Adjournment Debate.

Services for People with Disabilities.

Mr. Naughten

I thank the Ceann Comhairle for selecting this issue for discussion. There are currently serious deficiencies in the services available in the Ballinasloe area for people with developmental and learning disabilities ranging in age from the very young to the over sixties. In many cases their parents and carers are getting older and cannot continue to carry the can on behalf of the State, which has failed in its responsibility to provide much needed services.

In 2005 the Brothers of Charity Galway Services, which provides services in the Ballinasloe area, had a funding deficit of €1.8 million. The deficit was a direct consequence of the need to put in place additional staff to meet emergency situations which arose over the year.

One example of the type of emergency case which had to be dealt with is that of Michael, a young man in seven-day, 24-hour residential accommodation which he shares with four young adults, each of whom has a severe intellectual disability. During the past year Michael went through an extremely difficult period of challenging behaviour, with the result that it was necessary for the safety of Michael, the other young adults with whom he shared his accommodation and the staff to move him to accommodation on his own and provide him with 24-hour wraparound staffing. This successfully addressed the issue in Michael's case. However, the full cost to the service was €280,000 per year, a cost which was entered into with the clear understanding of the HSE western region.

While everybody fully expects emergencies to arise in the course of each year and the Brothers of Charity can cope with approximately three or four such emergencies per year, in the past eighteen months they have had to deal with approximately 17 such emergency cases, which has led to a €1.8 million funding deficit. The Health Service Executive and the Department of Health and Children are fully aware of the situation, yet the Brothers of Charity received additional funding for these emergency cases amounting to only €300,000. This is a full €1.5 million short of the actual cost, which has had a direct impact on day-to-day services for other clients. I call on the Minister for Health and Children to make immediately available the additional resources required for these emergency services, to provide the €1.5 million to cover the 2005 overspend and to address the current service deficits in theBallinasloe area.

These deficiencies are not just confined to one age group or segment but are evident across the board, as is clear from the following examples. In-home support provides a flexible respite service for families within their own homes. A number of families are on a waiting list for this service but at present it does not extend to adults due to the limited budget available. If the budget for the children's respite service based at Ashtree House was increased, it could offer the service to more children within the area who are on a waiting list. There is currently a waiting list tor the adult respite service, which is funded on part-time basis at present. If funding was made available, the half-time posts could be made full-time and it would be possible to offer a more comprehensive service and would ensure that the Brothers of Charity are in a position to respond to crises.

The residential service requires funding to be made available so that the five-day service could be extended to a seven-day residential placement to meet the needs of residential clients. The elderly programme requires extra funding for a full-time care assistant. With regard to the Springfield child development centre, if extra resources were allocated and staffing hours increased, it would be possible to bring additional children into the service and increase the number of days children avail of facilities in the centre.

These are basic funding needs in the Ballinasloe area. The services cannot be developed, first, as there is a deficit of €1.5 million from the budget for 2005; second, as the deficit is not being funded in 2006; and third, as additional funds are needed to develop these services into the future.

The Brothers of Charity provide an excellent service in Ballinasloe. They have traditionally provided that service not only to the children of east County Galway but also to the children of south County Roscommon. I implore the Minister to review this situation and ensure that the basic funding is provided. Elderly parents in these communities have provided the services for their children for many years. They want the State to assume its responsibilities and provide adequate funding for these services.

Minister for Community, Rural and Gaeltacht Affairs (Éamon Ó Cuív)

I thank the Deputy for raising this important issue. On behalf of the Tánaiste and Minister for Health and Children, I am happy to have the opportunity to address the issue raised by Deputy Naughten as it provides an opportunity to outline to the House the position regarding the additional funding provided for services for children and adults with disabilities in 2006. Under the multi-annual investment programme 2006-09, which is part of the national disability strategy, additional funding amounting to €51.5 million is being provided by the Government in 2006 to meet costs associated with the provision of certain specific high profile disability services. With regard to services to persons with intellectual disability and those with autism, this includes 255 new residential places, 85 new respite places, 535 new day places and the continuation of the implementation of the transfer of persons with intellectual disability and autism from psychiatric hospitals and other inappropriate placements.

In addition to the services referred to above, further additional funding of €22.5 million is also being provided in 2006. This funding has been allocated to enhance the multi-disciplinary support services for children and adults with physical, sensory and intellectual disabilities and those with autism, and to address core underfunding and staffing issues in services for people with disabilities provided by the voluntary sector. Capital funding amounting to €45 million has also been provided in 2006 to put in place the infrastructural supports associated with the above mentioned developments.

The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes the responsibility for the funding of new or enhanced levels of health and personal social services.

On the matter raised by the Deputy, the Health Service Executive has informed the Department of Health and Children that it is its policy to provide high quality services to people with disabilities in a timely, efficient and cost-effective manner within the resources available. The Health Service Executive further states that the planning and development of services to meet emerging needs is carried out by it at local level in partnership with all stakeholders and within the context of the totality of need in any geographical area. Service requirements in the Ballinasloe area are part of this consultation process and are considered by the Health Service Executive in line with agreed structures and resource allocation mechanisms.

Mr. Naughten

That response is an insult. It did not address one point.

Sports Capital Programme.

Mr. Crawford

The failure of Government to lead the funding necessary for the scouting project at the Castle Saunderson estate on the Clones to Cavan road along the Border must be explained to this House and to Scouting Ireland. As the letter from the company secretary stated: "While large amounts of funding were secured from donors and commitments received from Government and statutory agencies, the project itself was unable to raise the necessary matching funding within the required timeframe." It is strange that this issue should arise at a time when major questions are being raised by the Government over the Ulster Canal, another truly cross-Border project. The Ballybay Development Association wetlands project was not even viewed by the relevant Government authorities and yet was refused, while at the same time the Minister for Foreign Affairs issued a major statement advising that everybody must get involved and make sure that proper cross-Border projects are included in the national development plan for the next six years, which is now being developed.

Is it realistic for the Minister to request such a move when there has been clear Government inaction on the three most relevant cross-Border projects? The Ballybay wetlands project would involve all the schools of the region, North and South. The Ulster Canal would revolutionise tourism and has the backing of all sections of the community. The provision by Scouting Ireland of a jamboree structure at Castle Saunderson for the youth of the 32-county scouting organisation would bring enormous wealth to this hard-pressed Border area.

The Taoiseach visited the site in very difficult weather conditions. American donors and others were totally committed to the project. The cross-Border organisations are committed, yet once again the Government, with the exception of a small start-up grant, does not seem to understand the needs of the area. I realise no horse or greyhound tracks or other such activities are proposed and it is only for young people. However, I remind the Minister that 100% funding was provided for Punchestown without any evaluation. I understand generous grants were given in the Dundalk region for all-weather racing tracks. I urge that our sons and daughters in a truly cross-Border community project be reconsidered and that the necessary funding be provided. Some €3 million to €4 million would suffice and such money spent on encouraging our young people to take part in sport would more than be paid back through savings, not only in our health budget but also in Garda and security since young people would be doing something constructive and positive rather than causing problems.

Councillor John Scott, who is the chairman of Belturbet Town Council, like many others has been involved in scouting all his life and he, together with all his fellow town councillors, regardless of politics, wants this project funded and delivered. The intention was to open a peace and reconciliation youth activity centre on the 103-acre estate with lakes, rivers and forestry already on site. The site has an old church, castle and roadways.

In the past nine years the scouting organisations have come together on an all-Ireland basis. People on their behalf made contacts in the US for donations. They were in discussions with INTERREG, IFI and PEACE, all of which came on board. However, as happened in the Ballybay project, neither Fáilte Ireland nor any other Government body treated the project seriously. The Government must take action on the issue.

I am glad that the Minister for Community, Rural and Gaeltacht Affairs is here this evening as he has moneys through various funds to address the issue. I hope the money he spends is spent as well as it would be spent on this project. This is a golden opportunity for peace and reconciliation. It would certainly be a different situation from Dublin on Saturday.

Éamon Ó Cuív

I thank the Deputy for raising this issue. He also raised a number of other issues. It would be very wrong for me to upstage Deputy Connolly regarding the wetlands. As the Deputy is aware I am working very hard on the issue of the Ulster Canal and would be as committed to it as is Deputy Crawford. I hope all of us working together can progress the project.

I am replying on behalf of the Minister for Arts, Sport and Tourism, Deputy O'Donoghue. The funding available to him is for clearly identifiable programmes relating to sport, arts, culture and tourism. Under the national lottery-funded sports capital programme operated by the Department of Arts, Sport and Tourism, grants are awarded to sporting clubs and organisations and to voluntary and community groups for the development of sporting and recreational facilities. This programme is the primary means of financing the sporting infrastructure of the country and is administered on an annual basis. A total of almost €395 million has been allocated in sports capital grants to over 4,900 sporting projects since 1998. This funding has been of enormous benefit to the development of sport in this country.

The focus of the programme is the development of sport and recreational sport facilities. I understand the Castle Saunderson project involves the proposed establishment of a permanent national scouting jamboree site and it has a very small sporting element, being primarily a youth facility. An application on behalf of the project was submitted under the 2002 sports capital programme but was unsuccessful because of the minuscule sporting element in a project which at the time was costed at more than €8 million. In 1999 the then Minister for Tourism, Sport and Recreation, Deputy McDaid, met representatives Scouting Ireland, the promoters of this ambitious project, and explained to them that the project was not one suitable for consideration for funding under the sports capital programme. Scouting Ireland has not submitted a subsequent application for the project to the programme since 2002.

I have been informed by my colleague, the Minister of State with responsibility for youth affairs, Deputy de Valera, that a memorandum was received earlier this week for the project which states that the project, as originally envisaged, would require funding of approximately €10.7 million in phases 1 and 2. I have been advised that there are no funds available in the Department of Education and Science for funding of capital works of this level.

The Minister for Arts, Sport and Tourism has also contacted the Minister for Finance, Deputy Cowen, regarding possible sources of funding for the project from the Department of Finance and he has advised that the project may be able to apply for funding under the EU-funded PEACE II cross-Border programme. Last year PEACE II was extended for another two years, which means that spending under the programme can now occur until 2008. The Department of Finance stated that a further programme, PEACE III, will cover the 2007 to 2013 programming period. The Castle Saunderson project is advised to contact the special EU programmes body in Belfast for further information on the PEACE programmes.

Unfortunately, for the reasons outlined in the early part of my response I regret that the Minister is unable to offer any assistance towards the project as it falls outside the nature of projects for which funding is provided by the Department of Arts, Sport and Tourism.

Mr. Crawford

The Taoiseach visited the site and has overall responsibility.

Grant Payments.

Mr. Connolly

I thank the Ceann Comhairle for selecting this item for discussion. I hope the Minister is again responding on behalf of the Minister for Arts, Sport and Tourism, Deputy O'Donoghue, as I believe the matter is more relevant to that Minister.

Éamon Ó Cuív

The matter was allocated to me.

Mr. Connolly

I believe it is more relevant to tourism. An application was made to Fáilte Ireland on behalf of a voluntary organisation, which in the previous five years spent €500,000 of its money on this eco-tourism project, which complements the school curriculum very well. All schools in the neighbouring counties have expressed a keen interest in the project. There is a demand for such a project with the imminent introduction of the mandatory ecology practical projects for the junior and leaving certificate biology and geography courses. It has the capacity for cross-Border co-operation in attracting school students and other visitors from across the Border.

The grant aid sought has been fully indemnified enthusiastically by Monaghan County Council for the lifetime of the grant, which cannot be ignored. Private investors are involved and are willing to row in with a companion project to build eight ten-bed hostels there at a cost of €3 million. If the private investor believes a market exists, we cannot ignore it. We need to reconsider the project critically and objectively. The promoters are seeking fair play and due process. I wonder how we can ever develop or increase tourism in County Monaghan without projects to attract people. Tourism is currently worth about €4 billion annually, but County Monaghan gets a mere 0.25% of that. We also know that tourism is a diminishing market that is becoming more short term and tends more towards attracting people to cities.

I wonder what this BMW thing is all about, given that our region never seems to benefit from it. As Deputy Crawford pointed out, often only lip-service is paid to cross-Border projects such as those at Castle Saunderson, the Ulster Canal or the Ballybay wetlands project. The people in Fáilte Ireland seem to be untouchable and unanswerable to the democratic process.

Ms Harkin

I thank the Minister for the opportunity to put on the record of Dáil Éireann issues relating to the Ballybay wetlands project.

The overall context of the motion is that tourism revenues and visitor numbers in counties Monaghan and Cavan are, if not the lowest, certainly among the lowest in the entire country, while there is a serious underspend on tourism projects in the BMW region with much of the funding being diverted elsewhere. It is therefore reasonable to expect that every help and assistance should be given to good and sustainable tourism projects in County Monaghan.

In my opinion, the Ballybay wetlands project is a good development with a hugely committed development association working to ensure its success. Of course my opinion — which is just an opinion — does not count, but perhaps Fáilte Ireland could take into account the opinion of others, such as the International Fund for Ireland, which has offered substantial funding for the project and Area Development Management-Combat Poverty Agency, ADM-CPA, which has provided funding for a worker for two years. It might also take account of the opinions of Monaghan County Council, which has totally indemnified the project, and of the Department of the Environment, Heritage and Local Government, which has approved the legal agreement between Monaghan County Council and Ballybay Development Association. All those experts, groups and organisations have been willing to support the wetlands project, but Fáilte Ireland has not been able to come on board with the final piece of the jigsaw to start this worthwhile and much needed project.

I fail to understand why Fáilte Ireland will not accept the bona fides of Monaghan County Council and the Department of the Environment, Heritage and Local Government. Perhaps the left hand does not know what the right hand is doing or perhaps the left hand is just ignoring the right hand deliberately. Whatever is happening, Ballybay wetlands project is in the middle and the project could be lost just because one agency will not take the word and assurances of another.

I am not sure what the Minister's role in the situation is, but we cannot continue to allow a community group to find itself in the middle between, on the one hand, a county council and the Department of the Environment, Heritage and Local Government and, on the other, Fáilte Ireland. The community finds itself with no redress and no way out. That is just not acceptable. I do not know what the Minister can do, but someone must do something to move the situation forward.

Éamon Ó Cuív

I thank Deputies Connolly and Harkin for raising the issue. Senator O'Brien brought me one day to see the wetlands, but as someone who lives beside Lough Corrib and Lough Mask I was, I admit, a little bit disparaging about the lake. However, he forgave me because of the good spirit in which I made my remarks. It was a good time for the said Senator.

I have a bit of a problem tonight because the motion before us is "To discuss the funding of the Ballybay Derrvalley Wetlands Centre Project". To be honest, the matter was sent to my Department for answer because we presumed that the motion related to the application made under the Leader programme. I cannot throw any light on the application made to Fáilte Ireland. I suggest that the Deputies table a question to the Minister for Arts, Sport and Tourism to ask why the grant has been held up.

Mr. Connolly

We wanted the Minister for Arts, Sport and Tourism to reply to the motion.

Éamon Ó Cuív

My problem is that Deputies now have a copy of the speech I was going to read. They will already know the background to the projects, so I will skip the first page.

As the Deputies will know, when the Leader company in Cavan-Monaghan, the Cavan-Monaghan Rural Development Co-operative Society, evaluated the project in February 2004, it considered the project to be highly innovative and in line with the aims of the Leader programme. Clarification on the sources of the balance of funding was sought before a final recommendation to the board could be made. When the Ballybay Development Association clarified the proposal in August 2004, the amount of Leader funding sought was €65,000, out of a total cost of project of €915,000 excluding the site costs.

I understand from the local Leader company that Ballybay Development Association was at the time trying to secure additional funding for the project. The project secured €340,000 from the International Fund for Ireland but other applications for funding to the National Lottery and Fáilte Ireland were unsuccessful. The difficulties in raising additional funding for the project have meant that Cavan-Monaghan Rural Development Co-operative Society has been unable to allocate funding. The society has worked closely with Ballybay Development Association in the past on this and other projects, including the allocation of €20,000 for enhancement work in the Ballybay town environs, and it hopes to do so again.

It is open to the Leader company, subject to funds being available, to provide additional funding for the project. The development association should be able to go back to the Leader company. However, I cannot in any way influence the decision of a Leader company — the matter is its call — but that option is open to the group.

Mr. Connolly

The Minister seems to be sending the group to Leader for the full amount, but there is a vast difference in the amounts of money being requested. Leader can give only about €67,000, whereas the project is worth €800,000.

Éamon Ó Cuív

I can only suggest to the Deputy that, if he wanted to ensure that the Minister for Arts, Sport and Tourism replied to the motion, he should have tabled a motion to discuss Ballybay project's application to Fáilte Ireland. Had he done that, we would have known where to go looking. We were looking for a needle in a haystack and, unfortunately, we found the wrong needle.

Mr. Crawford

Fáilte Ireland has not even looked at the project.

Health Services.

Mr. Kelleher

I thank the Ceann-Comhairle for allowing me this opportunity to speak about orthodontic treatment in the Health Service Executive's southern region.

I raise this matter to highlight the plight of the thousands of young people in the southern region who are being denied orthodontic treatment within a reasonable timeframe. In some situations people are waiting up to three years for assessment and a further number of years before they receive treatment. It is wholly unacceptable that parents and young children are required to wait for so long.

Without a doubt the issue of orthodontic services has been debated ad nauseam in various committees of the Houses of the Oireachtas, including the Joint Committee on Health and Children which heard from experts on the issue in 2002 and 2005. However, we seem to have an unfortunate problem in Cork in that the HSE seems unable to provide to our young people there the services that are provided in the rest of the country. It is time to address the issue in a serious and professional manner.

I am not quite sure what the problems in Cork are but Dr. Ian O'Dowling, the consultant orthodontist in St. Finbarr's Hospital, has highlighted on numerous occasions, both privately to political representatives and openly to the public at large, that insufficient resources are being made available. A lack of training facilities has resulted in the region being unable to provide orthodontic services. Given that we have a dental training hospital attached to the Cork University Hospital, I feel we should take the opportunity to explore that as an avenue for addressing the problem. We need to ensure that the university hospital has the resources to provide adequate training and upskilling to ensure we can deliver services to those who most need them.

Dr. O'Dowling told Cork's Evening Echo:

In the past two weeks I received a call from a teenage girl's mother who said her daughter is suffering from depression and is on anti-depressants, as she is being bullied at school over her teeth.

Like Dr. O'Dowling, as a public representative over the past 14 years I have received similar phone calls from parents who, in exasperation, have gone to a private provider simply because their son or daughter has suffered psychologically — either by being bullied and intimidated at school or because they have low self-esteem — because they have been unable to receive proper orthodontic care.

I hope the Minister will convey to the Minister for Health and Children my genuine belief that, rather than engage in finger pointing, we need to resolve the issue. I do not know what the difficulties are in Cork, but there have been difficulties. Dr. O'Dowling has stated his case. Although appointments have been made to the dental hospital, those have been short term and we are still left with only one consultant orthodontist. It is time that we made a serious decision to address the chronic problems of orthodontic care in the former Southern Health Board region.

Some might say orthodontics is unimportant but some people have severe dental problems for which surgery is required, such as disproportionality of the jaw and crowding of teeth. All those issues create great problems for the individual concerned.

It is not good enough that we have 4,000 people waiting for assessment and another awaiting 3,500 treatment. Particularly when children are vulnerable, forming their identity, or going through their teenage years, this issue is of paramount importance. It affects their mental and physical well-being socially and in school with regard to dental and oral hygiene. I hope the Minister can take back my message that we must address this issue quickly.

I have already mentioned the fact that we have a dental hospital. Training is very important there. If patients were treated there it would facilitate the upskilling of those providing the treatment. If there is an issue regarding St. Finbarr's — and Dr. Ian O'Dowling says that he is the only consultant orthodontist — an appointment should be made immediately to assist and help him in addressing those problems. He has commented publicly on numerous occasions. I do not know who was right or wrong, but I know that thousands of children in the former Southern Health Board region are suffering because of the lack of orthodontic services. That is wholly unacceptable.

Éamon Ó Cuív

On behalf of the Tánaiste and Minister for Health and Children, Deputy Harney, I am happy to address the issue raised by Deputy Kelleher.

Under the Health Act 2004, provision of orthodontic treatment to eligible persons in the southern area is the statutory responsibility of the Health Service Executive, HSE. The Tánaiste and Minister for Health and Children is aware of the waiting list for orthodontic treatment in the HSE southern region. It has been noted that some improvement has been made there, with a decrease of 555 in the assessment waiting list and of 1,230 in the treatment waiting list.

At the end of September 2005 almost 24,000 patients were receiving orthodontic treatment in the public orthodontic service. Over twice as many patients are getting orthodontic treatment as are awaiting treatment. More than 7,000 extra patients are receiving treatment now compared with four years ago. That tangible improvement will be further enhanced as the HSE develops the orthodontic services.

Developing the quality, standards, treatment capacity and outcomes of our orthodontic services in a sustainable way is an objective shared by the Tánaiste, the Department of Health and Children and the HSE. I believe that it will be supported by all clinicians and professionals involved in the public orthodontic services. To ensure best use of resources and develop treatment capacity in a sustainable manner, guidelines were introduced by the Department of Health and Children to enable the HSE to prioritise resources for those with the severest orthodontic conditions.

The Joint Oireachtas Committee on Health and Children carried out a review of orthodontic services that culminated in 2002 in the publication of its report, The Orthodontic Service in Ireland. The Joint Oireachtas Committee also published a follow-up during 2005. The Department, in conjunction with the HSE, is considering each of the recommendations set out in the report of the Joint Oireachtas Committee. A range of measures to enhance the orthodontic services, both nationally and in the HSE southern region, has already been taken, and further improvements can be anticipated.

The grade of specialist in orthodontics has been created in the HSE's orthodontic service. The creation of that new grade has attracted orthodontists to work in the health service on a long-term basis. Over the last four years, the Department and the HSE have funded 22 dentists from various HSE areas for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. A further four public dentists commence specialist training in October 2006. Those additional trained specialists will play a vital role in increasing the numbers in treatment and reducing waiting times. No one should have to wait any longer than necessary for clinically needed orthodontic treatment.

The Department's commitment to training development is manifested in the funding provided for the training of specialist clinical staff and the recruitment of a professor in orthodontics for Cork Dental School. That appointment at the school is facilitating the development of an approved training programme leading to a specialist qualification in orthodontics.

In recognition of the importance of that post at Cork Dental School, the Department has provided €2.7 million to the school to make further substantial improvements to training facilities there for orthodontics. That project has seen the construction of a state-of-the-art orthodontic unit and support facilities; it will support an enhanced teaching and treatment service for the wider region under the leadership of the professor of orthodontics. Cork Dental School has advised the Department that training will commence at the start of the next academic year, October 2006. As part of the training programme, orthodontic treatments will be provided at the dental school, and it is envisaged that this will have a further positive impact on waiting list numbers in the southern HSE area.

Orthodontics is unique in that the treatment period for a child is between 18 and 24 months, and each year thousands of children with varying degrees of need are placed on assessment waiting lists. That undoubtedly presents challenges for service delivery and will continue to do so. The aim is to continue to make progress to develop a high-quality, reliable and sustainable public orthodontic service.

The Dáil adjourned at 11.05 p.m. until 10.30 a.m. on Wednesday, 1 March 2006.

Dáil Éireann debate - Tuesday, 28 Feb 2006