Dáil Éireann debate -
Tuesday, 27 Jan 2004

Vol. 578 No. 4

Speech Therapy Service.

Dr. Cowley

I thank the Ceann Comhairle for allowing me to raise this matter on the Adjournment.

There are hundreds of children with special needs and several hundred in need of special speech and language therapy. There are three speech and language therapists in the Western Care Association area, which is not sufficient. The Western Health Board community care service does not cater for children with special needs, even though they have very special needs.

There appears to be a big turnover of speech therapists. They do not seem to stay to pass on their valuable experience gained working with Down's syndrome children. I wonder why they appear to drift into the private sector. There is a scarcity of speech therapists. Places have been increased to train more of them but the problem did not happen today or yesterday. Successive Governments are to blame for the deficit. Rationing occurs when resources are scarce. Pre-school is the stage where the speech and language service is concentrated. Whatever is available is concentrated in that area, which is not sufficient. It is patchy. The issue of speech therapy has been ongoing for a long time. The Government always had the power to do something but did not choose to do so.

I met the father of the child in question. The seven year old boy is unable to speak because of the failure of the Department to provide speech and language therapy for him, despite his family highlighting the issue for the past two and a half years and the fact that the Western Care Association has recognised that the treatment is essential since the boy was three years of age. A special assessment was carried out before the boy started school and he was deemed suitable for national school. The aim of the last assessment was to assess his progress from infants to high infants on his ability to learn. He has this ability. During his earlier years he received a speech and language therapy service from the Western Care Association for one hour per week for four weeks. No service was provided for the next four weeks due to the scarcity of speech and language therapists. What a lousy service.

His father was and is still very concerned for his son. He hears him speak and realises that he needs speech therapy if he is to have a chance to develop to his full potential as a person. When such children reach a certain age, no matter how bad they are, they will no longer receive a speech and language therapy service because of the scarcity of speech and language therapists. His father would like him to have speech therapy to give him a chance to realise his full potential in order that he can be understood outside his close family. Currently that is not the case. He speaks too fast and if he is to be understood he will need training and speech and language therapy, which is not available.

This boy was born in the United Kingdom and when he and his parents came to Ireland they found the services here completely different from those at home. They found one has to fight for everything in this country. The child's parents do not want him to be a forgotten person but they fear this will be the case. The father does not begrudge the Government its jet, spike or stadium; all he asks is that the Government gets its priorities right and ensures that his son gets a chance because it will be too late in a few years. He is told everything will be satisfactory in ten years' time but the window of opportunity will be closed by then.

The Minister should act now to recruit speech and language therapists, from abroad if necessary. The lad in question deserves no less as a citizen of Ireland. He should be valued and allowed realise his maximum potential.

Mr. Callely

The way Deputy Cowley presented his case is a little unfair. To achieve a balance, I wish to address some of the broader issues and then deal with the specific issue. I thank the Deputy for raising it and for giving me the opportunity to outline the position.

Since 1997, my Department has allocated significant funds across the disability sector, which has resulted in significant and unprecedented developments in the quality and quantity of the health related services that 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 was additional revenue funding amounting to €20 million in 2003, with a full-year cost in 2004 of €30 million. A sum of €15 million was made available for services for persons with intellectual disability and those with autism to meet costs associated with emergency residential placements during 2003, the provision of day services, in particular for young adults who have just left school, and some enhancement of the health related support services for children. In addition, in December 2003, a further minor capital grant amounting to approximately €10 million was allocated by my Department to the service providers in respect of services to people with intellectual disability or autism.

The provision of the revenue funding, in particular for services to persons with an intellectual disability and those with autism, will provide around 175 emergency places and over 600 day places. It will enable the service providers to address key issues of concern that have been identified by the various representative groups.

In the budget an additional €18 million was allocated by my colleague, the Minister for Finance, to my Department specifically for intellectual disability services. These moneys will be used to provide additional emergency placements and extra day services, especially for school leavers, and to enhance the health related support service for children. Despite this very significant investment, demographic factors are contributing to growing waiting lists for residential services, in particular, even though the number of people in receipt of services, including full-time residential services, continues to increase.

The increased birth rate in the 1960s and 1970s has resulted in large numbers of adults in their late 20s and early 30s requiring full-time residential services. In addition people with an intellectual disability are living longer than those of previous generations, adding to the need for services. This has also been the international experience in service provision to this population.

One of the major difficulties facing the health services in delivering support services to people with disabilities is the shortage of certain professionals such as speech and language therapists, occupational therapists, physiotherapists and psychologists. Significant progress has been achieved in boosting the number of therapy training places. Last year, the Minister for Education and Science and the Minister for Health and Children announced 150 additional therapy training places in speech and language therapy and occupational therapy.

There has also been a concerted overseas recruitment drive on behalf of all health boards, the introduction of a fast-track working visa scheme for health and social care professionals and the streamlining of procedures for the validation of overseas qualifications. The success of these measures is reflected in the increases in speech and language therapists and occupational therapists employed in the public health service over the three year period to the end of 2002, with a 73% increase in occupational therapists and a 33% increases in speech and language therapists. However, I recognise that there is still a shortfall.

With regard to the details supplied by the Deputy. responsibility for the provision of services is a matter for the relevant health board. From inquiries made by my Department, I understand that the child concerned is being provided with the necessary therapies on a monthly basis.

Dr. Cowley

They are not adequate.

Mr. Callely

This forms part of the community development plan for the child concerned. This plan has been developed in consultation with the relevant health care professionals. I understand that the child's family has been fully briefed and engaged regarding this plan. Furthermore, it is the opinion of the relevant health care professionals that the child is receiving an appropriate health care service.

Dr. Cowley

I would not be here if he was.

Mr. Callely

If the Deputy's information differs from mine, I would appreciate if he should bring it to my attention. I will certainly investigate the matter and inform the Deputy accordingly. I hope the information I have provided is of some assistance to the Deputy.

Social Wefare Benefits.

Mr. Durkan

The matter I wish to raise refers to a social welfare query I made earlier. I see that the Minister of State opposite is the Minister for everything tonight, from education to health to social welfare. I do not wish to be disrespectful, but I remind Ministers with responsibilities for particular areas that they should be present at the Adjournment debate when their areas of responsibility are under discussion.

The individual whose case I wish to raise was, unfortunately, laid off work before Christmas, although he did not seek to be laid off. It was a great disappointment because obviously the finances suffer as a result. There are greater calls on the family finances at Christmas than at any other time.

The man in question has a wife and three children. Given the nature of his previous employment, he was assessed as having means derived from this employment. This is bizarre because I believed we had addressed a long time ago in the Department of Social and Family Affairs. It is an issue I have taken up before, although it has raised its ugly head once again in that the man in question was deemed to be in receipt of part of the income he earned last year when determining his entitlement to a social welfare payment this year.

I know money lasts for a long time if one looks after it and I am sure that there is a clear recognition of the needs of people in the Department of Social and Family Affairs, but one must question why it is expected that a person who had an income in the year ending 31 December 2003 — it was October in the case of the man in question — could be deemed to still have benefit from that income in January 2004.

This matter goes back to the poor law era, when people were deemed to be in good standing financially unless and until they were in penury. I can anticipate the Minister of State's reply and, indeed, I could write it. Although he is genuine, diligent and anxious to pursue issues presented to him, there is no excuse for attempting to pretend that the individual in question has income derived from the income he spent last year. That income is gone, last year was lived, last year's summer holidays are gone, the roses of last year are gone and even the snow of last year is gone. Expecting the man to live on last year's income this year is daft. I will be taking up this issue again if it is not resolved satisfactorily.

I know the Minister of State will state in his reply that the applicant was offered an option to appeal, which he was in a half-hearted way. This matter should not involve such an option. I also know deciding officers are involved. They must decide on the basis of the information available at the time but they make some peculiar decisions. I remind those who would say that the decisions are always correct of the decision made on equality payments in the 1980s — the issue would have cost £9 million to resolve in the beginning and £20 million a few years later but it eventually cost the State €320 million.

I ask the Minister to examine this genuine case. This man is honest and straightforward. He is not working and wants to work, but as soon as he finds employment he will be removed from the live register. The Minister should investigate the matter to ensure the nonsense applying at the moment does not continue and that his wife and three children receive the benefits to which they are entitled.

Mr. Callely

I will respond to the Deputy on behalf of the Minister for Social and Family Affairs, Deputy Coughlan, who is unavoidably absent on Government business. In response to Deputy Durkan's remark, I would not be the first to throw stones about making mistakes. We all do it, although we try not to. The Department of Social and Family Affairs and its officers have a difficult and challenging job in making decisions and usually get it right.

As the Deputy is aware, the termination of entitlement to unemployment assistance or any social welfare payment is not a function of the Minister for Social and Family Affairs. Under the relevant legislation, these are matters for deciding officers and, in the event of an appeal, for appeals officers appointed in accordance with the provisions of the Social Welfare Acts. There is a statutory obligation on all claimants for an unemployment payment to satisfy the conditions for entitlement to the payment. For unemployment assistance, a claimant must satisfy a means test, be unemployed, capable of, available for and genuinely seeking work.

In the case referred to by Deputy Durkan, the person concerned applied for unemployment assistance on 8 October 2003. His case was investigated by a social welfare inspector on 23 October 2003. On receipt of documentation and information which had been requested by the inspector, a report and assessment were completed on 5 December 2003. The legislative provisions governing the assessment of means from self-employment for the purpose of unemployment assistance are contained in Part I of the Third Schedule to the Social Welfare (Consolidation) Act 1993. Under these provisions, the income of a person, as outlined by Deputy Durkan, in the absence of other means of ascertaining it, is taken to be the income received during the year immediately preceding the date of calculation.

I agree with some of the points raised by the Deputy, who was once Minister of State at the Department of Social Welfare.

Mr. Durkan

That is right, and I challenged that view.

Mr. Callely

He had the opportunity to change the regulations.

Mr. Durkan

I did it.

Mr. Callely

Where there is no other way to establish the likely income of a claimant in the coming year, the net earnings during the year preceding the date of the claim may be taken, provided the deciding officer is satisfied that similar opportunities for self-employment will arise in the coming year. It is a difficult call to make. In this case, however, the claimant was self-employed in construction and allied trades for a number of years. From information supplied by the claimant, his earnings for 2003 were calculated to be €8,132.

Mr. Durkan

The same as last year.

Mr. Callely

This figure was used when deciding the claim. The inspector was satisfied that self-employment was likely to continue and on that basis he assessed weekly means as being €156.

Mr. Durkan

Based on last year's income.

Mr. Callely

Notification of this decision and the right to appeal was issued to the claimant on 13 January. The claimant is currently being paid unemployment assistance at a weekly rate of €118.60, which represents the full rate payable less means of €156.

It is open to the person concerned to appeal the decision of the deciding officer to the appeals office but he has not done so to date. It is my desire, and that of the Minister and others involved, that if the person wants to lodge an appeal and bring his case forward for a decision, he should do so as quickly as possible. I am assuming that Deputy Durkan wishes the subject matter of this debate to be treated as an appeal.

Mr. Durkan

I would love that. I will go down myself to the appeal as well.

Mr. Callely

The Department will now arrange this. It will, however, be necessary for the claimant to make known in writing the reasons or grounds for his appeal. Deputy Durkan will doubtless assist him with that. I assure the Deputy that the Department will be in contact with the claimant in the near future to process his appeal.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Wednesday, 28 January 2004.