Home Help Service.

I was forced to raise this issue as a result of a number of calls I received from distraught constituents at the weekend. The situation is totally unacceptable. A young man telephoned to tell me about his parents, an 80 year old man who cannot clothe himself and his 86 year old wife. They had five hours home care per week, one hour per day, but now that has been cut to two hours. What will people do if the home help is not available on Monday, Tuesday, Wednesday, Thursday and Friday when their families are not there? It is not realistic, sensible or constructive. Another person, who is a home help, wrote to me about the fact that her nine hours have been cut to three. The aged person she looks after has Alzheimer's disease and lives on her own. She does not know at times whether to get out of bed and she totally depends on her home help and on her neighbours. I spoke to the health board officials who were sympathetic. They said they would have to reconsider the issue. However, when I discussed the issue with them at length, I realised they would only consider it within the decimated budget for home helps and carers. They were not looking at the budget of administrators, but of those at the bottom of the ladder.

I do not make any apology for raising this issue in the House because this is where decisions are made. The Minister for Health and Children must provide an allocation if it cannot be found within the health board's budget. We cannot allow those who have given their lives to this country to be treated in this way. The people in the two cases I mentioned worked hard all their lives. They were not layabouts, but genuine family people. It is wrong that they are being treated in this way.

I have received several letters from people who are going into homes. One such letter states that all current subvention places are filled and that there is a waiting list in operation for subvention grants. It is difficult to understand how someone in desperate need of a home, who does not have any money or resources, could be put on a waiting list. Such people have been told their forms will be evaluated. However, if they try to fund their stay in a home, they are not entitled to a refund.

I also received a letter from a young woman who suffers from depression and who fell recently and injured herself. She wanted to get a taxi to attend a physiotherapy session. When she telephoned my office, my secretary contacted the relevant person. That person was nice to her, but she said there was no money left for taxis for people in need. How can that be possible in the month of February? What are we doing? The situation is desperate.

A number of people with intellectual disabilities have also written to me. They have been told that money has not been allocated to help them. I have received letters from people who are well off and from those who are not well off. A person with an intellectual disability is still suffering.

The most important letter I received came from a lady who looks after her Down's syndrome son. She stated that the level of civilisation of a society is often measured by the level of care accorded to its most vulnerable. While she welcomed the fact that successive Governments responded to pressure, she regretted the fact that it was necessary to take some cases to court. She gave the example of a person with a handicap having to leave at 7.30 a.m. to get to school because it takes two hours to travel 15 miles. That type of service for the disabled and the handicapped is not acceptable. As the parent of a young man with Down's syndrome, she is apprehensive about the present ruthless attitude of the Minister for Finance. She wants to know if the vulnerable will be expected to suffer again as a result of swingeing cutbacks or readjustments. She also wants to know if they, like the rest of us, will be asked to pay for the mismanagement of the country's finances. That is a plea from the heart.

I have received dozens of similar letters. Another example is that of a young man who wants help for his sister. This is an extremely important issue which must be dealt with.

I thank Deputy Crawford for raising this issue. I am pleased to take this opportunity to clarify the matter relating to the provision of health related services to people with disabilities, particularly to those in the North-Eastern Health Board region. The provision of health related services for people with disabilities, physical, sensory or intellectual, and for those with autism is a matter for the Eastern Regional Health Authority and the health boards in the first instance. My Department has since 1997 allocated significant levels of funding across the disability sector which has resulted in substantial advances in the quality and quantity of the health related services being provided to people with disabilities.

Additional funding of approximately €26 million has been allocated to services for persons with disabilities and those with autism in 2003 to meet the full year costs of 2002 developments and to further enhance the services in the sector. Some €13.3 million of this funding has been allocated for services for those with an intellectual disability, while €13 million has been assigned to those with physical or sensory disabilities. This funding is in addition to the significant revenue investment, amounting to €288 million, which has been made in these services in recent years and which is built into the ongoing budget base.

Approximately €100 million in additional ongoing revenue has been provided with regard to the maintenance and development of services to people with physical and sensory disabilities. Such services include residential, respite, home support services which includes personal assistance services, therapy services and day care services. A significant proportion of this funding, more than €20 million, has been provided specifically for home support services. A further €81 million has been provided in once-off grants for capital projects and issues such as the provision of technical aids and appliances.

The additional funding provided by this and the previous Government between 2000 and 2002 was used to put in place, in addition to a range of other services, over 900 new residential, 380 new respite and approximately 2,000 new day places for people with an intellectual disability and those with autism. Between 2000 and 2003, additional ongoing revenue funding of almost €17 million has been provided to the North-Eastern Health Board for the provision of health related services for people with disabilities and those with autism. Priorities for the allocation of funding available for the development of health related services are decided by the health boards in consultation with the regional co-ordinating committees for physical and sensory disabilities and the consultative and development committees for intellectual disability services. Voluntary sector service providers and advocates for people with disabilities are represented on these committees.

I understand the North-Eastern Health Board is undertaking a review in relation to the prioritisation of hours available for home help services and, in tandem, the development of agreed criteria with the intention of ensuring that priority is given to the most vulnerable groups – people with disabilities and older people.

That is the problem.

It is not intended that there will be any reduction of services to people with disabilities. The overall economic position in 2003 has had implications for all aspects of public investment and this is reflected in the Estimates and the budget adopted by the Government for 2003. Within this overall framework, however, two thirds of the additional funding available for non-capital investment in services has been allocated to the health services.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 6 February 2003.