I welcome the Minister to the House.
Services for the Mentally Handicapped: Motion.
I move:
That Seanad Éireann notes that the additional allocation for services for people with a mental handicap in 1993, at £8 million, is the highest increase in this allocation for many years; calls on the Government to bring forward an integrated plan, based on the Report Needs and Abilities and on the many submissions it has received, to ensure that services for people with a mental handicap are raised to the highest standard. Seanad Éireann further calls on the Government to ensure that—
(a) all policy is based on the recognition that people with a mental handicap have a right to education, training, employment, and residential care, as and when they need it;
(b) the highest possible contribution is made from the next round of EC Structural Funds to the elaboration and enhancement of these rights; and
(c) the parents of people with mental handicap are fully involved in the planning process.
I welcome the Minister. It will be interesting for him to hear the views of Members on an issue which is important to all of us. We welcome the additional £8 million allocated to services for the mentally handicapped in this budget. That is an above average increase at a time of financial constraints for a service which has recently become the subject of public debate.
There has been a move towards community rather than institution based services for the mentally handicapped. Perhaps I should not use the word "institution" but that is basically where services began. I am sure the Minister will distribute the £8 million equally among all the health boards. The North Western Health Board would have no trouble distributing the entire £8 million if it had it. I welcome any move which makes life more bearable for people with a mental handicap.
Community residences for the mentally handicapped may be allocated much of this money, that is where people want to see money spent. Funding is required to provide assistance for mentally handicapped people of all ages. The elderly with mental handicap both in hospital and in the community deserve special attention.
Many people with mild mental handicaps now living in the community spent 20, 30 or 40 years in psychiatric hospitals until the eighties when their situation was assessed and a more relaxed programme of care was introduced. These people had been locked up in institutions for many years until somebody discovered that they were not as ill as had been thought. With a struggle, society began to accept mentally handicapped people as human beings. Community based facilities were established, houses provided and after assessment many were allowed to leave psychiatric hospitals and move into the community.
As a psychiatric nurse for many years I believe this development was a move in the right direction. It is nice to walk downtown nowadays and bid the time of day to persons who, until five or six years ago, were locked up for no reason. New facilities, training and education programmes were made available to persons caring for the mentally handicapped. I admire RNMHs who undergo strict training and work in trying conditions. Funds provided by the Department and the EC have made life more pleasant for persons with mental handicap and helped them integrate into society.
Resource centres are being set up to provide programmes of care for the mentally handicapped. More therapists are required to give clients the benefit of a one-to-one relationship as they learn to survive in the community. It is amazing how some people have progressed from incarceration in an institution to an active life in the community. The wide range of mental handicaps needing specialised attention makes the job of the mental handicap nurse tougher all the time. The nurse must keep his or her head and adopt an understanding approach in a demanding job. RNMHs have performed well and have given terrific service to the community.
The RNMHs organise activities to teach the person with mental handicap to cook and to care for personal hygiene. They also help with integration into the community. Social activities such as going to the pictures or the pub were unheard of for such persons years ago. With help and education that is no longer so. Society will accept persons with mental handicap if ongoing education is provided on the changes taking place in services for the mentally handicapped.
Parents and relatives of persons with a mental handicap may feel that they are not sufficiently involved in the treatment which their child, brother or sister is receiving. Clubs have been established where the client and parent or relative can socialise together. Carers now come into the home to support families and to help the client get involved in the community. This is a tremendous fillip for families. Few families want to put the handicapped person into an institution or even a community home; they would rather keep them at home. Help and support are available at present but more is needed. It would take endless amounts of money to provide all of the support required but the Minister is moving in that direction.
In emergencies residential facilities can be made available for members of families to allow their brother or sister to be taken into care at weekends. While I am glad that respite beds will be made available, much more is required.
I acknowledge the tremendous work of the voluntary organisations who provide moneys for services for the handicapped. There is not a bottomless pit of money and, like many others, they are seeking an allocation. However, as I said, they have done tremendous work in bringing moneys to mentally handicapped services, especially in relation to providing housing and leisure facilities. I compliment them on the work they have done. There should be more leisure facilities for the handicapped in hospitals. Gymnasiums and swimming pools should be provided as the handicapped are well able to participate in all there activities and it brings them closer to a normal way of life. If the money is used to bring about improvements in that way, it will be a tremendous fillip to the people concerned.
I welcome the money made available by the Minister and I know it will be well spent.
I second the motion. The report, Needs and Abilities was published in 1990 in relation to people with a mental handicap and on the basis of that document this motion was brought before the House today. It is also based on the Programme for Partnership Government recently drawn up between Fianna Fáil and the Labour Party. The report was incorporated in the Programme for Social and Economic Progress in 1991 and it was costed at £50 million at the time.
There is a growing need for funding, commitment and co-ordination in the area of mental handicap of which I am aware as a member of a health board. The number of people with a mental handicap has risen by 25 per cent since 1981 and continues to rise. Both society in general and the various health boards are becoming more aware of the growing number of people in the community who need these services. I came across a family recently in which three mentally handicapped adults were being cared for by their elderly parents. Unfortunately, both parents died recently and the three dependants have been added to the statistics.
The motion is in three parts. The first is its introduction which talks about the need to bring forward an integrated plan. That is important because various Government Departments, voluntary organisations and health boards deal with the needs of the mentally handicapped, but there is an urgent need to co-ordinate and integrate them because many areas overlap and the services could be more coherently planned and delivered if there was co-ordination. It is important that the plan is integrated. Point 10 (a), the right of people to educational, employment and residential care, is most important and should be a statutory right. There should be a means redress for those whose rights are infringed, because they are meaningless otherwise.
I welcome the additional allocation from EC Structural Funds of £8.5 million, as even an extra £.5 million is urgently needed. The figure of £50 million in the 1990 report, Needs and Abilities also needs to be updated because it is now a higher figure. Even the £50 million would be difficult to raise through national resources, so we support the suggestion that we should get the highest possible contribution from the Structural Funds, because it is essential to provide for the mentally handicapped.
In the Mid-Western Health Board, we submitted a report to the board approximately a year ago, in which we identified 499 mentally handicapped persons who did not have any service — I am referring to only one health board area — so it is essential that the funding continues. The £8.5 million is the greatest increase to date and although it is welcome, we hope it will continue in future years because it is essential to address the needs of the mentally handicapped.
Thirdly, the involvement of parents of people with a mental handicap is crucial. There are excellent parent bodies working in this area producing reports and working with service providers. Indeed, I have a report here from my own health board which was drawn up by the health board, the service providers and the parents' organisations. It is essential that the parents are involved in the planning because they are probably more involved and give more of their time than any other parental group. Because these people, even in adulthood, are still dependent on others I agree with Senator Maloney that carers must be considered and their views incorporated in the plan.
Different levels and kinds of care are needed. While some need full residential care, others might only require day care, just some help in the home, or respite care, which gives the carers a break for a couple of weeks. The areas of preschool and early intervention is very important because progress could be made if the mentally handicapped were aided at an early stage, this has been proven elsewhere. We should have an integrated multi-disciplinary approach and the various Departments dealing with the situation — the Department of Health, the Department of Education, the Department of Enterprise and Employment and those dealing with EC funding — should be involved as well as the health boards and the service providers. This motion needs to be followed up by the Minister for Health and others. These should be planned over a number of years until all mentally handicapped people are provided with services appropriate to their needs.
We will also support the motion and I compliment the Members for tabling it. The mentally handicapped are often forgotten, except by their families and those who look after them. I welcome the Minister to the House and, I wish him well and congratulate him on his recent appointment.
We support the motion and the proposed points in relation to education, training, employment and residential care. We hope that mental health and mental disability will receive a portion of the money coming from Europe and that parents and professionals will be involved in the preparation of any plan as they are experienced in this area. I compliment Senator Maloney because he sees the problem at first hand. Some of us, through friends or individuals, may have come across it but unless one's family is directly affected one is looking at it from the sidelines.
We support every pound put into these services. I have a query about the £8 million mentioned in the motion as I have been told it may be only £6.5 million. Perhaps the Minister will clarify where the moneys will be spent. Despite our straitened circumstances I do not think any of us begrudge extra moneys for the development and care of mentally handicapped people. Indeed, a portion of national lottery funding should, on an annual basis, be allocated to assist the health and development of the mentally handicapped.
The motion refers to the Needs and Abilities report of 1990 which is a good document containing many recommendations. I hope it will not be left on the shelf like many other reports. I am not sure how many of its recommendations have been implemented so far but I hope that the key points in relation to the policy for the intellectually disabled will be implemented. Certain matters can be prioritised; for example Senator O'Sullivan mentioned that there are no services in some parts of her area and I suppose that may be the case in other areas. It is important to make decisions and progress.
A serious problem in the cases I have encountered is when parents are caring for a teenager, a stage that causes difficulties. Although parents put in a tremendous effort and work hard to do their best for their child, one of their biggest worries is about the future and what will happen to their child when they are too old to cope. The Minister must address the problems of those parents in relation to the development of services for the mentally handicapped.
The report's recommendations in relation to areas like the treatment of young children, residential treatment and treatment for older people should be implemented to ensure that people can live as normally as possible and to provide a back-up service to assist parents. Parents who live with a disabled child or relative throughout the year must get an annual break, it should be part and parcel of the system. An incapacitated relative's allowance or an extra allowance should be provided for carers. The general carer's allowance currently provided is minimal when the care, treatment and attention involved are taken into account.
The Minister might indicate what has been done, since the report was published in 1990, in relation to pilot schemes. As it is nearly three years since then I hope some attention has been paid to it. In my area there are three or four units attached to St. John of God's Hospital who do much good work for which they should be praised and thanked. There is also a shortage of speech therapists in some areas.
The Minister should also deal with the needs of various hospitals as I am sure there are many applications for additional resources. Progress has been made in our psychiatric hospitals where Victorian buildings are a thing of the past and a modern, newer and open policy is evolving. The Minister should look at those areas and, although my colleagues can make valid applications for extra funding, he should heed the advice of professionals in regard to the greatest need and how we can respond to that need. Money is probably the greatest necessity but, as in other sectors, just throwing money at the problem will not necessarily solve it. We should look at where we will get the best value for the moneys spent.
I pay a special tribute to the various voluntary organisations who daily assist families and organise outings. As Senator Maloney said, families of handicapped people should have the same quality of life as any of us and, as far as possible, should be able to do the things that some of us take for granted. A big annual event in Dublin is the outing for handicapped children organised by the city's taxi owners.
I would ask the Minister to consider what I have said and to respond positively to it. The Minister has our support in relation to the provision of extra moneys for services for people with mental handicap. With regard to the lottery, I hope that some amount, no matter how infinitesimal, will be allocated to specific projects or needs in certain areas of the country. Any programme for the provision of facilities would have our support.
I welcome the Minister and congratulate him on his interest in the mentally handicapped and ensuring the allocation of £8.5 million for this very worthy cause.
When I went into public life 26 years ago the only places for mentally handicapped people in my area were St. Columba's in Sligo and St. Conal's in Letterkenny, the psychiatric hospitals. We have come a long way since then. Too much money is spent on institutionalised care. Mentally handicapped people were taken from one institution and put into a better and more comfortable one, which was a step forward. However, they must now be brought into the community.
In the north-west a committee of parents, staff and health board officials work together. Great co-operation and progress is being made. When one makes changes staff are worried about being let go, what is to be done with them and where are they going to go. One runs into problems. Now parents and staff are represented on the committees and this ensures there are no problems and things get done. This is a step forward; and something like this should be done in every health board area.
Mentally handicapped people cannot and should not be institutionalised. They have a right to live in the community. It took a while to educate the community to accept mentally handicapped people. We have reached the stage now of providing them with bungalows. In my village six people have lived in a four bedroomed bungalow for the last four or five years. They are part of the community and are fully accepted by everybody. Unfortunately, the bungalows are only rented at the moment and that is a worry for patients, parents and staff. They worry that the lease may not be renewed or the house may be sold. I would like to see some of the £8.5 million made available to purchase bungalows in the community, in urban or rural areas, to allow the mentally handicapped to live in their own area, where parents and friends can visit them regularly.
There should be more support for carers — those who look after the mentally handicapped at home because we are not giving them enough. Some of the £8.5 million should be used to provide more professional help for carers and to provide more respite care. At present voluntary organisations are providing a great service but they cannot accommodate every handicapped person who needs help. Some of these units have been branded upmarket and some have been described as not so good. We should ensure all units provide the same high standard of care and attention. No one unit should be better than another.
These services are profession led. The professions say what should be done and we do as they say. The time has come to listen more to the parents and to the handicapped. They are being educated. They are reasonably intelligent, some very intelligent. They should be asked what they want, they should be facilitated and given a say in what is being done. Although professionals are needed, they cannot lead the way all the time. Giving the handicapped a say in their own lives is a way to give them independence. It also helps us accept they are human beings capable of making up their own minds. We should discuss matters with them, let them say what they like and, as far as possible, give them what they want. This will let them know they are playing a part in their own rehabilitation.
Care for the mentally handicapped has come a long way. We are bringing them all into the community. We will never again have the secured institutions we had a quarter of a century ago. Psychiatric patients are now accepted in the community and they must be kept there. It is not cheap. The cheapest way is to provide a big unit; the bigger the unit the cheaper the service but that is not giving a proper service. People cannot be treated like that. Extra money should be spent to make them part of the community and to give them a reason for living.
In one of the units in North Sligo the handicapped people have a vegetable garden. They are producing vegetables and selling them locally. This is giving them a purpose in life. They work in their greenhouse, and their tunnels, they go to the local shop, etc. This would not have been seen years ago. I see this transformation in the two units in north Sligo. This is also happening in Donegal, Sligo and Leitrim.
As I said, permanent accommodation must be provided in my area because at present parents, staff and the mentally handicapped are worried. They wonder how long they can remain in the rented bungalows. It was said one of the bungalows might be sold and everybody involved was very anxious until they were reassured it would not happen.
The £8.5 million should be evenly distributed. Because the North-Western Health Board is one of the best in the country, unfortunately, we do not get our fair share of cash. A new hospital was built in Sligo at £650,000 below the estimated cost but the health board did not get that money to develop further services in the community. The health board is not getting its fair share of the money that is available. This money should be used to make permanent services available so that the mentally handicapped can be rehabilitated in the community and can feel they are people, not inmates. That image of the inmate must be abolished. Each person has a name and we call them by their names. We want them to be part of the community and in permanent residence within the community.
At the outset I congratulate the Labour Senators for raising this important issue of service for persons with a mental handicap. I am grateful for the opportunity this affords me to put on the record my commitment and that of the Government to provide in accordance with the Programme for a Partnership Government the highest possible level of service for persons with a mental handicap to create an environment in which all persons with a disability of whatever kind can freely exercise their rights as citizens of this country.
Services for people with mental handicap are provided by voluntary organisations, both religious and lay, and by the statutory agencies, health boards. The expansion in the level of service provision can be seen in that the number of people in receipt of services increased from 8,600 in 1981 to 11,800 at the end of 1990, an increase of 37 per cent. In addition, some 7,500 children attend special schools and classes operated under the aegis of the Department of Education.
From the information currently available within the various health boards, there is a need now for about 1,300 residential places and 1,400 day places for about 2,200 with mental handicap as some persons require both a day and a residential place. In addition, there is a need to expand early intervention services to develop the potential of every child, to improve services for the 942 people with mental handicap still resident in our psychiatric hospitals, and to provide for the special needs of disturbed clients.
A substantial sum of money is being spent on health services for people with mental handicap. In 1992, almost £200 million was spent on these services. Of this, £158 million was spent on the provision of day, residential and support services. A further £36 million was spent on cash allowances. Relative to other public services, funding for the mental handicap services has been protected. The allocation of agencies funded directly by my Department increased from £39 million in 1981 to over £104 million in 1993, an increase of 167 per cent.
The objectives of the mental handicap services are to develop the person with mental handicap to the maximum of his or her potential by ensuring that people enjoy a life that is as normal as possible within the community for as long as possible; that people have access to personalised programmes and their families have access to adequate support, that people who can no longer live at home are cared for in a supportive and appropriate living environment.
This policy is set out clearly in the report of the Review Group on Mental Handicap Services entitled Needs and Abilities. The recommendations of this report were accepted by Government in the context of the Programme for Economic and Social Progress. The cost of their implementation is included in the financial commitment made in the programme for the development of community services over a seven year period, and I can assure this House of my resolve, and that of the Government, to implement as quickly as possible the recommendations contained in Needs and Abilities.
In the light of the recommendations and the priorities identified in the plans from each health board area, and in discussions with the National Association for the Mentally Handicapped of Ireland, my Department proposed that the shortfall in services be tackled on a broad front. It was decided that any additional funding should be used to address a number of gaps in services.
In 1992 an additional £5 million revenue and £1 million capital was made available to implement these proposals. The additional funding put in place last year helped to provide 127 residential places, 37 respite care places, 417 day places, home support services for over 1,000 families, and 26 emergency places. Six places for disturbed clients, including the replacement of Unit B at St. Loman's Hospital, Lucan, were also provided in addition to two early intervention teams and 48 child education and development centre places.
With the special additional funding for services for people with disabilities announced in the budget, it will be possible to put in place this year significant improvements in services in addition to strengthening existing services for people with mental handicap. I wish to confirm to the House that an additional £8.5 million will be spent over and above last year's expenditure for people with a mental handicap.
I am proposing to implement a package of measures similar to those put in place last year which will address the most acute needs for service developments. Additional funds will be made available throughout the country, with particular attention to the health boards with the greatest number of clients without services. This funding will be on top of the additional funding of £6 million made available last year, which is being repeated this year. We are talking about an increase of £6 million last year plus £8.5 million on top of that which I believe to be a significant advance and a significant honouring of the commitment in the Programme for a Partnership Government.
An additional 70 residential places will be available for people with a mental handicap and their families this year as well as an additional 200 day places, and an extension of respite services to support families. This extension will make progress towards the point where planned respite breaks will be available, on a regular basis, to all families and carers. The increased funding will mean additional home support services for 800 to 900 families, and improved services for those who are behaviourally disturbed. Further transfers of people with mental handicap from psychiatric hospitals to more appropriate placements within the mental handicap services are planned this year along with an extension of early intervention and child development services.
The actual services to be provided will be agreed in each health board area by the Regional Mental Handicap Co-ordinating Committee, and approved by my Department. The boards will shortly be given details of the additional allocation of funding. This additional funding of £8.5 million is the largest increase in any year in the amount of money made available to develop services for people with disabilities. It is a measure of the high priority which the Government and I, as Minister for Health, attach to developing services for people with mental handicap and their families.
The European Social Fund provides assistance towards the cost of training people, including people with mental handicap, for employment in the open market. Our vocational training service for people with disabilities currently receives in excess of £26 million per annum of which almost half is for people with mental handicap. However, the ESF does not aid sheltered work programmes or the training of people with disabilities for sheltered employment.
The current ESF rules remain in force until the end of this year. My Department is pressing strongly for a broadening of the role of eligible activities under the post-1993 ESF to include training for sheltered or supported employment. Our views have been made known at EC level.
I must also point out that the provision of sheltered work programmes and sheltered employment is an integral part of the services provided by voluntary and statutory mental handicap agencies. Again, I want to assure the House that this Government will leave no stone unturned to ensure the maximum possible contribution from the European Social Fund towards services for people with a disability.
I agree with the motion that parents of people with mental handicap should be fully involved in the planning process. I want to see this involvement extended and strengthened. In the past year, parent representatives, nominated by the National Association for the Mentally Handicapped of Ireland, have become members of each of the regional mental handicap co-ordinating committees. Parent interests are also represented on these committees through the involvement of the many voluntary parents and friends organisations which provide services for people with a mental handicap. My Department meets on a regular basis with the National Association for the Mentally Handicapped of Ireland and is kept informed of the main concerns of parents. While parents already make an important contribution to identifying needs and planning services, I believe this contribution could be strengthened. In line with the commitment of the Programme for a Partnership Government, I have asked my Department to examine ways in which parents' involvement in planning services can be made more effective.
As this House is aware the Government, through the Programme for a Partnership Government, is committed to improving the quality of life for people with mental handicap and their families. These proposals include the provision of additional funding to accelerate the implementation of the Needs and Abilities report; the enactment of legislation to put the rights of people with a mental handicap on a statutory basis, together with a means of redress for people whose rights are ignored; measures to ensure that the parents and families of people with a mental handicap are adequately consulted and involved in the planning and decision-making processes; measures to ensure greater co-operation among the agencies involved, in such areas, for example, as the assembling of financial and other information, and in the most rational and effective use of transport facilities; an educational programme based on the principle of choice-integration into mainstream schools and classes for those children whose families want it, and improved staffing and facilities in special schools for others; re-classification of special national schools, as junior and senior schools to recognise the fact that students attend such schools up to the age of eighteen. Over time, the equipping of all such schools to the same standards as all primary and secondary schools; the establishment of a vocational training centre for people with a mental handicap on the campus of one of our universities, as a pilot project, to enhance the rights and perception of people with a mental handicap, and to encourage and facilitate research into their training and developmental needs. All of these proposals I will pursue in conjunction with my Government colleagues. I will be working closely with my colleague, the Minister for Equality and Law Reform, Deputy Taylor, to ensure that these proposals become reality as speedily as possible.
The Government is firmly committed to eliminating inequality for all groups in society that have suffered from disability, disadvantage or discrimination. People with a disability are equal citizens of Ireland. The full expression of that citizenship requires the mobilisation of community resources and an injection of political will. We intend to ensure the equality of people with disabilities by ensuring that the services they need are theirs as of right. We will ensure that people with a disability and their families have as much choice as possible in the use of services and that they are consulted about policy and service issues. We will encourage the integration of services with those for the community as a whole, to the extent that people with a disability and their families so wish. I ask the support of the Seanad in this task.
I congratulate the Minister on his report and on his enthusiasm for this task. I liked his constant emphasis on integrating people with mental handicap into the community. This motion was a good one to put forward today. The number of people with mental handicap in the community can only increase over the next few years because of the increasingly longer lifespan of citizens with mental handicap. The sooner we realise this the better.
Persons with Down's Syndrome are often only mildly mentally handicapped. Their main problem can be the ease with which they are identified. Twenty years ago these people had a lifespan of 20 years. Now persons with Down's Syndrome live until their forties and fifties and in many cases can be integrated into the community. I have a friend with Down's Syndrome who is an usher at a cinema. It is a great pity that more of these people were not brought into the mainstream of community life sooner.
I welcome the Minister's remarks about integrating persons with mental handicap into the community. In matters of education it means a great deal to many parents and to the people themselves if they can be integrated into the ordinary school system. There is a need for training for persons with mental handicap. Not all of us are potential Einstein's with IQs of 130. Many handicapped people are excluded from training schemes for which they might qualify. I hope more generous assessment is introduced in this area. Large organisations should be encouraged to employ persons with mental handicap wherever possible.
Residential care in small units is preferable to accommodating people in large institutions. Small units enable residents to enjoy greater freedom and choice. It is desperately important to their relations that people with a mental handicap may lead ordinary lives.
Parents of a child with a mental handicap experience considerable fear about what will happen to the child when they die. I welcome the Minister's plans to invest money in this area but I am always fearful that money intended for one area may be diverted to another. If the Minister allocates money to a particular project he must ensure it gets there. Sometimes one finds that a vacancy can not be filled because money has been diverted elsewhere. Funding is better organised in some health board areas than in others. I hope distribution of this new funding will be co-ordinated carefully throughout the country.
I am anxious about the situation of persons with multiple handicaps. There are persons with a mental handicap who may also be deaf or blind or suffer from a physical disability. These people unfortunately seem to slip through the net. Those who deal with the blind say such persons should be catered for by mental health services; those, who deal with the mentally handicapped say they should be dealt with through services for the blind. As a result children with a multiple handicap may receive little teaching or training. I hope people with multiple handicaps will be carefully provided for. It is absolutely essential that persons with a mental handicap and their parents have more of a say in their treatment. When I talk to patients with mental handicap I am pleased at the number who watch more serious RTE programmes such as "Questions and Answers". When I have asked what they thought of the programme they say that such a person was hopeless and someone else was good. We underestimate the number of choices that people can make for themselves and persons with mental handicaps must be encouraged to make their own choices.
Respite care is marvellous where available and must be supported. Voluntary workers in this area are doing a tremendous job. Any funds, or moral support invested in respite care will pay dividends — people can cope with someone at home for a certain length of time, but a short break is essential then, to enable the carer to resume caring. Caring for somebody with a mental handicap is a major responsibility and a source of constant anxiety to many parents. I strongly recommend that the Minister divert funds into the provision of respite care.
I support this motion. Over the years people have been classified into specific groups according to particular characteristics which are seen to make them different from those whom society considers normal. Labels define individuals in such a way as to promote the denial of their equal rights within society. One has only to reflect on the perceptions and conduct aroused by terms such as race, religion and sex to realise the restrictions and abuse imposed on so-called minority groups categorised by these labels. While labels and classifications have been arrived at for clinical and administrative convenience they can be psychologically detrimental to the individual to whom they are attached. The same difficulties apply to the current use of the term "mental handicap" which is used to identify people who demonstrate varying degrees of learning difficulties.
We must be sensitive to the usage of demeaning terms and behaviours and we must be pro-active on the issue of negative labelling. I recognise that changing or removing labels would be effective only if it were done in conjunction with professionals acting as advocates on behalf of the individuals concerned. It behoves us as legislators to be supportive of positive attitudes already evident within some services that care for those with specific learning needs. I refer to one of the pioneers in this area namely the Hospitaller Order of St. John of God who incidentially introduced a magnificent document on this area entitled Enriching Lives. It is a policy statement and I would be glad to make it available to the Minister and any Member of the House.
When we speak about those with specific learning needs I think we should be aware of the current Irish situation some of which has been outlined by the Minister. Approximately 13,000 people in this country have been classified as having a moderate, severe or profound degree of intellectual disability. This represents 3.6 per 1,000 of the population; over 11,000 are in receipt of services on a day or residential basis and, approximately 8,000 children receive special education. Expenditure by the Department of Health on services to this population is in excess of £200 million. This figure includes expenditure on those with learning difficulties in psychiatric hospitals and the payment of cash allowances and approximately £70 million is spent by the Department of Education on special education.
The benefits of modern health care mean that people with specific learning needs can enjoy a near normal life span. Consequently, more people will require services over a longer time and it is incumbent upon us to provide the best possible services for them from birth to old age.
In Irish society today a number of issues will influence the lives of individuals who attend services for those with specific learning needs. Of particular significance is the continuing development of cosmopolitan and urbanised society, the emergence of an increasingly demanding environment and the changing patterns of employment. It is becoming more difficult for some people to keep pace with modern life which requires greater adaptability. The challenge facing those who avail of services is the increasing complexity of modern society. Future society, it seems, will be dominated by large cities and sprawling suburbs and such environments are not generally conducive to community participation. Since people have to cope with more personal and social issues, it seems to be difficult for them to appreciate and tolerate those who are less able.
It is our challenge to ensure that the individuals we serve are not only in the community but of the community. We must support the development of localised, small, decentralised programmes that promote the concept of full integration. This can only be achieved by co-operation between the service caring for those with specific learning needs and their parents as was stressed by the Minister and other speakers, and also in association with other agencies within the State. We should be attempting to provide services that are co-ordinated, coherent, continuous and comprehensive.
I am glad that paragraph (c) of the motion calls for parents to be fully involved in the planning process and I believe that this must start at the earliest possible time. The principal need of parents of young children is for clear information and support when it has been established that the child is at risk or is demonstrating developmental delays. Intervention for young children should aim to minimise the direct effects of their condition and to prevent the appearance of indirect effects.
The preferred early services model should be in a home-based or in a local community-based setting. The many variables necessary to deliver a home-based programme, such as cost factors, frequency of home visits and professional time, have to be considered in providing a comprehensive effective early services programme. I believe that a comprehensive model for early services should be composed of the following elements; family input and participation, family support and information, a multi-disciplinary team approach, optional programme settings in accordance with the concept of natural environments, developmental assessment and individual programme planning and programme evaluation.
Many of our services are day services and in the past they tended to be based at a central location that served a large catchment area. However, in keeping with the emphasis on improving the quality of life and incorporating the principles of normalisation future planning must provide for the development of small units situated as close as possible to the individual's home.
For the individual to become fully integrated within the community, the following at a minimum must be in place: positive community attitudes, appropriately qualified staff, a variety of day services, including domicilary services, and family support and education. While I am cognisant of the national policy of providing education to students with specific learning needs in special national schools supported by the Department of Education, I believe the time may have arrived when more can be done to bring the education of some or most students with specific learning needs back into the standard education system. At present, while specific education and remedial education programmes are provided within the standard education system, some children are channelled along a road a separation to special pre-schools, special primary or post-primary schools and special vocational training centres. While we recognise that some students have special needs which necessitate their attendance at special schools, I believe we should be promoting the idea of incorporating levels of community based instruction, that is, skills should be learned and practised in real settings, partial main streaming should be pursued and flexible creative learning opportunities should be provided.
With regard to training and employment, I believe that a new and radical approach is required in the planning and provision of programmes for the training and employment of individuals with specific learning needs and that the traditional single-purpose workshop training centre may now be outdated. I realise there is a severe shortage of vocational training and of employment opportunities for individuals with specific learning needs. However, the emerging training and employment services should include clusters of small localised enterprise schemes to provide a variety of training and employment opportunities. These opportunities should concentrate on providing marketable labour intensive services to the local community. As a result, training will be consolidated and skills will be developed relevant to open employment markets.
At the same time, the individual's quality of life should be kept in focus. Individuals should be placed on programmes appropriate to their abilities and, in line with the concept of normalisation, be provided with work opportunities and given a just monetary reward.
It is recognised that there is urgent need for development in training and employment and that additional resources will be needed to enable more enterprise schemes to be established. There has been some move in this direction. In the Hospitaller Order of St. John of God the experience of a number of enterprise type schemes have been very positive. The endeavours of new voluntary groups to provide work, training and employment opportunities should also be supported.
The motion also states that people with a mental handicap, or as I prefer people with specific learning needs, have a right to residential care. Within the last decade new concepts based on the principles of normalisation and quality of life have been developed. In upholding the concept of community-based living we should recognise the right of individuals to participate in choosing their own living arrangements. With the growth of community-based services, the trend towards maintaining individuals within the home setting and the gradual transfer of individuals from large residential services to small community residences, a changing role is emerging for the traditional residential centre.
While favouring various options of community based living arrangements, it will be necessary nevertheless to update and make accessible residential centres for the purpose of providing necessary services for individuals with significant needs including: an aging population with significant special needs; the individual who, in addition to severe profound learning disabilities, has a serious medical condition or a major physical disability; the individual who, in addition to severe learning disabilities, demonstrates challenging behaviour and or mental illness; and in addition to the preceding specialist groups, I believe there is a need to provide respite services to families who are maintaining a son or daughter at home.
I welcome the call on the Government to ensure that the highest possible contribution is made in the next round of the European Community Structural Funds, and I note what the Minister has said in this regard. If any funds are available they should be for the elaboration and enhancement of the rights of those with specific learning needs. We sometimes tend to forget that these rights include the involvement of individuals with specific learning needs in local social and recreational activities. Benefits resulting from such participation include increased contact with members of the community, the opportunity to develop friendships, to develop social networks, to learn new skills and to achieve new goals, all of which contribute to a positive self-esteem.
We should constantly remind ourselves that only a few short years ago, indeed until recently, many people with specific learning needs were referred to in terrible terms — as imbeciles and so on — and locked away in the back wards of institutions. Even today there are people, including some eminent professors, in some of our hallowed institutions of medicine and education — who would advocate killing these people before they were born but, thank God, we have moved on from that. Those who advocate such policies have never witnessed the love of parents for a special child. Often times our aspirations are seen as ideals, however, I am always reminded of the words of Montaigne who said, ideals are like the stars, we never reach them but like the mariners of the sea we chart our course by them.
I welcome the Minister to the House and congratulate him on his appointment.
I am disappointed at the level of contribution in the area of mental handicap over the years. Those involved in providing mental handicap services were under the impression that the £8 million mentioned by the Minister was the contribution for 1993. From the Minister's statement that amount is £14 million — £6 million, as in the previous year, plus an additional £8 million. There is confusion with regard to this allocation among those who work with the mentally handicapped. Confusion also arises from the fact that of the £8 million, £1.5 million was to be directed towards the physically handicapped. In fact, I understand from the Minister's contribution that this is not now the case.
That money would be provided in addition.
Therefore £14 million in full is going to services for the mentally handicapped in 1993. For the record, the Minister has just confirmed this.
You are underfunding it by £500,000.
We have found an extra £500,000 since we started. We are going well.
In 1990, the then Minister agreed to introduce the Report of the Review Group on Mental Handicap Services, Needs and Abilities: A Policy for the Intellectually Disabled at a cost of £50 million over five years. That would be a contribution of £10 million on average per year. When the Programme for Economic and Social Progress negotiations were completed this was changed to a period of seven years and it was decided to pay or to contribute on average £7 million per year. In the first year, 1990, £1 million was contributed by Government; in 1991, £2 million and in 1992, £6 million. That is a total of £9 million where contributions were expected to exceed £20 million. The Minister's contribution of £8 million will bring the total to £22.5 million while the agreement provides for a full contribution at this stage of around £30 million. That is the degree of underfunding on the agreement.
The motion talks of an integrated plan to introduce the report, Needs and Abilities. In fact, this report and its recommendations form an integrated plan making further planning unnecessary. Therefore the part of the motion which states that it is going to bring forward an integrated plan is irrelevant. The plan is there to be introduced and, indeed has been partially introduced at this stage.
I believe that this report is now out of date. It caters for 1,600 places, a figure which on the Minister's own submission is out of date. I understand that in the Eastern Health Board area alone, 1,000 mentally handicapped people are awaiting a service and 362 in the mid-west. In just two health board areas this amounts to 1,362 people. The report, Needs and Abilities, caters for just 1,600 people throughout all the health board areas. The reason why the report figure is now outdated is that when the report was compiled, the waiting list in the Eastern Health Board area, was used as a criterion for determining the numbers of people who would require services nationwide and was generalised for the country. However, now that the full figures are available, anticipated needs are much greater and the £50 million envisaged in the report is insufficient. A figure far in excess of £50 million is required to achieve the objectives set out in this report.
At the moment there are 362 people in the Mid-Western Health Board area who require and who are not in receipt of residential or day care services. The Minister in his speech proposed to provide 270 places for the country. On any evaluation, that figure is totally inadequate to solve the problem. Mr. Martin Duffy the programme manager in charge of services in the mid-west — Senator O'Sullivan and I are members of that health board and have spoken on the issue of services at health board level — has stated that £6.695 million is required to deal with immediate needs in this health board area alone before any programme whatsoever is introduced. I accept that in the mid-west the problem may be more acute than in other areas but let us treat it as an example. The £7 million required immediately by the Mid-Western Health Board is half of the 1993 allocation for the whole country. In 1992 this health board received £275,000. A pro rata allocation in 1993 would be approximately £500,000 or £600,000, sufficient to meet just 10 per cent of immediate needs. I do not want to play politics with this serious and sensitive issue. However, I want to point out the inadequacy of the present contribution and to urge the Government to provide more moneys.
The figure of £600,000 which we expect on a pro rata basis in 1993 will not provide the respite care required for the mid-west area. On a political point, the Labour Party in its document for Government guaranteed, following discussions with the Mid-Western Health Board and Mr. Gerard South of the Friends of the Mentally Handicapped, that £25 million would be invested in services for the mentally handicapped in 1993. It is disappointing that this guarantee has not been honoured.
I agree with the sentiments expressed regarding the need to assist those who care for the mentally handicapped. I congratulate the voluntary organisations who work so diligently in this area. I was approached lately by the Sisters of Charity in Lisnagry regarding the provisions of houses for persons with mental handicap and consideration is being given to applying to the voluntary housing scheme for funds. A similar application has been made in Ballina and Limerick County Council are also hopeful that funds will be made available from that scheme. Perhaps the Minister could encourage his Department officials to consider this application favourably. As Senators Farrell and Lydon have said, people with a mental handicap deserve to be treated as full citizens. As prospective tenants of houses surely they too, are eligible for funding under the voluntary housing scheme?
Unfortunately, the Minister is not here now but in his absence I want to compliment him on his responses to the motion set down by the Labour Party. I know we have support from all sides of the House, despite what Senator Neville said a few minutes ago regarding figures, because I know that if the Minister, Deputy Howlin could obtain an extra £88.5 million instead of £8.5 million he could use it to provide services for the mentally handicapped.
We are talking about a very complex and sensitive issue because, for too long in this Christian country, mental handicap was hidden, it was something of which to be ashamed. Thankfully, those dark days are over and we can now face a problem of this nature openly.
A physical handicap is a problem in itself but, coupled with a mental handicap, it causes dreadful difficulty for the person involved and the family. In the past, a family with a handicapped child — especially a severe mental handicap — was tied down for life looking after that person. This applied particularly to the mother of these children. As Senator Henry said, where mental handicap especially severe handicap, exists very often there is associated physical handicap. Caring for people with a mental handicap was often a 24 hour, 365 days a year responsibility for parents or other members of the family.
I am glad to hear from the Minister for Health, Deputy Howlin, that in addition to the 127 residential places and 37 respite care places, an extra 70 residential places and only 200 day places will be provided this year. These day and respite places interest me most because a family with a handicapped member benefits greatly when that person can go to a different environment for training or change. We need even more places.
As a teacher I know that unless special services are provided in the school, a person with a mental handicap cannot be adequately taught. I am not talking about serious mental handicap but quite mild mental handicap; it needs specialised training to teach such a person. We also need specialised equipment. Recently I came across an instance of a young handicapped girl who required a special computer in primary school. She is now leaving primary school to go to second level school and apparently the computer cannot be transferred from one school to the other. We will have to try to acquire another computer in the post-primary school for her, otherwise she will not be able to continue her education.
We also have to consider the effects of the ageing process. When the parents of handicapped persons die, the handicapped children — now adults — are left on their own. However, they need proper care and attention and must be accommodated in institutions. Very often a handicap caused by an accident can create great difficulties for some people. We need backup and training and finance has been allocated to provide a certain amount.
The psychiatric hospital in Cork comprises grey and red brick sections. In the past, if anybody went in there for treatment it meant the end of a normal life, if a person was in there for even a short time it carried a stigma for life. Thankfully, half that hospital is now closed and for sale, many of the former patients have returned to their own communities or been accommodated in smaller hospitals. However, some people cannot integrate with the community after being locked up in institutions for many years and respite centres provide care in a proper and humane fashion.
I thank the Minister for coming to the House and outlining the services which he will provide. The Minister, Deputy Howlin is very concerned about mental handicap. I know that the extra £8.5 million allocated this year will be increased and that the targets set by the Labour Party for Government will be reached shortly.
The Minister of State, Deputy Stagg, is from Kildare so it is a particular pleasure to welcome him to the House. I congratulate him on his appointment and wish him well.
We all agree that persons with mental handicap have, over the years, been among the most neglected groups in our community. They are still in many ways a very neglected group and I do not think any Government can be proud of its record over the years of funding and support for mental handicap. I note that we began with the figure of £8 million which had increased to £8.5 million when the Minister spoke, which is welcome. If we have that sort of progress over the next 24 hours we will do extremely well.
The Minister indicated that an additional £8.5 million would be made available which is very welcome but it contrasts sharply with the money allocated in the budget to county enterprise partnership boards. One would ask which of these two aspects of our national life is more important, the establishment of county enterprise partnership boards or the maintenance of a proper service for mental handicap? There is no argument about it, the service to the mentally handicapped people is more important.
The figure contrasts sharply with promises made during the election campaign by the Labour Party, that it would increase spending in this area by £25 million in 1993. The Minister referred to the figure in the Programme for a Partnership Government and I am prepared to accept that this is a different figure. Nevertheless, it is well short of the figure indicated to the electorate.
Senators asked how much of the £8.5 million is specifically for mental handicap and I am glad that the Minister indicated that the £1.5 million for physical disability which I had thought would come out of the £8.5 million is additional to it.
Will the Minister state how much of this figure will be allocated for staff, capital spending on workshops and hostels? Can it be broken down in a structured way? The central planning committee of the Eastern Health Board has specified needs of £11.5 million in revenue and £10 million in capital to deal with the backlog in mental handicap services.
People with a mental handicap were referred to at a meeting of KARE, the association of parents and friends of mentally handicapped people in Kildare, as "daoine le Dia"—God's people. It is a very good description, they are indeed God's people. They are fortunate people in many ways but they are unfortunate in others. As they are unable to protest or lobby on their own behalf, they have often been forgotten and, without the excellent work of the parents and the voluntary bodies, their situation would be even worse.
As the Minister is aware in County Kildare we have first hand experience of the wonderful work of the organisations for handicapped people, including KARE, the County Kildare association of parents and friends of handicaped people, Moore Abbey in Monasterevin, the St. John of God Brothers in Celbridge and the Camp Hill community outside Kilcullen. Anybody who visits these establishments is struck by the degree of love — I use the word advisedly — and without it and the care which these organisations give to the mentally handicapped, the situation would be catastrophic. The unfortunate aspect is that a great deal of their work goes into fund raising to keep afloat. For instance, KARE over the past ten years has raised £1 million, a stupendous achievement in terms of dedication to the people they serve.
Needs must be attended to as a matter of urgency. Examples of these are facilities for people with behavioural problems and workshop space for people graduating from the educational system. It does not make sense to educate people and then lose them because they are unable to progress and develop their personalities. Will the Minister say if the unit at the St. John of God Hospital for people with severe behavioural problems will open in 1993? There is also the problem of respite beds being used for other purposes because of a backlog in the system. It is necessary to have a backup system so that if people are bereaved and there is a need for temporary accommodation the necessary beds should be made available.
Senator Henry spoke about the problem of the increased life expectancy of people with a mental handicap. Elderly parents are very worried about what will happen to their children after they have passed on. It is an area which needs a great deal of attention and sympathy. It is causing serious concern at this stage and will probably become a growing concern.
Regarding the aspect of the motion which deals with policy based on a recognition that people with a mental handicap have a right to education, training etc., when is it intended to honour the right to education for severe and profoundly handicapped people? I welcome the Minister's assurance that he will press for a new way of looking at Structural Funds. From my discussions with people involved in the mental handicap area I know that they are most anxious that the EC Social Fund will allow for training for supported employment in addition to open employment. The new programme should include assistance for capital spending, workshops and help in offsetting depreciation of buildings and special machinery. I do not understand why that cannot be done and I am somewhat reassured by what the Minister said in that regard.
We welcome the involvement of parents at all levels in planning and they are already heavily involved in the voluntary bodies. This applies to the federation of the voluntary bodies in Kildare and the National Association for the Mentally Handicapped of Ireland. As the Minister said there are representatives on the regional committees and that is a good aspect.
I am glad the Minister of State, Deputy Stagg, is here because I have a specific request. Will he make more money available from his budget for the housing needs of persons with a mental handicap? I do not know if my next question relates to him or to the Minister for Equality and Law Reform but I appeal for an examination of the planning laws to prevent discrimination against people with mental handicap. It should not be necessary for a group of people to seek a change of use if they wish to live in a house. That is discrimination, it should not happen and a civilised society would not allow it to happen. Communities have fears about mentally handicapped people coming to live in the locality. However, these fears are groundless because it will benefit society to have such people living locally.
The Minister should also examine the way money is allocated through the Eastern Health Board. One of the major problems is that voluntary organisations are forced to find money just to pay bank interest charges. That is not very sensible.
I support the implementation of the Needs and Abilities report and the introduction of a new mental health Bill. Worries about service providers were raised by KARE earlier in the year relating to whether the Department of Health or the Department of Equality and Law Reform which has responsibility for services for people with a mental handicap. The point is that the pressure on parents with children with a mental handicap is bad enough without the State adding to it. This must be the priority in all the State's efforts in this area. We must ensure that the pressure is reduced, indeed eliminated, and that the energy of the parents is devoted to their children.
The mentally handicapped are people of profound merit and can contribute significantly to our self esteem as a society. They reflect our behaviour as a society and the place for them, if it can be done, is in the community. I welcome the Minister's commitment in that respect. One of the most inspiring events I attended last year was the presentation ceremony to people who had come back from the Special Olympics. They received their medals from Michael Carruth and the enthusiasm of those young people for the event and the affection they had for Michael Carruth was inspiring. It should be repeated all over the country and, therefore, I have pleasure in supporting the motion.
I will not delay the House but I would like to make a few points in regard to the motion. I support it and I am glad that it has been brought forward to an early date so that the Minister, the Minister of State and the Government will know that people need more help, institutionalised and community based. There is a growing need for funding and I welcome the additional allocation in the Programme for a Partnership Government towards this extremely worthy cause.
In the past ten years the level of mental problems has become apparent as a result of big institutions closing or reducing their intake. People with a mental handicap are living in the community. I am sure if Members examined their areas they would agree that those people are capable, with a reasonable amount of help, of integrating quite well with the community. For many years these people were kept in isolation from the community and the community was isolated from them and I am glad that has changed.
It is also recognised, I have seen it at first hand, that a mental handicap does not mean people are incapable of playing a small part in the community if they have proper education, training and supervision. It is wonderful to see people who have been institutionalised for many years living in housing estates and taking care of themselves as a result of training programmes. They are able to visit their local shops and are capable of doing to a large degree the things that so-called normal people in society can do. I am seeking help from the Minister.
An organisation called Grow, involved in community welfare in Ireland, may be the missing link in our mental health network. These people, who have gone through the trauma of mental illness and recovered are helping those who are suffering from mental illness or mental handicap. They are better able to concentrate the minds of the people who have the handicap and give them the benefit of their experiences.
Even if conventional resources, facilities and personnel were more readily available to tackle the daunting task of limiting the damage to those who are incapacitated. One additional element would still be required, that is, the awareness and the commitment of the individual, strengthened and enhanced by interactive contact to achieve recovery, rehabilitation, reinforcement and prevention. Grow provides this element through its philosophy of personal growth.
I have seen at first hand the great value of these projects on people who have developed through interaction on a one to one basis with people who have themselves suffered mental illness. The Grow method is based on the conviction that habits, not diseases, make us ill and that learning together to change these habits can make us well. This approach empowers sufferers to develop practical know-how for the rebuilding and transforming of disorganised, rebellious and tormented minds by rediscovering from experience a natural wholesome order in human living.
It can be a profound experience to go into one of these Grow communities and see the development of people who were neglected in and rejected by society. Whether that development is in the arts or in education one can see the great joy that is given not only to the person with the handicap but to the person who passes on the knowledge in a caring and sharing way.
The Grow community concept is one the Minister should look at carefully. It is a group which was formed in Australia in 1957, and has expanded dramatically. From my experience of it in the southeast, it is a concept I would like to see receiving funding for development. A small amount of funding could be shared by groups who are caring, and who have the knowledge and motivation to share. This would be much less costly than caring arrangements provided by institutions or professional groups. I am not suggesting that it is the only way forward but it is a way forward I would recommend.
The concept of isolating people with a mental handicap is, thankfully, a thing of the past. I am delighted that the large, old hospitals — and in many cases they were high-walled prisons — are fast disappearing. However, we have to be careful. I saw in a report from Wales yesterday that a man who had been institutionalised for many years was put into a small community of four or five people. On the first day he decided to have a bath but did not realise he had to check the temperature of the water. The water was too hot and he died. That can happen to any elderly person. If people are taken out of the institutional environment they have been used to and go into a different environment, they need close supervision initially, but they can develop.
Victor Hugo said nothing is so powerful as an idea whose time has come. Institutionalisation is not just living in an anonymous and impersonal environment; it can also be a state of mind. If the sentiments behind this motion are acted upon and if the money to implement an integrated plan in the report Needs and Abilities is forthcoming, I think this Government will help to create a more caring attitude and a better environment for people with mental handicap.
I wish to share time with Senator Maloney.
Is that agreed? Agreed.
I welcome the Minister of State, Deputy Stagg, to the House. It is appropriate that he take over this debate from the Minister for Health because it involves his portfolio in a real way.
In his contribution Senator Dardis made two points with which I agree. First, the idea that one has to seek a change of usage for a house to accommodate mentally handicapped fellow citizens is an abomination. This situation arose in the housing estate where I live which is close to the COPE Foundation in Cork, a very sophisticated facility. A house was bought and an application made for change of use. A neighbour approached me and asked me to sign a petition protesting about the housing of four or five mentally handicapped people in our estate. I was horrified but I understood the fears they were expressing about their cars, their gardens, their children not being able to play football and so on. Two years on, these people are as much a part of our community as any of the other children. It took a bit of getting used to but it was more than worth the effort; it was a valuable method of integration. This is an issue the Minister for Equality and Law Reform, Deputy Taylor, should examine; it is simply not justifiable in any circumstances.
The second point Senator Dardis made related to housing allocation. The Minister of State, Deputy Stagg, has special responsibility for providing houses for the citizens of Ireland. We are talking about citizens of Ireland and I know that the Minister of State has a deep interest in this area; and I am sure, with the Minister for Health, he will do what he can to alleviate the problems associated with housing the mentally handicapped in the community.
I was heartened by the attitude and support of Members of the Opposition. They received the motion in a generous way. Some of their comments in relation to the Labour Party's commitment to provide £25 million for the mentally handicapped were valid political points but the reality is that in the present financial climate, with high unemployment and problems facing companies like Aer Lingus and Greencore, the provision of an extra £8.5 million to any area is a huge sum of money. It is indicative that this Government which appointed the first Minister for Equality should decide to help a group where unjustified inequality is rife and which does not have a political lobby. In this country lobby groups are powerful and have voting rights but the handicapped do not have a vote or a powerful media lobby.
There are 25,000 people with a mental handicap, and mothers are trying to keep 40 year olds at home. It seemed to this Government that if there were extra resources this is where they should go. I am glad that in addition to the £6 million allocated in 1992, we now have £8.5 million to relieve some of the burden on those people.
I have been involved with groups and I have friends with mentally handicapped children. When I visit their home I leave with a feeling of awe as to how they cope and stay sane. We should do everything we can to help them, to share their burden and to alleviate their suffering. On the birth of a Down's Syndrome baby there is shock and fear as to what will happen to that child as they grow older. The other question is what is going to happen to them when the parents die. Parents should know what is going to happen to their mentally handicapped children when they die. If ever the State was in loco parentis, it is in this area. Nobody should have to wonder what is going to happen to their son or daughter when they die. That question should be answered and the information should be available. It should not be a question which adds to the fears and burdens these parents already carry.
The extra money will do a number of things. It will help to reduce that fear. It will also confer rights on all citizens with a mental handicap. This is not charity; these are their entitlements. As far as this Government is concerned, I hope it is the beginning of a process, and at the end of four years, if we can point to this one area and say we have effected real, fundamental, long lasting change, I would leave this Chamber happy.
Responsibility for the handicapped is spread over the Departments of the Environment, Education, Health and Finance. For the information of the media and Members of the Opposition, the much criticised programme managers structure set up by this Government will work, and is working, to co-ordinate a planned approach to deal with this area. In the empire building structure of Government — and all parties are guilty — nobody wants to surrender either a part of their budget or a part of their responsibility. They defend what they have. I believe that under this Government people will recognise that one Department can co-ordinate the services for the mentally handicapped more efficiently than when it is fragmented throughout the system. It will also allow the parents of mentally handicapped people to ascertain their entitlements throughout a child's development by contacting one Department. That is how it should be. The programme managers will make a considerable contribution towards streamlining the service and making it accessible. As Senator Dardis said, that is the civilised thing to do.
Sweden has one of the best health services in Europe. It always struck me as a measure of their commitment to their fellow citizens that they were prepared to impose substantial taxes on themselves to provide facilities to those who are less fortunate. Their record in terms of the mentally and physically handicapped is second to none. It is a country from which we could take lessons. When allocating money to this sector, the old Irish element of begrudgery does not come into play. Nobody begrudges money spent in this area. It is evident that these people deserve help and giving it has a civilising influence on us. We can learn more from the mentally handicapped than we can teach them.
I thank the Minister, Deputy Howlin, for listening to the views expressed over what were two of the best hours I have spent in the Seanad. I also thank the Minister of State, Deputy Stagg, who I am sure was enlightened by what he heard.
My mind goes back to St. Patrick's Day in Letterkenny. I was walking up the street to the platform before the parade started and I met two former inmates of the psychiatric hospital where I used to work. In the early 1980s they were assessed as mildly mentally handicapped and had spent 20 or 30 years in the psychiatric hospital at that stage. They left the hospital in the mid-1980s having been locked up for many years. They came across the street, shook hands with me and asked me to go for a bottle of stout; it was one of the most enjoyable bottles of stout I ever had. That kind of improvement is the result of more money being spent on the mentally handicapped services.
I thank the Senators who contributed and welcome their views; we all learned from them. There was no mention in the document of the Special Olympics; it was mentioned by Senator Dardis. A small number of people will go from this country to the Special Olympics in Greece. I would like more money allocated to that area to allow more people to participate. Maybe the Minister, Deputy Stagg, could suggest to the Minister that this money could be allocated from the national lottery. To paraphrase the motto of the Special Olympics, ask not that I win but at least give me a chance to win. If what we have done here today improves the environment for people with disability of any kind to exercise their rights as citizens, we will have done a good day's work.
Question put and agreed to.