parents who have to care for those suffering from mental handicap. There is an emphasis on providing a funding infrastructure for the delivery of a proper service in this area. This is evident by the amount of money provided over an 18 month period.

Obviously, the amount of money that has been provided is not adequate to deliver the full and comprehensive service. However, I ask the people in the Visitors' Gallery to remember that this is a four year programme and that, as part of that programme, the Government and the Minister are committed to delivering the type of service they need and which those proposing this motion did not deliver, which is to their eternal shame.

Ms Hanafin

Over the past two nights in discussing persons with mental handicap we have been talking in terms of thousands looking for day services, for residential care and for respite care. It is important to look behind the numbers at the people we are talking about.

We are talking about Andrew who is autistic and whose only pleasure in life is the fast forward button on the video machine. We are talking about Stephen who only likes noise. We are talking about Mark who finds it difficult to communicate. We are talking about young children and adults whose very happy laugh I am quite sure belies the frustration and pain felt by their parents. These parents love their children to the end and are proud of those children's bravery, achievements, sense of optimism and zest for life.

It is all very well to love these children as children, but when is an adult not an adult? It is when he has the mind of a child and needs to be cared for, toileted and bathed like a child. These are the matters which cause stress and hardship for the parents and families of young adults with mental handicap. These families find it difficult to lead a life outside that child. For example, they cannot find babysitters — how does one ask a 15 year old to babysit an 18 year old?

These people are dependent on the support of voluntary agencies and groups, such as parents' and friends' associations and the St. John of Gods. A good friend of mine, Vincent, said that when his other children were born he was given an education for them but when young Vinnie was born he was given a collection box because he was forced to fund-raise over the years for his child. In this regard, I welcome the initiative of £4 million introduced in the past week by the Minister, Deputy Martin, to help children with special needs.

We are talking about giving thousands of people millions of pounds but hundreds of Members of this House have failed to live up to the problem in recent years. A very similar motion to this one was discussed in the House 21 years ago. We have all seen at a local and personal level the service offered to people who need such services, none more special than the Carmona services of St. John of God in my constituency of Dun Laoghaire, where there is a long waiting list for the tremendous service offered. They have made a budget submission of £7 million, which I support. I thank the Minister for agreeing to meet Deputies of all parties next week to discuss that submission.

I was particularly taken yesterday by the comment of a young mother who said that if her child were a criminal, a cow or had a hurley in his left hand he would get more money from the State. I share the commitment of this Minister and his concern. I know he is committed to the five year programme. I know this debate has given us an opportunity to articulate those needs and I also know that when the term of this Government is over we will have met those needs.

An Leas-Cheann Comhairle

I ask people in the Visitors' Gallery to refrain from applauding as it is not the practice in the House. There is a long list of speakers which we wish to get through as quickly as possible.

Mr. C. Lenihan

I join my colleague, Deputy Batt O'Keeffe, in acknowledging the presence in the Visitors' Gallery tonight and last night of the parents, families and representatives of those with mental handicap. They face a difficult situation and it is terrible they have had to make their protest in this manner. As Deputy Hanafin said, it is symptomatic of a much deeper malaise which has occurred over a period of 21 years.

However, I am glad I am part of a Government which will support an amendment to this motion which will put in place the building blocks for a better future for the people in the Visitors' Gallery and the children for whom they work every day. The Minister, Deputy Cowen, has a combative and aggressive public image and style of debate. However, as many of my colleagues will agree, he goes about his business as a Minister in a quiet and efficient manner, which is important in this difficult and emotional situation in which many parents in the Visitors' Gallery and elsewhere find themselves.

I saw that difficult situation at first hand on the doorsteps of my constituency during my first election campaign last year. I saw parents of children with mental disabilities who were in tears on the doorstep about the terrible situation they were facing into and the feeling of being trapped in their own homes without any assistance from the State. I am lucky that none of my immediate family have had to face that terrible and difficult situation.

The Government has emphasised the need to put the cares and considerations of these people at the very forefront. The Minister, Deputy Cowen, is a serious player in the Government but we also have the Minister of State, Deputy Mary Wallace, who is the first Minister of State to be dedicated full-time to the cause which concerns the people in the Visitors' Gallery. That is a signal of our commitment. We gave that signal before the election and we maintained it afterwards with the appointment of the Minister of State, Deputy Mary Wallace, which was deeply significant. I am glad the people in the Visitors' Gallery and the organisations they represent are now formally represented by a Minister of State, and long may that continue.

The Government's emphasis is on planned provision and the elimination of waiting lists. There are 900 people waiting for residential places and 300 for day care. It is a serious challenge and we do not know if the waiting lists will expand later. We are facing a difficult situation but we are facing it in a planned and proper manner, a manner which will involve planning for the future and meeting the requirements we saw in the assessment of need, which stretches from 1997 to 2001. It sets the path by which we will go forth, plan and spend the money.

Over the four year period of that plan there is a sum of £65.3 million on the revenue side to fund the day to day essential services and £39 million on the capital side. I emphasise that the last Government, some members of which are proposing this motion, spent £12 million last year, while we spent £28 million this year. The last Government conveniently omitted to indicate before it broke up, how much it would spend on the capital side. If one looks at the overall picture, during the life time of this Government we will spend £65.3 million on the services side and an extra £39 million on the capital side. After 2001, we will have spent well over £1 billion on this area. We are not saying the worst is over, but we are saying a start has been made and for that the Government, the Minister, Deputy Cowen, and the Minister of State, Deputy Mary Wallace, should be congratulated.

An Leas-Cheann Comhairle

I understand Deputy Sargent is sharing his time with Deputies Ó Caoláin, Joe Higgins, Lowry, Neville, Ring, Belton, Burke, Naughten, Crawford and Mitchell. Times have been allocated and I will notify Deputies when their times have elapsed.

Mr. Sargent

I recently met with CROSS-CARE, an organisation which supports many families in need of respite care and residential care. I have some idea of the huge frustration felt by people caring for those with mental handicap. I have worked with ARCH in Portmarnock and I have an idea of the needs of families with young children in that position. However, none of that can prepare one for the experience which those families must face.

In the short time available to me I will use the example of St. Ita's Hospital in my constituency as an indicator of how the mentally handicapped are treated in 1998. St. Ita's Hospital, Portrane was opened in 1896 as an auxiliary hospital to ease pressure on places in the then Richmond Asylum. It was built to cater for more than 2,000 patients. In 1993 the Eastern Health Board produced a document entitled "St. Ita's Past, Present and Future" of which the main element was a recommendation to close the hospital and resettle people in more appropriate environments. In 1997 the Commission on the Status of People with Disabilities specifically highlighted conditions in St. Ita's Hospital.

In the wider community currently more than 1,400 people — and the figure is rising — have learning difficulties and mental handicap and are in critical need of residential care. The funding allocation for services for people with learning disabilities and mental handicap is proportionately lower than for other services. Psychiatric services have 10 per cent of the funding allocation, general hospital services, 51 per cent, but the handicapped, covering all areas of handicap including the blind and the deaf, have only 9 per cent. Patients in St. Ita's Hospital have lived in condemned wards and units in the past and continue to do so. This was cited in a case brought to Europe as an instance of an abuse of fundamental human rights. The recently published database on the assessment of needs 1997 to 2001 reported that an investment of £65 million at that time, or £70 million today, was needed to meet the current identified needs of people with learning disabilities or mental handicap. The £13 million planned for St. Ita's Hospital is inadequate, given the number of patients for whom the hospital is currently providing.

St. Ita's Hospital will be the test case as to whether the Government can provide for the needs of people with learning difficulties or mental handicap at a national level. Cuts in the late 1980s and early 1990s made it extremely difficult for health boards to implement the planning for the future policy. What is at issue is not the need to fundamentally change the policy set out in planning for the future, but the need to implement those policies that have been articulated. That is all this motion is seeking to do. The Green Party, An Comhaontas Glas, fully supports it.

Caoimhghín Ó Caoláin

I wholeheartedly support this motion. It addresses a huge section of the population, those with a mental handicap and those whose lives are dedicated to the care of the handicapped. The full extent of this section of our population in terms of numbers is not fully known, but it is so extensive that there are very few people who do not have some direct or indirect knowledge of the problem from family experience. My brother, Dermot, has Down's Syndrome.

The financial allocations sought in this motion are in tens of millions of pounds, but those caring for the mentally handicapped have saved and continue to save this State hundreds of millions of pounds by the constant care which they give at great cost to themselves. Those with a mental handicap have a right to care whether provided by caring relatives or by the State. In the case of the vast majority who are cared for by their relatives, it must be recognised that their special needs have not been met and commitments repeatedly given have yet to be fulfilled. Successive Governments have undertaken to provide mental handicap services for those without services at present and for those people with a mental handicap who are currently resident in psychiatric hospitals. It is a national scandal that the latter category still exists.

The provision of services overall remain inadequate and piecemeal and fail to address the plight of those ageing parents or siblings of the mentally handicapped who bear the burden of care. Older parents and ageing brothers and sisters are trying to cope in very limited home conditions, many of them on their own. They face physical and mental hardship. Their social lives are severely curtailed or non-existent because of the demands of round the clock care. In many cases their domestic finances are strained to breaking point. On top of the physical burden of catering for all the needs of their mentally handicapped relatives, they have the constant worry and question that grows more urgent as they grow older, "what will become of him or her when I am gone". This worry looms larger for carers than the daily strain of care which takes such a physical toll on older people.

The measures called for in this motion would address that worry and provide the services so badly needed and long overdue. I urge the Government to listen to the voice of the most vulnerable and implement these measures.

Mr. Higgins

(Dublin West): On behalf of myself and the Socialist Party, I express our total support for this motion which seeks to give necessary and crucially needed resources to those who suffer from a mental handicap and to those who care for them. No words of mine can express the suffering, the anguish and the exhaustion of those who, in many cases, are on their own or have very little back-up support in taking care of a person with a mental handicap. Our society stands condemned when it allows the mothers, fathers, brothers and sisters of those with a handicap to stand alone without providing the support that is necessary and forces them to take on the role of the great exploited in our society, the unpaid carers of those who cannot care for themselves.

A major issue in this area, about which people regularly contact me, is the provision of respite care for people with disabilities. It would be hard for us to know what a few weekends off and a holiday of a few weeks would mean to a parent, brother sister or carer of a person with a mental handicap. All we are being asked to do is to provide the resources that would make that possible. If we cannot find a few tens of millions of pounds to take care of those who desperately need it and channel it away from the greedy minority in an era when the Celtic tiger is running right riot and the banks, financial institutions and industries are making profits hand over fist, we do not deserve to be a Parliament of the Irish people.

Mr. Lowry

We know the statistics on this issue and they are truly shameful. We also know the reality of the position because parent groups have lobbied TDs and Governments for years. They left us with no doubt as to the depth of the crisis and their growing frustration and sense of hopelessness. The Minister for Health and Children is fully aware that the mentally handicapped on waiting lists are long overdue funds to provide for their basic essential requirements. Tonight all of us have a unique opportunity to show that politics works and that we can unite and deliver on reasonable and legitimate demands. I am happy to support this motion and hope that all Members will set aside party politics and other considerations and join together in acknowledging in a practical way the justifiable fears and concerns of a vulnerable section of our community.

Families with mentally handicapped members are positive and patient people. They are generous in their acceptance of the heavy burden thrust upon them. All they seek is a level of support which will enable them to care for their handicapped children as long as possible and in an environment suited to the level of his or her handicap. In the absence of proper support and a planned cradle to the grave service the burden on parents becomes intolerable. How often have we heard parents say, they simply cannot die for fear of what will happen to their sons or daughters when they are gone, who will care for them and who will cater for their needs? How often have we seen the immense pressure and strain result in ill health in one or both parents leading to an eventual family crisis when the inevitable happens?

There are many examples where a brother or sister has to take on the responsibility of care on the death of their parents and the cycle of care continues into the next generation. Against that background we can only imagine the isolation and confusion of mentally handicapped people as they try to understand what is evolving about them. In this modern and sophisticated age it is an affront to the dignity of the mentally handicapped that they are not guaranteed a sustained quality level of service.

Mr. Neville

I welcome the mothers, fathers and carers of the mentally handicapped who are here. Coming from the mid-west I pay special tribute to Ger South from Limerick who has done excellent work over many tireless years on behalf of the mentally handicapped. The motion deals with one of the most vulnerable groups in our society. It is a disgrace that people with a mental handicap are forced to live in the outer margins of society.

It is unfair that fathers, mothers, brothers, sisters and carers are put in a situation where they suffer extreme stress because their loved one, who is mentally retarded, is denied basic human rights. It is unacceptable that at the height of the success of the Celtic tiger, 1,000 citizens with mental handicap live in completely inappropriate surroundings.

A just and humane society would make it a priority to meet the legitimate demands of people with a mental handicap such as residential service, respite care, training, education and employment. The present crisis must be dealt with in a humane, comprehensive and consultative way. The strong state of the Exchequer finances provides a unique opportunity to make significant inroads into the unacceptable waiting lists. The Minister has a moral and political duty to do so. I support the proposal in the motion that the Government allocate a minimum of £30 million in capital funding to enable the residential and respite care crisis to be addressed and that a further amount of at least £30 million be provided for new services in education, training, shelter and support employment.

The mother of a 23 year old handicapped son, a traveller, presented me with a letter dated 19 October from the consultant psychiatrist in learning disability at Bawnmore Brothers of Charity. The letter says the child urgently requires residential placement within the mentally handicapped services but unfortunately Bawnmore cannot offer him a bed as there are no vacancies. The letter went on to inform the mother that the matter had been discussed that afternoon with the director of services, that they were acutely aware of the situation and suggested she write to the director of disability services at the Mid-Western Health Board in connection with this most serious problem.

However, the health board does not have the finances to create further places. In 1998, allocation for the development of services in the mid-west region for those requiring a mentally handicapped service was totally inadequate. It did not meet the immediate and urgent needs of persons in the region with a mental handicap. I ask the Minister to immediately increase the allocation of funds available for residential services in 1999. There is an immediate and urgent requirement for the provision of 31 residential places in the mid-west region.

Mr. Ring

I received telephone calls last weekend from many people in County Mayo who would have loved to attend this debate but could not do so because they had to stay at home to look after their children as they get very little care from the health board. People in the county must travel long distances for services. For example, those in Belmullet have to travel 75 miles to Castlebar or Ballina and almost 90 miles to Galway. It is terrible that they must suffer in this way.

Two major collections for autism take place in the county to send two children to Boston to be educated. That is scandalous that in 1988 people have to raise that money themselves. While £20 million is spent on sporting organisations, we cannot look after people with a mental handicap. It is a disgrace.

A woman telephoned me on Monday asking me for my support in the Dáil on this debate. I assured her I would support the motion, but I told her there was no point in approaching me because it was a matter for the Government. This issue is above politics. We should support and assist people with disabilities. We are told the Celtic tiger is awash with money, yet this woman asks me what will happen when she dies and there is nobody to look after her son? That is a serious situation.

We have very little services in the west. Western Care collects money on a daily basis by knocking on doors and organising benefit dances. Yet, the State cannot provide support and assistance. Collections are necessary to send our handicapped children to Boston and other parts of America to be educated and assisted. Approximately £1 million is won on the national lottery every Saturday. Would £300,000 not be enough in winnings with the balance going to people who need to be looked after, especially the mentally handicapped?

Mr. Belton

I support the motion. This matter has been before the House on other occasions, but no matter how often it arises those involved continue to look after their loved ones in their homes. It is more difficult for older people to look after mentally handicapped children.

Originally friends of the mentally handicapped raised funds on a voluntary basis. In this regard, I pay tribute to all the work done by St. Christopher's in County Longford. There are now two residential homes in the county, one in Longford, the other in Abbeylara. I also thank the former Minister for Health, Deputy Noonan, who helped us on that occasion.

At a time when we are told people are travelling from other parts of the world to learn about the Celtic tiger let the visitors attending this debate and people like them enjoy some of the benefits of this booming economy. If we do not look after our handicapped people it is a bad reflection on the caring Irish. We are known across the world for the way we care for people. Let us care for our own first.

I have no doubt the Minister, being from a midland constituency, will support the proposal for St. Christopher's in Longford and the other demands across the country. It can be done if the will is there. The money is available, it is there to be given away. Any sporting organisation in need of money can get it from the Minister for Finance. The Minster should get the money from him for this purpose.

Mr. U. Burke

I thank my colleagues for enabling me to share time. Few Ministers have had the opportunity afforded to the Minster on this occasion to respond positively to the needs of people with a mental handicap. Over the years services to the mentally handicapped have been ad hoc. They have been provided in reaction to crises rather than being focused on long-term policies to provide facilities for those in need.

People with a mental handicap should be given the opportunity to live as full a life as possible in their own environments with their families and friends. We do not fully understand or acknowledge the contribution of parents and family towards care, attention and provision of education for a member of their family with a mental handicap. It has been described as a 24 hour job, 365 days a year without pay.

The Department of Health and Children and health boards have rarely been proactive in their efforts to help or assist in this matter. Rather, they put parents and families literally through the wringer before they will respond, often grudgingly, to their needs. If the Department of Health and Children has an additional £120 million as a result of the Estimates today, surely the Minister can respond to the needs of the 3,000 members of our community who are handicapped. They have been overlooked in the past. There has been ongoing neglect and indifference to children in need. I find it difficult to say why it is the Department of Health and Children alone that has to take responsibility for the handicapped. These children are not sick. They are handicapped. The current Education (No. 2) Bill going through the Dáil does little to reassure me that the Department of Education and Science is prepared to shoulder its responsibilities in this area. The language throughout many sections of this Bill clearly indicates reservations with the inclusion of terms like "as far as resources permit" or "within the resources provided". I plead with the Minister to co-ordinate between health and education so that one will not be played off against the other and give an excuse to do nothing as has happened all too often in the past. It is difficult for parents to reconcile how the Minister for Education and Science can provide £250 million to teach computer skills in our schools and still deny the disabled access even to proper facilities within a school.

Parents' groups in Ballinasloe, whom the Minister has met, known as the Ballinasloe Advocates for the Mentally Handicapped, are asking only for fair play for their children in need, equality for their children with disability. They want appropriate and adequate service for their children. The Minister has the responsibility on this occasion. When the Minister last met this group he told them the resources were all gone. The health board had no further responsibility to provide care for the people in the Ballinasloe area. Was it fair that on many occasions parents had to see children spend six hours on a bus outside their catchment area in order to avail of even basic facilities? I ask the Minister, now that he has the opportunity, to provide facilities for the people in Ballinasloe.

Mr. Naughten

In the short time I have, I want to raise a number of important issues. First, we have a situation within a number of our psychiatric hospitals where people with a mental handicap are being accommodated. In one case of which I am aware there are approximately 50 people ranging in age from their early 20s to their mid 50s in a psychiatric hospital. The majority of these people have a medium to severe mental handicap which, the health board agrees, makes them unsuitable for this type of institution. However, the board are penny-pinching to try to get the funds to provide suitable accommodation for these people. They have continually requested funding from the Department of Health and Children, but their requests seem to be falling on deaf ears. The days of putting people with a mental handicap into psychiatric institutions and forgetting about them must be consigned to history once and for all. We cannot allow people with a mental handicap to be pushed to the margins of society, out of sight, out of mind.

The biggest worry facing many parents with adult children with a mental handicap is the lack of residential care. Speaking with elderly parents, one can see fear in their eyes when they raise the question of what is going to happen to their son or daughter when they pass away. Residential care is a basic requirement. Funds must be provided immediately to meet this growing demand.

The lack of speech therapy for children with a disability is nothing short of a disgrace. Recently I met a woman who had a son, John, with Down's Syndrome. This child, after nine years of education, has not received one hour of speech therapy. This is because of the lack of funding for this service and the petty bickering between the Department of Health and Children and the Department of Education and Science. There is no co-ordination between those Departments on services for the mentally handicapped. How can we pontificate about integration when children are not given the opportunity even to communicate properly? It is a disgraceful situation. This child spent five years in a school that did not even have heating, a basic requirement that every other primary school has. What was done here tonight by members of the Government in calling this a political issue is a disgrace. Fathers, mothers and siblings of mentally handicapped children have spoken here tonight. It is not a political issue. Everyone is speaking from their hearts on issues that need to be addressed and which must be addressed. I urge the Minister to support this motion.

Mr. Crawford

I add my support to this motion. I congratulate and thank the people who made it to the Public Gallery tonight for their support down through the years on behalf of parents and siblings. It is one of the most difficult situations any family can face to have a handicapped person to look after on a day to day basis. My direct involvement is through a next door neighbour who has a child with cerebral palsy.

I beg the Minister tonight to realise that services are needed for people like this outside Dublin. I do not suggest the Minister is the only person responsible. His predecessors have failed to provide the necessary physiotherapists and other back-up services that handicapped people need in the more remote areas. People spoke about millions of pounds, and it certainly is necessary. However, I want to concentrate on a few small things.

Many families need a couple of weeks' respite care to allow them to take a holiday or to have a break. They need the odd weekend off. When a person caring for a young adult needing 24-hour care can get only five hours help a week from the health board, we must look seriously at our commitment to these families who are trying their best to keep their handicapped relatives at home. They get one hour's help per day, and no help at the weekend. I ask the Minister to make sure that whatever funds health boards need are made available so that they can rectify that situation not just for the handicapped but also for the elderly.

I could go through a list of people. I have a letter here from somebody who had to go from the health boards to the Department of Education and Science for two and a half years looking for help and who eventually, at his cost, had to go to London. Somebody else had to wait five years to get agreement between the Department of Education and Science and the Department of Health and Children on the question of the education of his child.

We have some great services. Camphill Communities is a national group backed by outside bodies. The problem is to provide funding for the very great job they are doing. Will the Minister ensure that voluntary groups such as Camphill Communities will be facilitated in every way.

Ms O. Mitchell

This has been a very emotional and emotive debate. I will not be emotional tonight because, after 20 years of involvement in this issue I realise that emotion does no good. I will speak about waiting lists, the fact that they are growing and that we are not coming to grips with them. Year in and year out these lists are growing, particularly in the Eastern Health Board area where this year the list stands at 528, 80 more than last year. Despite commitments by this and successive Governments to gradually eliminate the list, the list is growing, and for totally predictable and understandable reasons. Because of the way they are structured, they do not take account of the fact that every year there are predictable emergencies, because children are born with multiple handicaps and life-threatening conditions for which they have to be immediately admitted, and when one child is admitted as an emergency somebody else goes to the bottom of the list. The list is growing because parents die each year, because they have breakdowns, because they are no longer able to cope. The result is that people have to be admitted in an emergency and then other people have to go to the bottom of the list. This year the Eastern Health Board is taking in people as an emergency measure and spending the following year's allocation, so that there is always a catch-up and the list is never eliminated.

Other speakers spoke about the pain and misery experienced by parents. They cannot even begin to understand that; even the families themselves cannot communicate it. It is our job to address this problem. I urge the Minister, even at this eleventh hour, to do something about this scandal which is a shameful reflection on all of us.

Minister of State at the Department of Health and Children (Miss M. Wallace)

I welcome the visitors in the Gallery and I welcome this debate on the crucial issue of services for people with a mental handicap. The Government has no problem in agreeing that these services must be improved. We must ensure that services are appropriate and responsive to the needs of people who, for too long, have been low on the public policy agenda. I have listened carefully to the debate on this issue.

To date, this Government has a record of delivering funding for services to the mentally handicapped which is unmatched by any previous Government. In the past year, the Government has put in place a £39 million capital commitment and provided significant additional current funding. While I accept that Members of the Opposition are sincere in their comments, they cannot run away from the fact that the £25 million provided in 1998 is double that provided in 1997 by the previous Government.

We are all interested in the provision of properly planned, accessible and appropriate services for people with mental handicap. The intellectual disability database provided us with a clear picture of what was needed in this area. That database was developed and the assessment of needs document was published by the former Government. The document outlined a five year plan from 1997 to the year 2001. The plan states that the Government must, during that five year period, provide 1,439 places on the residential side and 1,036 on the day side to meet the assessment of needs.

Yesterday, the Minister for Health stated that between 1997 and 1998, the first two years of the plan, more than 500 new residential places and 760 new day places have been provided, leaving a balance of 900 places on the residential/respite side and 300 on the day side. I am very aware of the impact which the lack of residential places and, in particular, the lack of respite places has on the lives of people with a mental handicap and on their families and I am aware of the toll which waiting for such services places upon them. I reiterate and endorse the comments made by the Minister yesterday; we all wish to be of assistance to those parents in working with them and the service providers to meet the needs which have been clearly identified.

The Minister outlined the strategy which has been put in place to manage the development of new residential services. Given the age profile of both the clients and their carers and the fact that we are, in effect, working through a backlog of needs, it is important that if progress is to be made quickly, effectively and in an equitable manner, everyone must be clear about the way forward.

There are three main components involved in this issue. The first relates to the management of emergency cases which will arise, the second relates to the provision of new residential places for those who have been assessed as requiring the service and the third relates to the provision of an increase in the level of respite care. Since taking up office last year, this Government has already accelerated the pace at which the development of services to meet the needs identified in the assessment of needs document is moving. The provision of additional funding of £25 million over a 12 month period is double that provided by the previous Government last year.

One important aspect of the Minister's announcements during the past 12 months was the £30 million national capital programme, the first time such a programme was made available to the services. It has already produced significant results such as the important announcement of £13 million for St. Ita's Hospital in Portrane. I could not believe that Deputy Sargent, in whose constituency the hospital is based, did not have the grace to acknowledge that the £13 million investment will make a huge difference and has been welcomed by all involved.

The pace of development under the programme will speed up in 1999, thanks to the Minister's action over the past 12 months which provided a total £30 million capital commitment. It must be remembered that the previous Government did not make any capital allocation to support the five year plan.

Deputy Ulick Burke must not have known that the Minister for Education and Science made an announcement last week in regard to the education of children with special needs in terms of the provision of additional classroom assistants and resource teachers.

The Government has clearly stated that the development of services to meet the needs of persons with a mental handicap, as outlined in the assessment of need document, is one of its priorities. The Minister has accorded priority to the development of these services since taking up office. The evidence of this commitment has been concrete and it is the Government's intention to further accelerate the pace at which progress is being made to ensure residential, respite, day care and other support services are provided as quickly as possible within the timeframe outlined in the assessment of needs document and the programme for Government.

Mr. Quinn

I wish to share my time, limited though it now is, with Deputies Finucane, Durkan and Shatter.

An Ceann Comhairle

Is that agreed? Agreed.

Mr. Quinn

I am enormously saddened by the fact that this Government, on the day on which the Estimates were published — a day of unbelievable riches, the likes of which this country has never previously seen — is actually opposing a joint Opposition motion. I am shattered by that. We know the Minister of State at the Department of Foreign Affairs will be given extra money in the budget because she threatened to resign. Why can the Government not accept this all-party Opposition motion?

The Minister of State had the good grace to recognise we are sincere; I thank her for that patronising comment. No previous Government has had the kind of money she now has at her disposal. Only a couple of weeks ago, the Minister for Finance banked £1,000 million against the national debt. He should try telling that to the parents and children in the Gallery. We are only seeking a fraction of the amount lodged to pay off our national mortgage. The Minister of State, in her gratuitous and patronising contribution, stated the Government is accelerating the programme.

When Deputy Brian O'Shea approached me when I was Minister for Finance, stating it was necessary to carry out an assessment of need in order to determine the real picture on this issue, I was advised by officials in the Department to be wary. If the full picture were obtained, the Department would not have any defence and did not have any money to spend on services. We did not have the kind of money the Government has now.

Miss M. Wallace

The Deputy was the Minister for Finance.

Mr. Cowen

The Deputy presided over three budgets.

Mr. Quinn

It was only in the last budget that we had a current budget surplus. No previous Minister for Finance and no previous Administration has been in a position to bank £1,000 million and still have £500 million to give away on budget day. Capital gains tax was reduced by 50 per cent last year.

Mr. Cowen

That brought in more money.

Mr. Quinn

The Minister should spend that money where it is required. The real national debt this country has is to its people, to people who, through no fault of their own, enter into life with a handicap. Their parents and siblings carry that responsibility for their entire lives and parents are forced to wonder what will happen when they can no longer handle that burden. They wonder whether they can reasonably ask the siblings who have lived with the reality of mental handicap to care for their brother or sister. Understandably, parents give a great deal of time to the person with the mental handicap but they agonise over whether they do that at a cost to their other children. All of the Government's backbenchers — including those it bought on this side of the House — know the Government has the money to do something about this issue. Reinforced by this display of unity and his declarations of concern, the Minister should at least have the courage to look for the miserable extra few million pounds out of the £1 billion that was banked. I urge the Government and the absent backbenchers whose votes have been bought and who have not had the courage to come into the House to do what we ask. Previous Governments did not have the resources to do it.

Mr. Finucane

I am pleased to support the motion and compliment the parties which have attached their names to it and the Independent Members for supporting it. The Government should be magnanimous and accede to it. It should provide the £60 million being sought for mental handicap services.

The manager of the centre run by the Brothers of Charity in Limerick is a good friend of mine. He has been highlighting the difficulties being experienced in respite and residential care services. He told me recently that when the Garda Síochána broke into a house they found that the elderly mother of a woman with a mental handicap had been dead for at least 24 hours. There was no option but to admit to the centre the woman who had no understanding of what had happened. Elderly persons are worried about what will happen to their next of kin when they pass on. There was never a better time to respond to ease their pain. The motion is timely. The grudging attitude of Members opposite surprises me.

Mr. Durkan

The message of the carers in the public gallery is that they have laboured for too long on their own. The burden is getting heavier and their children older. If the Minister is of the view that there are greater priorities than those set out in the motion, he should ignore it. If not, he has the power to respond positively.

Mr. Shatter

The motion was tabled to focus on the recognised needs of those who suffer from a mental handicap and of their families and to seek all-party agreement that these should be addressed speedily and given the priority they deserve. It is proposed in recognition that previous Governments did not have available to them the capital and current funding necessary to provide the essential comprehensive services required to fully meet the needs in this area. It is our case that at a time of historic economic growth and when the Exchequer returns show a budget credit in excess of £1 billion we have a unique opportunity to put in place within a short period the vital residential, respite and other services required, the absence of which adds to the great burden experienced by those caring for a mentally handicapped child or adult.

All parties recognise the need for a £30 million national capital programme. We are saying that there should be an allocation of this sum at this time to facilitate putting in place by the end of next year all the residential facilities necessary as recommended in the critical reports published which highlight the essential needs of the mentally handicapped. It is the Government's case that it is acceptable to implement such a programme over a four or five year period. We disagree. It is the Government's case that the current budget allocation in this area is adequate. We disagree and are calling for at least an additional £30 million in revenue funding for new services in areas such as education, training, sheltered and supported employment.

The Fine Gael Party believes social justice demands, in the context of the unprecedented increase in revenue returns, that specific social initiatives be taken to improve the quality of life of many of those not currently benefiting from our unprecedented economic growth. Social patriotism demands in areas of deficiency that we reconstruct our health and education services and overcome the administrative, bureaucratic and institutional lethargy which traditionally is incapable of urgently addressing issues of social disadvantage. The case we are making for the mentally handicapped can also be made for the physically handicapped.

We hoped the debate would result in an agreement across the floor of the House to the terms of the motion and that this would result in the Government radically revising the timeframe within which the needs of the mentally handicapped would be catered for. The Government's amendment to the motion refers to the commitments outlined in the programme for Government and Partnership 2000. The Minister of State made a similar contribution. At the time the programme was put together the extent of the success of the economy was not appreciated nor was the level of Exchequer returns for 1998 correctly predicted. The response of the Minister and that of his colleague to the motion was extremely disappointing. It displays no understanding of the need for urgent action and the present day financial capacity to urgently act. It displays no understanding of the individual burden experienced by elderly persons in caring for mentally handicapped children, many of whom have no quality of life as a result of the pressures and strains experienced by them in providing everyday care for those who suffer from a mental handicap or disability.

The motion is not about whether the Government is committed to meeting the needs identified. It is about the Government recognising the urgency of those needs, identifying with and truly understanding the real pressures experienced by those families caring for the mentally handicapped and acknowledging that they have a right to a better life.

The Minister referred to what the Government is doing to meet the needs identified for "this population group". The use of such language betrays the reality that the mentally handicapped and their families are merely seen by the Minister as one of a variety of groups with needs which can be addressed over an extended period of years. While it is the Minister's job to assess objectively the needs in a particular area, it should not be his role to emotionally neutralise the everyday reality for those who require better services nor should he portray them as some anonymous population group as opposed to individual men, women and children who are experiencing unacceptable difficulties and strains in their daily lives. We need to humanise our politics. There is a need to move away from the institutional language used by the Minister.

It is the duty of Members to alleviate the difficulties of the mentally handicapped and their families and meet their vital needs with the minimum possible delay. The Estimates published today afforded the Minister a unique opportunity to address needs in this area. We have discovered that not only will the Estimates for next year not allow the Minister to implement the proposals contained in the motion but that £32 million made available in revenue funding this year by the Department of Finance remains unspent and will not be spent.

Mrs. Owen

Disgraceful.

Mr. Shatter

This money could be spent on the mentally handicapped.

Mr. Quinn

Incompetence.

Mr. Cowen

The Deputy had thousands of millions of pounds available to him.

Mr. Shatter

The failure to provide funds to meet needs in this area is extraordinary and indefensible. The report of the Commission on the Status of People with Disabilities quoted a submission made to it which stated that, "The level of service is poor because people with disabilities are a minority and have no worthwhile voice". It is the duty of Members not just on the Opposition benches but also on the Government and Independent benches to give them the voice to which they are entitled and demand that the additional £60 million sought in the motion to provide essential services, including residential and respite facilities, be made available without delay. They should immediately form part of the Government's programme for implementation before December 31 1999.

Amendment put.

The Dáil divided: Tá, 73; Níl, 71.

Tá

• Ahern, Dermot.
• Ahern, Michael.
• Ahern, Noel.
• Andrews, David.
• Ardagh, Sén.
• Aylward, Liam.
• Brady, Johnny.
• Brady, Martin.
• Brennan, Matt.
• Brennan, Séamus.
• Briscoe, Ben.
• Browne, John (Wexford).
• Byrne, Hugh.
• Callely, Ivor.
• Carey, Pat.
• Collins, Michael.
• Cooper-Flynn, Beverley.
• Coughlan, Mary.
• Cowen, Brian.
• Daly, Brendan.
• Davern, Noel.
• de Valera, Síle.
• Dennehy, John.
• Doherty, Seán.
• Ellis, John.
• Fahey, Frank.
• Fleming, Seán.
• Flood, Chris.
• Fox, Mildred.
• Gildea, Thomas.
• Hanafin, Mary.
• Harney, Mary.
• Haughey, Seán.
• Healy-Rae, Jackie.
• Jacob, Joe.
• Keaveney, Cecilia.
• Kelleher, Billy.
• Kenneally, Brendan.
• Kirk, Séamus.
• Kitt, Michael.
• Kitt, Tom.
• Lenihan, Brian.
• Lenihan, Conor.
• McCreevy, Charlie.
• McDaid, James.
• McGennis, Marian.
• McGuinness, John.
• Martin, Michél.
• Moffatt, Thomas.
• Molloy, Robert.
• Moloney, John.
• Moynihan, Donal.
• Moynihan, Michael.
• Ó Cuív, Éamon.
• O'Dea, Willie.
• O'Flynn, Noel.
• O'Hanlon, Rory.
• O'Keeffe, Batt.
• O'Keeffe, Ned.
• O'Kennedy, Michael.
• O'Malley, Desmond.
• O'Rourke, Mary.
• Power, Seán.
• Roche, Dick.
• Smith, Brendan.
• Smith, Michael.
• Treacy, Noel.
• Wade, Eddie.
• Wallace, Dan.
• Wallace, Mary.
• Walsh, Joe.
• Woods, Michael.
• Wright, G. V.

Níl

• Ahearn, Theresa.
• Allen, Bernard.
• Barnes, Monica.
• Barrett, Seán.
• Bell, Michael.
• Belton, Louis.
• Boylan, Andrew.
• Bradford, Paul.
• Broughan, Thomas.
• Bruton, John.
• Bruton, Richard.
• Burke, Liam.
• Burke, Ulick.
• Carey, Donal.
• Clune, Deirdre.
• Connaughton, Paul.
• Cosgrave, Michael.
• Coveney, Simon.
• Crawford, Seymour.
• Currie, Austin.
• D'Arcy, Michael.
• De Rossa, Proinsias.
• Deasy, Austin.
• Deenihan, Jimmy.
• Durkan, Bernard.
• Farrelly, John.
• Ferris, Michael.
• Finucane, Michael.
• Fitzgerald, Frances.
• Flanagan, Charles.
• Gilmore, Éamon. Gormley, John.
• Spring, Dick.
• Stagg, Emmet.
• Stanton, David.
• Timmins, Billy.
• Gregory, Tony.
• Higgins, Jim.
• Higgins, Joe.
• Higgins, Michael.
• Kenny, Enda.
• Lowry, Michael.
• McCormack, Pádraic.
• McDowell, Derek.
• McGinley, Dinny.
• McGrath, Paul.
• McManus, Liz.
• Mitchell, Gay.
• Mitchell, Jim.
• Mitchell, Olivia.
• Moynihan-Cronin, Breeda.
• Naughten, Denis.
• Neville, Dan.
• Noonan, Michael.
• Ó Caoláin, Caoimhghín.
• O'Shea, Brian.
• O'Sullivan, Jan.
• Owen, Nora.
• Penrose, William.
• Perry, John.
• Quinn, Ruairí.
• Rabbitte, Pat.
• Ring, Michael.
• Ryan, Seán.
• Sargent, Trevor.
• Shatter, Alan.
• Sheehan, Patrick. Shortall, Róisín.
• Upton, Pat.
• Wall, Jack.
• Yates, Ivan.

Tellers: Tá, Deputies S. Brennan and Power; Níl, Deputies Barrett and Stagg.

Amendment declared carried.

Question put: "That the motion, as amended, be agreed to."

The Dáil divided: Tá, 73; Níl, 71.

Tá

• Ahern, Dermot.
• Ahern, Michael.
• Ahern, Noel.
• Andrews, David.
• Ardagh, Seán.
• Aylward, Liam.
• Brady, Johnny.
• Brady, Martin.
• Brennan, Matt.
• Brennan, Séamus.
• Briscoe, Ben.
• Browne, John (Wexford).
• Byrne, Hugh.
• Callely, Ivor.
• Carey, Pat.
• Collins, Michael.
• Cooper-Flynn, Beverley.
• Coughlan, Mary.
• Cowen, Brian.
• Daly, Brendan.
• Davern, Noel.
• de Valera, Síle.
• Dennehy, John.
• Doherty, Seán.
• Ellis, John.
• Fahey, Frank.
• Fleming, Seán.
• Flood, Chris.
• Fox, Mildred.
• Gildea, Thomas.
• Hanafin, Mary.
• Harney, Mary.
• Haughey, Seán.
• Healy-Rae, Jackie.
• Jacob, Joe.
• Keaveney, Cecilia.
• Kelleher, Billy.
• Kenneally, Brendan
• Kirk, Séamus.
• Kitt, Michael.
• Kitt, Tom.
• Lenihan, Brian.
• Lenihan, Conor.
• McCreevy, Charlie.
• McDaid, James.
• McGennis, Marian.
• McGuinness, John.
• Martin, Micheal.
• Moffatt, Thomas.
• Molloy, Robert.
• Moloney, John.
• Moynihan, Donal.
• Moynihan, Michael.
• Ó Cuív, Éamon.
• O'Dea, Willie.
• O'Flynn, Noel.
• O'Hanlon, Rory.
• O'Keeffe, Batt.
• O'Keeffe, Ned.
• O'Kennedy, Michael.
• O'Malley, Desmond.
• O'Rourke, Mary.
• Power, Seán.
• Roche, Dick.
• Smith, Brendan.
• Smith, Michael.
• Treacy, Noel.
• Wade, Eddie.
• Wallace, Dan.
• Wallace, Mary.
• Walsh, Joe.
• Woods, Michael.
• Wright, G. V.

Níl

• Ahearn, Theresa.
• Allen, Bernard.
• Barnes, Monica.
• Barrett, Seán.
• Bell, Michael.
• Belton, Louis.
• Boylan, Andrew.
• Bradford, Paul.
• Broughan, Thomas.
• Bruton, John.
• Bruton, Richard.
• Burke, Liam.
• Burke, Ulick.
• Carey, Donal.
• Clune, Deirdre.
• Connaughton, Paul.
• Cosgrave, Michael.
• Coveney, Simon.
• Crawford, Seymour.
• Currie, Austin.
• D'Arcy, Michael. De Rossa, Proinsias.
• Mitchell, Jim.
• Mitchell, Olivia.
• Moynihan-Cronin, Breeda.
• Naughten, Denis.
• Neville, Dan.
• Noonan, Michael.
• Ó Caoláin, Caoimhghín.
• O'Shea, Brian.
• O'Sullivan, Jan.
• Owen, Nora.
• Penrose, William.
• Perry, John.
• Quinn, Ruairí.
• Deasy, Austin.
• Deenihan, Jimmy.
• Durkan, Bernard.
• Farrelly, John.
• Ferris, Michael.
• Finucane, Michael.
• Fitzgerald, Frances.
• Flanagan, Charles.
• Gilmore, Éamon.
• Gormley, John.
• Gregory, Tony.
• Higgins, Jim.
• Higgins, Joe.
• Higgins, Michael.
• Kenny, Enda.
• Lowry, Michael.
• McCormack, Pádraic.
• McDowell, Derek.
• McGinley, Dinny.
• McGrath, Paul.
• McManus, Liz. Mitchell, Gay.
• Rabbitte, Pat.
• Ring, Michael.
• Ryan, Seán.
• Sargent, Trevor.
• Shatter, Alan.
• Sheehan, Patrick.
• Shortall, Róisín.
• Spring, Dick.
• Stagg, Emmet.
• Stanton, David.
• Timmins, Billy.
• Upton, Pat.
• Wall, Jack.
• Yates, Ivan.

Question declared carried.

Mr. Shatter

The Government was saved by the Independents.