Dáil Éireann debate -
Tuesday, 1 Jul 2008

Vol. 658 No. 1

Services for People with Disabilities.

Deputy Michael Creed

I thank the Ceann Comhairle's office for facilitating me in raising the plight of intellectually and disabled people who have finished their education in the special education school in St. Gabriel's, Bishopstown, County Cork. They have received letters from their service provider, the Brothers of Charity, indicating that there is to be no subsequent placement for them. They had expected an adult or a day-training placement. Unfortunately, no such placement has been offered.

As the Minister of State will appreciate, this is causing great consternation to the young people concerned and their parents. Such treatment might well be considered the thin end of the wedge but many more people can expect a similar outcome because of the lack of planning and foresight of the Government in preparing for the downturn in the economy and the recession we are experiencing.

If such is the case this week, I shudder to think what will happen to the most vulnerable, needy and voiceless in our society the week after the House closes, when the Cabinet will take its decision to slash and burn services. If this is a hallmark, or a foretaste, of what we can expect, then God help the most needy in society. An old political slogan from the era of Charles J. Haughey stated that health cuts hurt the old, the sick and the handicapped. Undoubtedly, that adage still applies.

I have no doubt that the Minister of State's heart is in the right place. I urge him to step out from behind his prepared script tonight and reassert the primacy of this House. This is a House, not a Government, a House that voted to ring-fence €50 million of moneys for the care of people with a disability. Who is running the country? Is it the Oireachtas, by way of its Votes and specific funds for specific purposes, or is it the Health Service Executive and its bookkeepers, who are so involved in cash management?

If it is simply a case of cash management within the HSE, then it should be remembered that the service providers — of which there are many, and voluntary organisations also — provide excellent care, sheltered employment, rehabilitation and assisted living home support, the whole range of services for people with a disability. It should not be the case that these service providers and voluntary organisations are driven to a situation where they are obliged to communicate with their clients and with the parents of these unfortunate people with a disability. They have been forced to tell parents that, as matters stand, there is no placement for their children in these organisations next September. That is entirely unacceptable. It causes trauma not only to the young people by putting an obstacle in front of them that prevents them achieving their potential, but also their parents.

At the weekend I was contacted by parents of one such person. Both parents work and it is not an option for them to leave their child unattended throughout the day at home. These are real situations involving real people. Who is in charge? If the Government and the Oireachtas votes €50 million for people with a disability, it behoves the HSE to communicate with the voluntary organisations and service providers and ensure that those funds are delivered. It is not acceptable management that these people should be treated like pawns in a political game between the Government and the HSE.

This issue was raised earlier today by my colleague, Deputy Olivia Mitchell, who spoke about one of her constituents. Each of the 166 Deputies has come across similar experiences. Who is in charge? Is it the Government, the Oireachtas or the HSE? If we vote €50 million specifically for disability purposes, these people should not be denied a placement next September.

The Minister should step out from behind his brief and prepared script and reassert the primacy of democracy in this House. He must provide for the most vulnerable people because if this is the way the Government intends to act next week, or next month, when the Oireachtas is in recess, God help the most vulnerable and voiceless ones in society. They will be the victims of Government cutbacks and of recession and that is not as it should be.

Acting Chairman (Deputy John Cregan)

The Minister of State will respond to both matters together.

Deputy Kieran O’Donnell

The fact that I speak tonight is a clear indication that this is a national problem. I speak specifically on behalf of the parents of young adults who attend St. Vincent's in Lisnagry, County Limerick. The service providers, the Daughters of Charity, have been forced to write to parents. Nine young adults are involved, three of them school leavers, the other six finishing a rehabilitative training course. I have a letter dated 25 June and I have no doubt that many such letters have been sent to parents of children with an intellectual disability because the service providers were not informed by the HSE that they can go ahead and recruit staff. The letter states, in part:

The Daughters of Charity have applied for funding to the Health Service Executive in order to provide the appropriate adult day service for your daughter this year. Unfortunately, funding has not been released and, as a result, the Daughters of Charity are concerned that we may not be in a position to offer new services in 2008. Therefore we cannot guarantee a service for your daughter in September. The HSE is fully aware of our inability to provide additional services without additional funding.

I put a question to the Minister for Health and Children, Deputy Mary Harney. I am glad to see that the Minister of State with responsibility for the disabilities area, Deputy John Moloney, is in the House tonight. It is appropriate that he is here and I am glad that he recognises the seriousness of the situation.

I asked the Minister to clarify that multi-annual funding for the disability sector promised in the programme for Government is to be fulfilled in 2008. I got a reply just over a month ago which stated: "The Government has fulfilled its promise in relation to the 2008 element of the multi-annual investment programme 2006-2009 by allocating additional funding of €50 million to the HSE's 2008 budget".

That is not true. The funding has not been allocated. The Government must put its money where its mouth is. I understand from my soundings that the Department of Health and Children is engaged in discussions with the HSE regarding how the €50 million will be spent. I require an explanation from the Minister of State, Deputy Moloney, who has responsibility for the disability sector. Is the Department of Health and Children using this issue as no more than an exercise in cash management? Will the Government come forward and provide the funding? The Minister of State's constituency colleague, the Taoiseach, Deputy Brian Cowen, has repeatedly said that he has a personal commitment to people with disabilities. Where is it?

In the instance I raised, concerning the Daughters of Charity at St. Vincent's in Lisnagry, three of the nine young adults left school last Friday. They have no future and do not know where they stand and neither do their parents. Furthermore, the other six young adults who will finish their rehabilitative training programme this month are in a similar situation. The Government must put its money where its mouth is. This is an appalling situation.

I understand the HSE's national disability steering group was to meet today to discuss this issue. I hope the Minister will be able to state the HSE will provide the funding. I hope he is aware of what happened at the meeting because what is occurring is absolutely disgraceful and appalling. I want to be able to tell the parents and young adults associated with the Daughters of Charity Service for Persons with Intellectual Disability, St. Vincent's, Lisnagry, that the Daughters of Charity can proceed with recruiting the staff. I refer to two care workers, one nurse and one programme supervisor. A capital allocation of €120,000 is required to enable certain of the buildings on the campus to be adapted in order to provide the adult services.

I have written to Seamus McNulty, the assistant national director who is responsible for disability services in the HSE. I expect the Minister of State, Deputy Moloney, will honour the commitment the Government made at budget time to provide the €50 million to one of the most vulnerable sectors of society. We should not have to be here tonight. The Daughters of Charity, along with many other service providers for the intellectually disabled, should be recruiting at present and should be able to tell the parents and young adults that they will be availing of proper adult day care services from 1 September. I want to hear a positive response from the Minister of State.

Minister of State at the Department of Health and Children (Deputy John Moloney)

I fully appreciate the comments made by both Deputies Creed and O'Donnell. I have been asked not to read my prepared script and have no difficulty doing so. I have no difficulty reiterating for the House the commitment of the Taoiseach. The commitment in the programme for Government will be honoured.

(Interruptions).

Deputy John Moloney

I have only a few minutes in which to respond and want to do so.

It is false to allege the country is run by some conglomerate, such as the HSE; it is run by the Government. In referring to my script, I will deal with all the issues raised by the Deputies.

Deputy Kieran O’Donnell

When will the funding be provided?

Deputy John Moloney

The funding will be in place for the children in question. There has been a delay in explaining how soon it will come through. Most of the concerns raised, quite properly, by the voluntary organisations were raised because they had not heard that the funding was in place. The reality is that once we can commit ourselves to allocating the funding, the issue will be dealt with.

I am pleased to take this opportunity to address the important issues raised by Deputies Creed and O'Donnell. As they will be aware, within the health and training sector, a range of training, health and personal social day services are provided by several State agencies, including the HSE, non-statutory agencies funded by the HSE and specialist training providers funded by and behalf of FÁS, to young people with disabilities when they leave school.

On the question of training, particularly the provision of life skills training, otherwise referred to as rehabilitative training, the HSE and HSE-funded agencies provide such training services for persons with disabilities to enhance their individual skill level. The services focus on the enhancement of an individual's care, fundamental skills, life skills and social skills.

The outcome of rehabilitative training is not predetermined but is dependent on the level of the development capacity of each individual. Consequently, it is important that training services be matched to a person's need. In meeting such needs, the HSE employs guidance officers at local level to assist in the profiling of young school leavers with disabilities to appropriate training and day services. The guidance officers work with school leavers, their families, school authorities and service providers to ensure that school leavers with disabilities have access to appropriate services.

The co-ordination and planning of services to meet the needs of people with disabilities form a central tenet of the national disability strategy. A critical element of such co-ordination and planning is the requirement to provide financial support for the development and implementation of services.

On funding requirements for service development for HSE-funded services, the Government has set aside specific funds for service delivery for people with disabilities under the multi-annual investment programme. Significant additional funding has already been provided and has been spent on developing new and enhanced health and personal social services for people with a disability, including young people leaving school in the period 2006 to 2007. These areas will continue to be the focus of developments for the remaining years of the multi-annual investment programme, 2008 and 2009.

The Government provided the HSE with an additional €75 million in both 2006 and 2007. This funding resulted in an additional 506 day places and 492 day places in 2006 and 2007, respectively.

Deputy Michael Creed

What about 2008?

Deputy John Moloney

I am coming to the point.

Acting Chairman

The Deputies should allow the Minister of State to continue.

Deputy John Moloney

I entered the House to be totally up-front with my colleagues. I take responsibility for my portfolio and, since the subject in question is clearly my area of responsibility, I will deal with it.

Deputy Michael Creed

Is the €50 million guaranteed?

Deputy John Moloney

The Deputy will hear about that in a few minutes. I would like to have ten minutes in which to respond. I have listened to both Deputies Creed and O'Donnell, who were allowed five minutes each. They asked me to be accountable and I entered the House to be accountable.

Deputy Michael Creed

I do not see a reference to €50 million anywhere in the Minister of State's script.

Deputy John Moloney

If the Deputy listens, he might hear such a reference.

Deputy Michael Creed

I am listening.

Deputy John Moloney

An Adjournment matter was selected and I came to the House to answer questions, yet I cannot get the opportunity to speak.

Deputy Kieran O’Donnell

Ah, come on.

Deputy John Moloney

I am being factual.

Acting Chairman

Allow the Minister of State to continue without interruption.

Deputy John Moloney

Day services were enhanced through the provision of additional supports to deal with school leavers or other adults with significant disabilities. The supports include 52 places in 2006 and 66 places in 2007.

The increase in services in recent years has ensured that young people with intellectual disabilities and autism have appropriate services in place to ensure a smooth transition from secondary school. This is what we are tying to achieve this evening. In some cases, the funding provided supported school leavers to access appropriate day services in line with a person-centred plan. In many cases, this funding provided places for individuals completing rehabilitative training, thereby creating training places for other school leavers. The HSE and HSE-funded agencies also provide a range of other day services, designed to meet the needs of adults with disabilities.

The multi-annual investment programme for disability services makes provision for the development of additional day, residential and respite places each year between 2006 and 2009 for people with intellectual disability and autism. The €50 million to which the Deputy keeps referring was provided to the HSE in budget 2008 for additional services to people with disabilities, including 467 additional day places for people with intellectual disabilities. As the Deputies will be aware, the commencement of the planned developments in disability services this year was delayed due to a financial review in the HSE. This did not just concern the disability sector but pertained to the whole spectrum of health services.

I am more than pleased to inform the House that the HSE has assured me, following discussions all week, that it is now in a position to roll out the planned developments, as outlined in its 2008 service plan. It is not a case of the Government alone taking credit as all Deputies are involved in their capacity as representatives of people with disabilities. It was agreed that nobody would want to see the disability sector short-changed or funding reduced.

Deputy Kieran O’Donnell

Will the HSE be writing to the service providers?

Deputy John Moloney

I have asked that it do exactly that.

Deputy Kieran O’Donnell

Will it be tomorrow?

Acting Chairman

Allow the Minister of State to continue without interruption.

Deputy John Moloney

I want to respond and recognise the seriousness of the case. On the real issue, which concerns people entering new services, I am saying those services will be guaranteed.

Deputy Kieran O’Donnell

Is the Minister of State guaranteeing that personally?

Deputy John Moloney

I am giving that personal commitment.

Deputy Kieran O’Donnell

Is he guaranteeing the services will be provided?

Deputy John Moloney

There is not much point in my keeping my views to myself and it is up to the HSE to let people know the position. I would not be in a position to write to or ring everybody.

Deputy Michael Creed

The Minister of State——

Acting Chairman

Allow the Minister of State to finish.

Deputy Kieran O’Donnell

The Minister of State is missing the key point.

Deputy John Moloney

I am making the key point that the positions outlined in the service plan for 2008 are now secured and, quite clearly, the HSE will be making a public announcement on that. It issued a press release this evening announcing the funding.

Deputy Michael Creed

It is a disgrace that it put the people——

Acting Chairman

I will suspend the sitting if Members do not co-operate. Allow the Minister of State to finish his script.

Deputy John Moloney

I do not believe for a moment that the disability sector was ever under threat.

Deputy Kieran O’Donnell

What about the letters?

Deputy John Moloney

Letters were issued, quite rightly, by the voluntary organisations to warn people. Can I finish my script?

Acting Chairman

Please do.

Deputy Kieran O’Donnell

Does the Minister of State understand the difficulty and the worry this has caused?

Acting Chairman

The Minister of State should continue.

Deputy John Moloney

I certainly do and I share the Deputy's concern. Developments will include new day places for young people leaving school and additional therapy supports for preschool children and for children with autism. It also is important to point this out. I also understand the Health Service Executive will be able to finalise the position in respect of the commencement of the developments, including those required to meet the needs of school leavers with disabilities, over the next ten days. I suggest this should be a sufficiently strong commitment to be able to assure the Deputy and all concerned.

Deputy Kieran O’Donnell

I welcome that.

Deputy John Moloney

Within ten days, the HSE will be in a position to do this. I understand the Deputies' specific questions regarding adult day training for students at St Gabriel's, Cork, and St. Vincent's, Lisnagry, are being considered by HSE in the context of its funding priorities for 2008.

I also wish to inform the House of some developments in areas related to the issues raised by Deputies Creed and O'Donnell. As for services for adults with a disability, the HSE is in the process of undertaking a comprehensive national review of HSE-funded adult day services. This review will seek to advise on the reconfiguration and modernisation of existing adult day services to reflect the core principles of the health strategy, namely, access, quality, accountability and person centredness. The review includes, as part of its work, examining and reviewing the range of day services such as activation, rehabilitative training and sheltered work.

To date the strategic review of HSE-funded adult day services has consulted widely with service users, families and service providers and is about to engage in discussions with all parties to the sectoral plans, including the Departments of Enterprise, Trade and Employment and Social and Family Affairs. A census of HSE-funded adult day services has been completed and the findings will help inform decision making in this process.

As a further significant development in support of the national disability strategy, the Office for Disability and Mental Health was established by the Government in January this year. The office brings together responsibility for different policy areas and a range of services which have an impact on the lives of people with a disability and people with mental health difficulties. The main focus of the office is to improve co-ordination and communication across Departments and agencies in the delivery of disability and mental health services.

I have been appointed Minister of State with responsibility for equality, disability and mental health and my objective is to move the disability agenda to a level which compares with the best in the world. We should do so in partnership with all stakeholders.

I agree the difficulty may have been due to the delayed announcement. However, I emphasise that people should be there to guarantee that whatever funding is allocated to the disability sector will remain intact.

Deputy Kieran O’Donnell

And on time.

Health Services.

Deputy Thomas Byrne

I thank the Ceann Comhairle for permitting this matter to be discussed on the Adjournment. The existing health centre in Laytown, County Meath, was built for a former era, that is, before the area of Laytown, Bettystown and Mornington became the second largest town in County Meath, which it effectively now is after Navan. The health centre also serves areas beyond that, including Grangerath, where I live, Donacarney, Stamullen and Julianstown. It serves a wide population in east County Meath.

The staff at the health centre provide a good service to the community. While they do the best they can, given the population they do so in small and cramped conditions. I acknowledge that senior local HSE officials in the HSE north-east area have confirmed to me that east Meath is a priority for them. The services provided at the health centre include two doctors, a practice nurse a number of public health nurses, dentistry services for children — although there are delays in this regard — a community welfare officer and certain speech therapy facilities. However, other services should be provided there, including social work, child protection, disability services, services for older people, ophthalmic services, audiology services, physiotherapy services and some psychiatric services. Such services are not being provided and in many cases my constituents are obliged to travel to Dunshaughlin, Slane or Navan to obtain them. This is highly inconvenient for many of them, especially older people and young families with children.

Last January, the HSE informed me there was a serious proposal to acquire another property to be used as the health centre for east County Meath. While I was pleased with this news, I made a commitment to the HSE to keep quiet about it as best I could because discussions regarding the premises were at an advanced stage but had not been completed. Consequently, I was content to allow the HSE to complete the deal. However, I recently have been approached by the property's owners, to whom I had never spoken previously, who informed me the HSE had told them there was no money available for this project. Other rumours are flying about in the area to the effect the HSE is in conversations with other landowners and developers with a view to providing an improved health centre in the area.

While I welcome the commitment of the local HSE officials in their search for a premises, I hope it is not the case that the HSE does not have the money to provide an improved, enlarged and much needed centre in a area of massively growing population. I hope the financial commitment is present at a national level as well as the local commitment. I would be grateful were the Minister of State to inform me this matter is a priority for health services in growing areas. Two doctors work at Laytown health centre and two others also operate in the community, serving a population of more than 10,000. They are under pressure and despite the property downturn, people continue to move into the area. I thank the Minister of State at the Department of Health and Children for coming to the House to respond to this issue and I look forward to his response.

Deputy John Moloney

I will take this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Thomas Byrne for raising this issue as it provides me with an opportunity to reaffirm the Government's commitment to developing community-based services at local level. The Government strategy of 2001, Primary Care: A New Direction, is the roadmap for the development of primary care services in Ireland over a period of ten to 15 years. The development of such services is an essential component of the health service reform process. It has been estimated that in a developed primary care system, 90% to 95% of people's day-to-day health and social care needs can be met in the primary care setting. The key objective in primary care policy is to develop services in the community that will give people direct access to integrated multidisciplinary teams.

Under the Towards 2016 social partnership agreement, the Government has committed itself to the establishment of 300 primary care teams by 2008, 400 by 2009 and 500 by 2011. In line with the agreement, a review of these targets is under way at present. The provision of these services, including the furthering of health centres and primary care teams at local level, is an operational matter for the HSE.

I understand from the HSE there is a health centre located at Alverno Heights, Laytown, at present. While this centre was extended several years ago, given the rapid growth in population in east County Meath, difficulties are being experienced regarding its existing capacity. At present, the centre provides a range of services, including general practitioner services, public health nursing services and community welfare officer services. Consultation rooms also are available for visiting allied health professionals such as speech and language therapists and the area medical officer.

In keeping with the primary care strategy, the HSE is developing proposals at present for a primary care team in Laytown. This development will necessitate the renting or leasing of additional accommodation in the short term. Suitable accommodation for this purpose is being identified in the Laytown-east County Meath area. The medium-term plan for the Laytown area is to source new accommodation via a public private partnership process. While a national advertisement seeking expressions of interest from developers was placed in late 2007, unfortunately no submissions for the Laytown area were received. It is intended that the advertisement process will be repeated later in the year as east County Meath remains a priority for a public private partnership development.

Since 2002, the Government has provided significant new funding to enable the primary care strategy to be rolled out. In addition to the additional resources being put in place, membership of primary care teams is drawn from existing professional and other staff working in primary, community and continuing care services. The Minister for Health and Children, Deputy Harney, has emphasised to the HSE the importance she attaches to the continued development and roll-out of primary care teams. I am satisfied that services for the Laytown area will be significantly enhanced with the development of a primary care team for the area. I again thank Deputy Byrne for raising the issue and I hope he is satisfied with the response.

Schools Building Projects.

Deputy Joe Costello

I am pleased to have the opportunity of raising this issue again. It concerns a new school for Gaelscoil Bharra in Cabra, an issue I have been raising virtually every year I have been a Member of the Dáil. Gaelscoil Bharra is located just off Fassaugh Avenue and has been in prefabricated buildings since it was founded 13 years ago. I am blue in the face raising the issue with the Minister and trying to determine when some movement will take place on the part of the Department of Education and Science to replace the prefabricated buildings with a new school, which the children and the parents have been requesting all those years.

Recent figures indicated that 40,000 pupils are educated in prefabricated buildings but those prefabs would be extensions to the original school building. In this case the entire school building is prefabricated. This has been the case for the past 13 years and it is not good enough. During the winter time the buildings are cold, damp and unsuitable for children. During the summer time they are too hot, and when it rains there are pools of water everywhere, including in the yard, and toilets block up. It is a nightmare for everybody concerned — the staff, the pupils and their parents.

I raise this issue more than once a year and receive a variation of the same answer, namely, that the Department of Education and Science is doing its best and that it is on the lookout for a site for a permanent school but, strangely, 13 years later those people from the Department who have been out searching for a site still have not discovered one. I hope this might be the night the Minister of State will give me the good news that new eagle-eyed civil servants in the Department of Education and Science have at last discovered a suitable site.

Meanwhile, parents are concerned about their children's health and the conditions under which they are educated. The children themselves suffer physically and educationally from the lack of good quality services. Also, the parents and the staff are constantly fundraising to try to plug some of the gaps in maintaining the unsuitable buildings that are now well past their sell-by date.

We are at the end of the construction boom and as we move into something of a recession and there is no longer an emphasis on the construction of residential dwellings, there may be scope for moving the construction industry into providing much needed infrastructure of this nature. I am sure many developers would be delighted to get contracts to build schools. Those contracts would not be that much different from the type of contracts they would get for housing estates. This might be an opportunity for the Government to retain its spending power to do whatever borrowing is necessary. It is the way to go. There is the opportunity to do that and to try to keep the construction industry moving. If that is the decision of the Government, it will be able to address the problem of the large number of prefabs and the need to have permanent school structures constructed.

I have come into this House too often asking that something suitable in the line of an educational facility be provided for children who should be cherished by the nation, as we all know. That is not the case with these particular children. The Minister of State might have some good information for me tonight.

Deputy John Moloney

I wish I could impart some good information on my first Adjournment Debate in response to Deputy Costello.

I thank the Deputy for raising the matter as it provides me with the opportunity to outline to the House the Government's strategy for capital investment in education projects and also to outline the current position regarding the future plans for Gaelscoil Bharra, Cabra.

Modernising facilities in our existing building projects as well as the need to respond to emerging needs in areas of rapid population growth, is a significant challenge and something I understand will be one of the priorities of the Minister, Deputy O'Keeffe.

The Government has already dramatically increased investment in the schools building programme to almost €600 million this year. Under the lifetime of the national development plan, almost €4.5 billion will be invested in schools. That is an unprecedented level of capital investment which reflects the commitment of the Government to continue its programme of sustained investment in primary and post-primary schools.

It will underpin a particular emphasis on the delivery of additional school places in rapidly developing areas while continuing to develop the Government's commitment to delivering improvements in the quality of existing primary and post-primary accommodation throughout the country. It will also enable the purchase of sites to facilitate the smooth delivery of the schools building programme, again with the focus being on site requirements in rapidly developing areas.

On the specific matter raised by Deputy Costello, the Office of Public Works, which acts on behalf of the Department of Education and Science in regard to site acquisitions generally, had been requested to source a greenfield site for this Gaelscoil. On foot of advertising, no proposals were received for a greenfield site in the Cabra area. Further to that, the OPW was requested by the Department to look into building a permanent school on the existing temporary site.

The further progression of the acquisition of this site will be considered in the context of the capital budget available to the Department for school buildings generally. The Department is not in a position to say at this stage when the acquisition will be concluded.

I thank the Deputy and wish I could have been a font of knowledge but, unfortunately, I cannot be one. I am glad to have the opportunity to outline the current position to the House.

Deputy Joe Costello

I could have written that response for the Minister of State.

Deputy John Moloney

I guessed that.

The Dáil adjourned at 10.35 p.m. until 10.30 a.m. on Wednesday, 2 July 2008.