Dáil Éireann debate -
Tuesday, 14 Oct 2003

Vol. 572 No. 3

Residential Care.

Mr. F. McGrath

I thank the Leas-Cheann Comhairle for the opportunity to speak on this important issue.

I wish to strongly criticise the Government on its lack of real action in dealing with the crisis at St. Michael's House. People with intellectual disabilities are being forgotten again mere months after the Special Olympics, which is unacceptable. There has been a great deal of discussion about disability Bills and the rights of people. However, the people to whom I refer are being ignored by the Government.

Let us consider the facts. There are 548 people on the waiting list for St. Michael's House. Of these, 263 are categorised as priority and urgently awaiting an immediate placement. They account for 40% of the total number of people waiting for a residential place in the ERHA area. The people to whom I refer are adults whose parents are seriously ill or dead or who are elderly – in their 80s – and are unable to look after sons and daughters with intellectual disabilities. Some elderly parents are forced to accept services over 100 kilometres from their homes. I object to this and I strongly challenge the Government on this serious issue.

There are currently 21 service users out of home, mainly due to the death of the final care giver, who are urgently awaiting a permanent residential placement. In order to meet this immediate need, they have to rent accommodation and take on additional staff. It has also been necessary to book eight respite beds. The blocking of respite beds had regrettably resulted in a reduced service to other service users and their families. The need to develop these additional services without Government funding has placed considerable pressure on the finances of St. Michael's House. With no money available for the development of any day care services, it has been difficult to meet the needs of service users who have completed their education programme which is funded by the Department of Education and Science, namely, graduates from the short-term training centre and special national schools.

It has also been difficult to meet the needs of new referrals. The ERHA has allocated the additional funds to the three health board areas and I welcome that, as I welcomed its announcement during the summer. St. Michael's House has the longest waiting list for residential services of any organisation in the country. There are currently 548 service users on the residential waiting list. Of these, 263 are categorised as priority. These are urgent cases. These service users account for 40% of the total number of people waiting for a residential place in the ERHA area. No decision has been made by the health boards regarding the distribution of additional funds. The ERHA has requested the three area health board local development committees to submit a proposal prioritising those service users already placed in emergency residential care, for which there is no funding, and for young adults who have left school in June 2003 and now require a day service.

St. Michael's House is represented on the local development committees of all three area health boards. Through its involvement on these committees, St. Michael's House has continued to highlight the immediate need to fund permanent residential places for the 21 service users already out of home and for service users who are currently in crisis requiring immediate residential placement.

The need for funding for young adults requiring day places also needs to be highlighted. St. Michael's will also continue to highlight the needs of new referrals to the services, although it has not been specifically identified as a priority by the ERHA.

While I welcome the Minister's announcement to allocate additional funds for 2003, the campaign to secure adequate funds for 2003 has to continue. In order to meet the needs for residential services, we need to develop 85 new places each year for the next five years. Its ability to provide this level of expansion is conditional on Government funding.

I urge all Members to support my call. I was elected on a disability platform and was a member of the independent health alliance. I cannot stress sufficiently the importance that funding be made available in the forthcoming budget for the development of additional residential and respite places. I urge the Minister to act and to act now.

Mr. T. O'Malley

On behalf of my colleague, the Minister for Health and Children, Deputy Martin, I would like to thank the Deputy for raising the matter and giving me the opportunity to outline the position concerning the issue.

Since 1997, my Department has allocated significant levels of funding across the disability sector which has resulted in significant and unprecedented developments in the quality and quantity of the health-related services which are being provided to people with disabilities. In July 2003 additional revenue and capital funding totalling €50 million was made available to services for people with disabilities. Included in this figure, additional revenue funding amounting to €20 million is being provided with a full year cost in 2004 of €30 million.

Some €15 million was made available for services to persons with intellectual disabilities and those with autism to meet costs associated with emergency residential placements during 2003, the provision of day services for young adults who have just left school and some enhancement of health-related support services for children. Some €5 million was made available for services for people with physical or sensory disabilities to meet service pressures as identified by the Eastern Regional Health Authority and the health boards in consultation with other relevant agencies.

My Department has allocated capital funding amounting to €30 million to the Eastern Regional Health Authority and the health boards in respect of minor capital works for services for people with disabilities. This included €15 million for services to people with intellectual disability or autism and €15 million for services to people with physical or sensory disabilities. This funding will allow the authority and the health boards to address such areas as the backlog of maintenance, refurbishment, re-equipping, replacement of vehicles used within the services or works related to fire precautions and health and safety issues.

The provision of the revenue funding in particular will provide around 175 emergency places and over 600 day places and will enable the authority and the health boards to address key issues of concern which had been identified by the various representative groups. The allocation of an additional €50 million is further evidence of the Government's commitment to these services and to supporting people with disabilities and their families.

With regard to the matter raised by the Deputy, the Eastern Regional Health Authority states that it is aware of St. Michael's House having 263 of its clients requiring some form of residential care in 2003. Out of funding of €6.65 million this year, the ERHA states that it has commissioned, or is about to commission, 89 new residential places and give ten existing places extra funding to bring them to an appropriate level of care. It is anticipated that St. Michael's House will receive 24 new places at full-year costs of €1,754,120.

It is important to note that St. Michael's House is in the same position as other intellectual disability agencies in so far as they all have clients requiring residential care. Furthermore it must be noted that although 510 clients are awaiting some form of residential care, this does not imply that there is a crisis with regard to all of these clients. In fact as part of the provider planning process between the Eastern Region Health Authority and the providers, each provider is asked to estimate the number of emergency placements anticipated for the coming year. In 2003 St. Michael's House estimated that there would be 24 crisis cases in which the organisation would have to intervene by taking a client out of home. To date in 2003, St. Michael's House facilitated 17 such crisis or emergency placements and has been allocated full-year funding by the Eastern Region Health Authority to meet these costs. St. Michael's House has funding for seven more emergency placements to year's end.