Adjournment Debate.

Flood Relief.

Deputy Joanna Tuffy

I was asked to raise this issue by Seamus Rogers, who lives in Donegal, near Derrybeg and Bunbeg and who is a former Donegal county councillor and a very active member of the Labour Party. I spoke to him yesterday and today about the flooding that affected Derrybeg and Bunbeg. He told me a lot of damage was done to the area. A number of bridges were swept away and road surfaces, business premises, houses and a local church were damaged.

The local library was housed in an old church and a number of book stocks were destroyed. There is a picture in the Irish Independent of the damage to the library, which shows that a great deal of damage was done to books. A lot of public property was damaged, according to the Irish Independent. Access to some local households was destroyed. People have been affected and families’ homes have been water damaged. It is lucky nobody was badly injured or worse.

Deputy Dinny McGinley also raised this matter. When I spoke to him earlier, he was on his way home to assess the damage. From newspaper reports, I know he wanted an audit of the damage to be carried out and for a Minister to visit the area to assess it. The Minister responsible will know from the reports and from their local representatives that there has been damage. I understand the Donegal county manager was on Radio na Gaeltachta today and told the interviewer that while Donegal County Council can carry out temporary repairs, for example, to the bridges that have been destroyed, there would only be funding for stop-gap measures. He said funding from Government was needed if further measures were to be implemented.

What funding will be made available to Donegal County Council to carry out the works and repair the damage that has been caused by this flooding and when will it be provided? When will the decisions be taken with regard to this funding? Obviously, the council will need to know in order to make its own decisions on its response to the flooding and the damage caused.

Has the Minister for Social and Family Affairs, Deputy Hanafin, information at this stage with regard to funding that would be available and individuals who have suffered damage in their homes and so on because of the flooding? I would appreciate an update in this regard.

Minister for Social and Family Affairs (Deputy Mary Hanafin)

I thank the Deputy for giving me an opportunity to come to the House to discuss the severe flooding which occurred in the Gweedore Gaeltacht area in County Donegal on 23 June 2009. It is ironic that this flooding took place at a time when most of the rest of the country was basking in sunshine. The Donegal fire service has described the weather as freakish. My colleague, Deputy Martin Mansergh, Minister of State with special responsibility for the Office of Public Works, is very much aware of the hardship and loss suffered as a result of flooding and is pleased, through me, to have the opportunity to place on the record of the House his personal sympathy and concern and that of the Government for the victims of the flooding.

The Minister of State has visited the scenes of flooding in many parts of the country where severe flooding has occurred and has first-hand knowledge of the hardship and worry that flooding causes. The Minister of State and the Office of Public Works are acutely aware of the impacts of flooding and are committed to doing all they can to alleviate them both through the provision of defences to best practice standards to reduce existing flood risk and by taking steps to prevent the creation of future risk. This is not the time to go into detail on those matters as time is limited and the topic under discussion is the flooding in the Gweedore area.

The OPW engineering staff met on site with engineering staff from Donegal County Council on 24 June 2009. A combination of spring tides together with prolonged torrential rain on 23 June contributed to flooding in lower level lands. The heavy rain commenced at approximately 3 p.m. and continued unabated for a period of about four hours. Eight county road bridges were damaged — mainly parapet, soffit and scouring damage — and four private bridges were also damaged. Two of these private bridges serve blocks of six or nine houses approximately. Parts of county roads were washed away or suffered surface damage along the course of the channel. Among the buildings flooded were a craft shop, a flower shop and the old church at Derrybeg, which now houses the Gweedore library. A number of private properties were also flooded and more details in regard to the precise number affected are awaited. These are preliminary findings and the process of gathering further information is ongoing. It is hoped that a preliminary report will be available shortly and an early meeting will be set up between Donegal County Council and OPW officials to assess what can be done to prevent any recurrence.

The Minister of State is conscious that in addition to the trauma caused by the flooding, people also suffered financial loss arising from the damage to their property. The Department of Social and Family Affairs has responsibility for providing humanitarian assistance where it is considered appropriate and is providing help through the community welfare officer network to victims of the recent flooding. Where people are suffering hardship they should contact the local community welfare officer for assistance and each case will be dealt with confidentially and on its merits. Recent humanitarian assistance schemes have not extended to cover business or agriculture.

The supplementary welfare allowance scheme, which is administered by the community welfare officers, is designed to provide immediate and flexible assistance for those in need who do not qualify for payment under other State schemes. Under the legislation governing the scheme, the HSE may make a single payment to meet an exceptional need to people on social welfare or health service executive payments. This is a once-off payment to meet an unforeseen or special need that cannot be met from a person's basic income.

Assistance in the form of an urgent needs payment can be also made to persons who would not normally be entitled to supplementary welfare allowance, to assist, for example, in cases of flood damage with immediate needs such as food, clothing, fuel, household goods and perhaps shelter. Assistance can be provided to people affected in cash or in kind.

There is no automatic entitlement to these payments. Each application is determined on the particular circumstances of the case. In assessing income, consideration is given as to whether a person is in receipt of a social welfare or HSE payment or to the gross household income with allowance made as appropriate under normal supplementary welfare allowance means assessments. This Department's role in response to the flooding primarily involves supporting the community welfare service in the provision of exceptional needs and urgent needs funding in the short term and other supports, where applicable, to cater for the long-term effects of the flooding. Any support given relates to damage to a person's home or loss of essential items. It does not extend to business or commercial losses. Local community welfare officers are available to provide assistance on an individual basis where that is warranted. Any person who is experiencing hardship should contact his or her local community welfare office.

The two community welfare officers in the area are aware of the situation in Gweedore as they both live locally. However, they have not as yet been asked to provide assistance to any individuals affected by the flooding. My understanding, from discussing the situation with the community welfare staff in the area, is that the damage incurred is mainly structural to businesses, and structural damage to a number of roads and bridges has also occurred. A number of water facilities may also have been damaged. The community welfare officers have also stated that a number of representatives from Donegal County Council have been examining the situation and are due to visit Gweedore again this evening to assess the damage and report back to their parent Department.

I can assure the House that the Office of Public Works will continue to work in partnership with Donegal County Council to try to alleviate the risk of future flooding in Gweedore and the surrounding areas. I will conclude by again expressing my sympathy to the victims of the flooding in Gweedore and the surrounding areas and assuring them of the Government's support for the work that is already under way to provide reassurance to them in regard to risk in the future.

Mental Health Services.

Deputy Dan Neville

I am thankful to have the opportunity to raise the report of the committee of inquiry to review care and treatment practices in St. Michael's unit, South Tipperary General Hospital, Clonmel and St. Luke's Hospital, Clonmel included in the quality and planning of care and the use of restraint and seclusion, and to report to the Mental Health Commission. I will deal with one small but important area of the comprehensive and detailed report.

The clinical risk manager reviewed fractures recorded in St Luke's Hospital, Clonmel from July 2002 to 31 January 2004. The regional risk manager calculated that, at the time of the September 2004 report, the risk of residents of St. Luke's Hospital or St. Michael's unit sustaining a fracture was between two and three times higher than the average risk of residents of the other psychiatric hospitals in the region.

The fractures in Clonmel were of small bones in hands and feet and fractures to the upper end of the humerus differed from the number and type of fractures seen in the other units where fractures of the hip and wrist are as a result of falls from bed and falls on an outstretched hand. The report referred to the fact that most patients are cared for in wards which are permanently locked and where there is restriction of movement. A number of patients are elderly frail and vulnerable. The report stated:

There is a lack of rationale for combining patients with different diagnoses i.e. patients with challenging behaviour and frail patients. The resulting patient mix means that some patients are at risk of injury from other patients.

It is a cause of concern that this review highlighted many other incidents of fractures occurring in these specific patients in the past. In some situations, old fractures or healing fractures were identified coincidently on X-ray. The report went on to state that a worrying observation made during the course of this review was that in 18 of the 19 incidents involving fractures the documentation states that they were not witnessed. In the remaining one, it is unclear whether there were any witnesses. Two of the 19 residents each had fractures on two occasions during the 18 month period and five of the residents suffered earlier fractures.

A retrospective examination of the charts of the patients of St. Luke's Hospital showed that in many cases there was no documented supporting history of injury, trauma or signs or symptoms to account for the previously undiagnosed fractures. On 15 July 2005, a meeting of senior managers and clinicians was held to consider the report. The meeting was not minuted. Many of those attending were unclear about the authority of the meeting. At the meeting the regional risk manager outlined the findings of the report and indicated that there was a strong possibility of non-accidental injury. The possibility of informing the Garda was considered. The need for further investigation into the causes of the injuries and the very high proportion of unobserved injuries was discussed and generally agreed. However the matter was not reported to the Garda and no effective action was taken on foot of the risk manager's report.

No minutes of the meeting were kept or circulated and no follow-up meeting was arranged. Those attending the meeting expected it would lead to the development of an action plan for the implementation of the recommendations of the report but discussion about how this would be achieved, whether through further investigation or a review of clinical and organisational practice, was not concluded.

The Mental Health Commission inquiry report makes the following observations in regard to the investigation into the fractures: "Taking into account the lack of further investigation following the September 2004 report, the limited implementation of its recommendations and the extreme slowness of the process, the inquiry team considers that the safety and welfare of residents was not given the highest priority." The inquiry team believes that, where the safety and welfare of residents appears to be at risk, prompt action is required. Further investigation to clarify the level of risk and implementation of measures aimed at reducing the risk is necessary. The inquiry team believes that the lack of urgency of the process following the September 2004 report, the lack of further investigation to clarify the level of risk to residents and the failure to implement many of the report's recommendations indicate that the safety and welfare of residents was not given the highest priority. The inquiry team believes that this was probably influenced by industrial relations problems, a concern to avoid bad publicity and potential for distress.

Patients and their families should feel safe and when one considers that only one of the 19 injuries uncovered in September 2004 was witnessed by the staff, it is of great concern. The failure to refer the matter to the Garda following consideration smacks of a cover up. The risk of sustaining a fracture in St. Luke's hospital was between two and three times higher than that of the local psychiatric hospital which highlights the seriousness of the level of injury. The welfare of the patients continues to be of concern and will only be satisfied by the closure of the hospital and the transfer of patients to modern hospital conditions.

This hospital was recommended for closure because of the conditions. I have only referred to a section of the report, which contains details of the conditions which prevail but we do not have time to go further into the detail today. If these conditions applied to any other group of patients, there would be a three hour debate in the Dáil on the matter.

Deputy Mary Hanafin

I thank Deputy Neville for raising this important matter, to which I will reply on behalf of my colleagues, the Minister for Health and Children, Deputy Mary Harney, and the Minister of State at the Department of Health and Children, Deputy John Moloney.

The report made for very difficult reading, highlighting significant deficiencies in the mental health services in Clonmel. The Minister of State, Deputy Moloney, requested that I mention that the publication last April of the report on St. Luke's and St. Michael's represented one of his lowest points since he was appointed Minister of State for with responsibility for equality, disability issues and mental health.

To put the report into context, in June 2007 the Mental Health Commission established an inquiry under section 55 of the Mental Health Act 2001 to review care and treatment practices in St. Michael's Unit, South Tipperary General Hospital, Clonmel, and St. Luke's Hospital, Clonmel, including the quality and planning of care and the use of restraint and seclusion.

The inquiry was established in the light of concerns regarding services in Clonmel which had been identified in several annual reports of the inspector of mental health services. The report found that individual, person-centred care was not at the heart of the system in Clonmel and this was attributed to staffing and environmental constraints, as well as outdated practices. The report also pointed to a lack of clear leadership and a shared sense of purpose and concluded that the safety and welfare of residents had not been given sufficient priority.

While the Government fully accepts the findings and recommendations in the report and readily admits that aspects of the service provision described in the report are totally unacceptable in a modern mental health service, the publication of the report demonstrates the robustness of the Mental Health Act 2001, the independence of the Mental Health Commission and the importance of its role in safeguarding the standards and quality of care in the mental health services. It is clear the systems put in place by the 2001 Act to promote high standards and good practices in our mental health services are working. Unacceptable standards and practices can no longer be swept under the carpet and tolerated; deficiencies must and will be addressed.

In terms of Clonmel, the Mental Health Commission and the HSE have held several meetings on the implementation of the report's recommendations. It is anticipated that a detailed project plan for the development of the mental health services in south Tipperary, which will be time bound and have clear lines of responsibility for implementation, will be finalised in the coming weeks. I am informed that the Inspector of Mental Health Services will monitor closely the HSE project plan and report to the Mental Health Commission on a regular basis. The Mental Health Commission has now attached conditions under the Mental Health Act 2001 to the continued operation of St. Michael's and St. Luke's as approved centres.

Since the Mental Health Commission's inquiry team visited Clonmel in autumn 2007, progress has been made in making service users partners in their own care, providing more services in the community, reducing hospital admissions and providing more home-based treatments and outreach services.

In line with the recommendations for the closure of the old psychiatric hospitals in A Vision for Change, it is proposed to close St. Luke's in 2010. The closure will take place on a phased basis with wards closing sequentially and the hospital can only finally close when the clinical needs of the remaining patients have been addressed in more appropriate settings. However, I am satisfied that plans are well advanced for the complete closure of the hospital by December 2010. I understand some wards have already closed and the number of residents in the hospital has reduced. A further two wards are due for closure this year. All current residents will be provided with care in more appropriate settings as identified through multi-disciplinary assessments, in partnership with the residents and their families and carers. Also, as wards close, staff will re-deploy to community-based teams which will further enhance services in the community.

The focal point of modern mental health services is the community and developing a community-based service is the way forward. To that end, extended hours services are now available in both Cashel and Clonmel, providing more accessibility. The extension and renovation of the Morton Street Day Centre has been completed and is availed of by more than 20 service users daily. Such initiatives whereby supports are provided in the community will, it is anticipated, greatly reduce the need for hospital admission and will help service users to achieve meaningful integration and participation in community life.

I assure the House that the Government continues to be fully committed to the improvement of mental services, not only in Clonmel, but throughout the country, through the implementation of A Vision for Change. The deficiencies in the services in Clonmel have been identified and these deficiencies will be addressed by the HSE and closely monitored by the inspector of mental health services.

Special Educational Needs.

Deputy Jimmy Deenihan

Recently, I received a letter from the board of management, parents council, staff and principal of St. Ita's and St. Joseph's School, Balloonagh, Tralee, and I will read the contents of the letter into the record:

The Board of Management, Parents Council, staff and Principal of the above school are deeply concerned at the delay currently experienced by graduates from the school in being offered places for further education and training in the Kerry area. We regard this delay is as an unnecessary source of stress on the students and their parents; as this seems to be an annual problem we urge those involved to adequately fund the various service providers so that a seamless transition from school to further education and training can take place. As the number of students involved in the transition from school is generally low (10/12) we believe this issue should be addressed by the H.S.E. to avoid the stress, confusion and delay presently experienced by the students and their parents.

I also received an e-mail from concerned parents on behalf of their son which states: "Our son had been accepted for a place in Kerry Parents and Friends, Listowel. We went to the Kerry Parents and Friends AGM last week. The chief executive stated there was no funding for school leavers for 2009." It was also pointed out there was a shortfall of 1.4 million for the Kerry Cork area. The parents were subsequently told by the manager with responsibility for intellectual disability in the HSE south region that there were approximately 96 people with no placement for September. This is certainly a disgrace. The e-mail continues:

At this moment we do not know where James will be in September. This is quite stressful for us going into the summer. James had 12 wonderful years in Nano Nagle school, Listowel which come to an end at the end of June.

There is a feeling of powerlessness at this stage because it is not known what will happen to James in September. The three schools most affected are Nano Nagle special school, Listowel, St. Ita's and St. Joseph's school, Tralee, and St. Francis school in Beaufort. The service-providers taking children from these schools are Kerry Parents and Friends centres in Listowel and Killarney, the National Learning Network in Tralee, which is funded by FÁS and has only four places available this year, and St. John of God. A total of 34 referrals have come from those three schools alone. The schools cannot keep them once they reach 18 years. This means that 34 young people who are now 18 years will have to leave education.

As a former Minister for Education and Science, Deputy Hanafin will know that the students will regress if not placed in a training or educational situation. It also places significant stress on their families. The parents may both be out working or the parent at home may have to provide continuous care. The centres have no capacity due to cutbacks. There is no flexibility nor additional capacity to facilitate these students.

I am aware that we are here at 8.15 p.m. in the evening and this Adjournment matter may not have much impact but if the service-providers are not given the adequate funding they require, I ask that an exception be made for the special schools to allow them keep pupils who are over 18 years for an additional year. It could be referred to as a transitional year in which the students could undertake work experience and other activities. This might be one way of helping them to overcome this problem.

The age of 18 is the cut-off point in special schools and this is wrong, especially if there is no other placement for the students. Children in mainstream education can stay on longer. If this situation was repeated for children in mainstream education there would be an outcry but nobody seems to be concerned about these children, who are special children. The parents do not know where their children will be going in September and nobody seems to care. This is a significant issue of blatant discrimination between parents of special children and parents of children in mainstream education. I look forward to the Minister's reply.

Deputy Mary Hanafin

I thank Deputy Deenihan for raising this matter and apologise on behalf of my colleague, the Minister for Education and Science, Deputy Batt O'Keeffe, who could not be present. I am pleased to have been given the opportunity by the Deputy to clarify the position with regard to the matter raised by him.

The Department of Education and Science funds post-school provision for young adults, including those with a disability, generally through multiple providers, which include universities, post-leaving certificate courses, vocational training centres and national learning networks. In addition, vocational educational committees provide grant assistance to some service-providers within the health service towards an education component of its provision through the co-operation hours scheme.

There are currently 23 vocational training centres and approximately 34 national learning network centres throughout the country. They provide a service to approximately 1,300 young adults with a disability. Two of these facilities are located in County Kerry. Young adults attending the vocational training centres typically have a diagnosis of mild or moderate general learning disability and are unsuited to open training centres. Participants must be under 25 and they attend for a maximum three years' duration. Department officials have contacted the Health Service Executive in the context of the Deputy's inquiry with regard to its responsibility for young adults with special educational needs who are over 18 years. The HSE has advised that approximately 30 school leavers have been identified by the Kerry occupational guidance service of the HSE for training and day-care places. The HSE is currently working with service-providers to ensure that the individuals in question have access to services in September 2009 in the context of the available funding. The HSE intends communicating with the individuals or their parents or guardians, as appropriate, within the next ten to 14 days, to confirm the arrangements for each individual for September.

People with disabilities may also avail of adult literacy courses provided by the VECs around the country. The Deputy may also be familiar with the back to education initiative which provides part-time further education programmes for adults to give them an opportunity to combine a return to learning with family, work and other responsibilities. People with disabilities are one of the target groups of the programme. The BTEI programme is a part-time initiative for learners who wish to pursue part-time or modular programmes. Under the BTEI, a programme may be offered for as little as one hour per week or as much as 17 hours per week, depending on the needs and demands of the prospective learners. It is recommended that programme duration for individual learners, class contact hours, not exceed 400 hours per annum, over a twelve-month period.

I thank the Deputy for giving me the opportunity to clarify the position with regard to the matter raised by him. I hope the issues are resolved shortly in the interests of those young people and their families.

The Dáil adjourned at 8.15 p.m. until 2.30 p.m. on Tuesday, 30 June 2009.

Dáil Éireann debate - Thursday, 25 Jun 2009