It is a pleasure for me and for all Members of this House to welcome the Minister for Health, Deputy O'Connell who formerly served as a Member of this House with great distinction. I have no doubt that he will bring to his new brief those same qualities and will serve the country with equal distinction.
Adjournment Matter. - Wicklow Community Services.
Acting Chairman
I join with the Chair in his congratulations to the new Minister on his appointment. I have absolutely no doubt that it proves to have been a very appropriate and good one. The Minister is as well qualified as anybody else in his party for the position which he has taken on. I welcome him to this House, especially as a former Member and colleague of ours. It is nice to see that they can come back and fit so well into the atmosphere here which we enjoy.
It is always a great pleasure to approach a new Minister especially on an issue of this kind and to bring it to his attention so early in his appointment because one hopes that he will be able to remember it and consider it a priority in the period ahead.
The matter I raise is one which affects Wicklow town and the surrounding area of about eight to 12 miles. I bring this before the House and make no apology for special pleading on behalf of Wicklow community services. The reason why they have a special case is that they are one of the few community services which do not receive funding from the Eastern Health Board or a grant or special funding from the Department of Health. County Kildare is another one. Apart from that, most have received funding from one State source or another. The Wicklow community services for some reason — and I suspect because they are so good — have not received such funding from the Eastern Health Board in the past and do not receive it at present. I deeply regret this and am interested to know why this is the case and what prospects or plans the Minister has for funding Wicklow community service or asking the Eastern Health Board to do so in the future.
Wicklow community services were set up in a different form in 1984. It is often felt that Wicklow is a middle class town. Wicklow is very much a disadvantaged town with chronic problems such as unemployment, which is far above the national average. It is crying out for new industry. The population is neglected in terms of community services and there are scant facilities available for the underprivileged of Wicklow. The Wicklow support group was formed in 1984 by an extremely dedicated and small group of people who decided to set up a voluntary committee to attack the almost insurmountable problems which appeared to be chronic in Wicklow at the time. In December 1985 they collected £2,000 purely by way of voluntary subscription in order to fund their activities.
Their first problem was to find a premises. They found a premises, the parochial hall in Wicklow, which was in bad need of refurbishment. Six unemployed people gave their time voluntarily day and night and refurbished the premises. When that was done Wicklow community services were born. They provide what I suppose is the equivalent of a resource centre in many other places. They provide care for the elderly, support for families, play groups, referral services and now hope to provide a citizens' information service in Wicklow.
I will read into the record a letter from the Wicklow town clerk to Mr. Mervyn Taylor, Manager, Planning and Organisation Services of the National Social Services Boards. I do this because it indicates the tremendous proficiency of those who run the Wicklow community services, the great work they do, the esteem in which they are held by people, and the great reputation they have established for themselves. The letter asks for the immediate setting up of a citizens' information service in Wicklow Town and that he lends his support and that of the Urban District Council to the request of Mrs. Bridie Cardiff and the Wicklow community services for official recognition to become an information service. That is the respect in which they are held in Wicklow. This is a letter, not from a politician but from a town clerk in Wicklow asking for that particular status to be granted. He states:
In my daily duties, it is obvious that neither the Urban District Council, the Eastern Health Board or indeed the St. Vincent De Paul Society are in a position to provide the type of service and information that is now required and demanded in a modern society. The incidences of such diverse problems as marriage breakdowns, unemployment, alcohol abuse, child sexual abuse, itinerant rehabilitation and its consequent effects on the settled community, home and financial management, are increasing rapidly and, in my view, the public authorities are unable to properly cater for and respond to these problems. More and more I find that I am continually availing of the Wicklow community services to help families in need.
Until recent years, these types of problems we all associated with the major cities and felt they did not apply to our small local communities. Sadly, the problems associated with the cities are now mirrored in our towns and there is an onus placed upon us to react and respond in a positive a manner as possible. The only group capable of providing these essential services is the Wicklow community services.
Recently this council undertook a survey of the largest local authority estate in the town which comprises 112 houses. We found some 70 per cent of households were totally dependent upon social welfare payments. Unemployment was extremely high, much greater than the national average and satisfaction rates among families low. The estate also comprises five travelling families which gives rise to ongoing problems relating to itinerant rehabiliation, unease and mistrust between the settled community and the travellers. There have been many flash points and the council requested the Wicklow Community Services to devise a special programme of education for both parents and children of the travelling community. We are hopeful that this programme will educate travelling people to appreciate the obligations which living in communities brings upon themselves while, at the same time, fostering their particular culture and customs.
It is surprising in this modern age the problem substantial numbers of our community experience with adult literacy and how to properly manage and finance a home. The work the local community service group are doing in these areas is commendable and they are helping to develop the skills and personalities of individuals who otherwise would remain on the fringe of society.
The area of home help and care, particularly for the elderly, is of major concern and an area which is going to grow as the population ages. Our elderly people and those in need are not getting the consistent back-up type of service they require and, unfortunately, the public authorities are unlikely to ever be in a position to offer a supportive and on the spot service. Again, I find the number of cases I refer to the community services group growing weekly.
Finally, I must commend the determination of Bridie Cardiff and her team at the Wicklow community services. Less committed individuals would have abandoned the services long ago. They have constantly met with major difficulties over funding and premises in their six years of existence but vigorously and with tenacity have soldiered on from strength to strength. They have now become an indispensable support to many families in need and I know that without them our local community would be seriously deprived in many respects.
I sincerely hope your board can provide the necessary assistance to the community services group to enable them to continue and to expand. Wicklow badly needs their services.
That puts in a nutshell the work these people do the status they should be accorded by the Minister, and the crying need for permanent funding from the Eastern Health Board or from some other State agency.
One of the great problems which this body have is that they do not have any permanent form of funding or any permanent staff. They receive people from the FÁS training schemes but, as everybody knows, such people come and go. They do not stay for more than 52 weeks at a time and as a result, there is no permanence about the people who are employed there. Sometimes they return, sometimes they do not. At the moment, there are 14 people under the FÁS scheme. Some of them have trained for 52 weeks but often they go off and do not return.
The other main problem the Wicklow community services body have is that they have no suitable premises. They have been in and out of various premises over the years. At the moment, they are in the Bridge Street Arcade which is in very bad condition, particularly for anybody suffering from stress. They are looking at other premises, in particular the old Garda station in Wicklow but for that they need extensive funding, and they need Government help. Their funding in the past and in the current year consists of voluntary contributions, which is really fund raising activities, which everybody knows is very difficult especially in a town like Wicklow. Last year, they got £1,000 from the ISPCC, £500 from the urban council, £1,200 from the vocational education committee and nothing else. That is a paltry sum. The Eastern Health Board happily accept that this dedicated and committed group are doing a job of work which the board should be doing or at least giving permanent funding to. To a certain extent, these people, because they are doing such a good job, are being exploited and are the victims of their own success. There is a real danger that this voluntary group could close down at any moment because their funding is so precarious. They are frustrated at the lack of response from the Eastern Health Board. A close-down would be unacceptable to the Minister, to the people of Wicklow and to the Wicklow community services themselves but, in effect, that is the danger which lies ahead. They are collecting signatures throughout Wicklow for a petition to get such funding and that will undoubtedly find its way onto the Minister's desk in the near future.
I know the Minister has sympathy for the underprivileged. I know he has a record of caring for the elderly, for families in need, for marriages in trouble and so on. I know he will consider this carefully in his time in office.
The Minister should look again at why some resource centres receive grants and others do not. I come from Bray and it will not do me any good politically to say that both resource centres in Bray, the one in Oldcourt and the one in Fasseroe have received grants from the Government in recent times. That is tremendous. It is commendable. They are doing magnificent work in those resource centres but the people in Wicklow who are doing such work are entitled to the same treatment. It is inexplicable that one resource centre should get a grant and others should not when they are basically doing the same work.
Will the Minister allow a community service like this to close or will he consider setting up a permanent funding arrangement? I am not asking for large amounts of funds but for certainties for the people doing voluntary work. What they have done in the last ten years is superb and there is much scope for expansion, but they are in a limbo at the moment. They do not know whether to expand or contract. They do not know how much money they will get from year to year. I would like the Minister to say he will give them X amount per annum. It may be a small amount but they know they will receive it.
They are doing tremendous work with pre-school playgroups and are affiliated to the IPPA. They run courses sponsored by the vocational education committee. They liaise with the Eastern Health Board. Their credentials are impeccable and are recognised by all the recognised boards in these areas. The home care services are affiliated to the national home care organisations. These people recognise the great work being done. This is a responsible group and I ask the Minister to put them in a position from which they can advance, in other words, let them know exactly where they stand in relation to funding.
I thank the Chair for his kind words. I thought I should answer this question because I have great sympathy with what Senator Ross said. I ask him to bear with me a moment while I state what my predecessor had prepared and then I will give my own views on it.
The Eastern Health Board provide a comprehensive range of services for the elderly. The main focus of the service is community based in line with Government policy for the care of the elderly. The board's community services are wide ranging and were greatly enhanced recently by making available special allocations for services for the elderly.
Of the £8 million additional funding made available for services for the elderly in 1990 and 1991, the area to benefit most was the home care service. The EHB was allocated £2.25 million and returns indicate that many extra staff have been recruited comprising nurses, home helps, attendants, physiotherapists, occupational therapists and chiropodists.
There are 9,011 people aged 65 years and over in the Eastern Health Board's community care area — ten which embrace all of County Wicklow. Community services in the Wicklow area have been enhanced by the additional funding made available for services for the elderly.
There are approximately 185 home helps providing service to an average of 330 clients per month in the Bray, Greystones and Arklow areas. In addition, a home help service for approximately 100 clients per month is provided through the community welfare service. It is estimated that the above services will cost the Eastern Health Board in the region of £345,000 in 1992. Two hundred and fifty people per week benefit from the meals-on-wheels service. Approximately 600 meals are provided each week at an annual cost of £7,000.
There are five day care centres for the elderly in the Wicklow area. These centres provide a service such as a mid-day meal, a bath and physiotherapy. In addition, they promote social contact among the elderly in the area and prevent loneliness. Day care centres also offer support to relatives by sharing the task of caring for the elderly person at least one day a week.
A comprehensive nursing service is available for elderly people in Wicklow. There is a staff complement of 30 comprising one superintendent public health nurse, two senior public health nurses and 27 public health nurses. The district care unit in Bray provides service to an average of 20 elderly people who are both pre- and post-discharge patients. This unit has three registered general nurses, three care attendants and avails of the services of both an occupational therapist and physiotherapists.
I am satisfied that there is adequate provision of funding for community services in Wicklow. The Eastern Health Board are constantly monitoring their funding of these services and will be providing approximately £400,000 in 1992 for this purpose.
I have not referred to private nursing homes as they are part of the Eastern Health Board's hospital programme.
My Department's policy on the provision of services for people with mental handicap is outlined in the "Report of the Review Group on Mental Handicap Services, Needs and Abilities". The report indicates that with adequate support, the majority of people with mental handicap can live in the community. The Government have accepted the recommendations of the report in principle and are committed to their implementation under the Programme for Economic and Social Progress.
I am pleased to inform the Senator that, on a national basis, an additional allocation of £6 million has been provided for the development of services for the mentally handicapped in 1992. This will enable significant improvements in services to be put in place.
The extra services to be put in place will include additional residential and day places. The total number of places involved will be about 400 and they will be allocated according to need and in accordance with the plans for the development of services for persons with a mental handicap which have been prepared by the health boards in co-operation with the co-ordinating committees.
Further respite facilities will be developed. This will mean that about 550 additional families will be able to have a respite break of one month in the year. Many families suffer considerable hardship and make enormous sacrifices in caring at home for a son or daughter with a mental handicap who may be 30, 40 or more years of age.
A home care or outreach programme will also be initiated this year to meet the needs of these families. The concept envisages the provision of varying degrees of help and support to the person with mental handicap and to their family. This scheme will work in a flexible way and could, for example, involve a more adaptable and out of hours use of day care facilities. The scheme should provide a service for 600 to 700 families.
Crisis intervention and services for disturbed persons will also be developed. There is a particular need to have an effective and immediate response when crises arise. There is also the need to cater for those persons who are very disturbed. Special measures will be put in place to meet these needs. Services for children will be expanded by the provision of extra early intervention teams and centres for child education and development.
While it is of course necessary to address the needs of those who have a handicap, it is also important to reduce the prevalence of genetic disorders by means of the provision of a specialist genetic counselling service to people for whom there is a risk of handicap which is genetically determined in themselves or their families. Accordingly, such a service will be initiated this year at Our Lady's Hospital, Crumlin.
A significant amount of the additional funds available this year for mental handicap services will be allocated to the Eastern Health Board region where the problem of unmet need is greatest. The Mental Handicap Central Planning Committee, on which the county Wicklow mental handicap services are represented, will be directly involved in advising on the services and manner in which they will be provided within the priorities that I outlined earlier. The extent to which additional services in county Wicklow will be developed will not, therefore, be clear until the recommendations of the Central Planning Committee are received. The additional funds allocated this year represent the single largest annual investment ever in mental handicap services. These services will now be maintained at these increased levels of provision and improved on in future years.
Wicklow community psychiatric services are provided by the Eastern Health Board, with the main in-patient base at Newcastle Hospital. The catchment area serves a population of approximately 98,000. The day hospital for the area is based at the Lincarra Centre, Boghall Road, Bray, and the facility also accommodates a sector headquarters and a sheltered workshop. The west Wicklow sector with a population of 12,000 was transferred to the Kildare service on 1 February 1992.
Community facilities include 85 day places which are provided as follows: 50 in the north county at the Lincarra Centre, Bray; 20 in the mid-county at the Kilmullen Enterprise Centre, Newcastle; and 15 at the Mews in Arklow. There were 298 outpatient clinics held at 11 locations in 1990. A total of 890 persons attended the clinics of whom 255 were first time attenders. There are seven group homes and hostels in this service, excluding the high support hostel located in the grounds of Newcastle Hospital, which has 22 places. There were 54 places available in the hostels in 1990. There is also a travelling day centre in Carnew, which has 24 persons on the books with an average daily attendance of 17 and a small day centre in Arklow town.
There are 13 psychiatric nurses assigned to community facilities in the Wicklow area. The cost of the service in 1990 was approximately £2.2 million.
For the past few years the Government have made available a special additional allocation specifically for the development of the adult dental services and the provision of orthodontic treatment. A sum of £3 million was provided by the Government in 1990 and a further £3 million was provided in 1991. In 1991 the Eastern Health Board received an additional £570,000 for adult dental services and an additional £292,500 for specialist orthodontic treatments. The extra allocations enabled the board to provide treatment for an additional 24,000 adults and to bring an additional 710 children into specialist orthodontic treatment for the first time as well as allowing the board to continue the specialist treatment of cases commenced in 1990.
The Eastern Health board allocation for 1992 includes a repeat of the special provision in respect of the continuing development of dental services for adults and the improvement of orthodontic services. The board have included the provision of a new health centre in Bray in their capital programme for community services.
Having heard all that, had I put down the question I would have said "Things are very good. There is no need for complaint". But, of course, I agree that the reality can be very different. We still have serious problems. What I will do to give some comfort to Senator Ross is to ask the Eastern Health Board to examine the specific points he has raised and I will come back to the Seanad with a full detailed reply and see if we can give some kind of assurance to the Wicklow community services. I respect the great work they do and I would like to pay tribute to them. But if they and others like them live in a state of uncertainty, it will be the end of voluntary effort in our society. It would be my aim to see, where possible, that they get support and get the assurance they need so that they can continue to carry out the great work they are doing. Unfortunately, I take over when all the money has been spent or allocated. I am conscious of that fact but to deal with the points raised and if there are other points on which there is any doubt I will ask them to contact Senator Ross and I will come back to him with whatever proposals are possible.
Could I ask a supplementary question and it is not in an adversarial way. I thank the Minister for his last comments which I think are more valuable than the other ones. I think there was a slight misunderstanding in the scripted reply in that he continually mentioned Bray, Arklow, Greystones, Newcastle and areas like that and he referred to County Wicklow all the time. I am referring to Wicklow town, which was conspicuously left out of his reply. I am referring to the Wicklow community services in Wicklow town which are, as his reply demonstrated so obviously, neglected in the whole context of County Wicklow. Bray and Greystones do not come into this, nor do Arklow or Newcastle. I am very grateful for the Minister's response. Perhaps he could ask the Eastern Health Board, when they come back to me, to concentrate specifically on the Wicklow community services which apply only to Wicklow town; they do not apply to the rest of Wicklow.
The Seanad adjourned at 4.30 p.m. until 2.30 p.m. on Wednesday, 19 February 1992.