I thank Senator O'Sullivan, Senator Wall, Senator Kelly and their colleagues for tabling this motion. I also thank all who contributed to what has been a very constructive debate.
I welcome the opportunity provided by this motion to reiterate my commitment and that of the Government to provide, in accordance with the policy agreement A Government of Renewal, the highest possible level of services for persons with a mental handicap. We aim to create an environment in which all persons with a disability, of whatever kind, can freely exercise their full rights as citizens in our society.
Senator Kelly spoke eloquently about the late councillor Michael O'Regan. Michael was blind for a great part of his life. However, this did not prevent him from living a full and active life and participating in a full range of public service positions. In his capacity as chairman and member of Tralee Urban District Council, chairman of the board of management of Tralee regional technical college and Tralee Town vocational education committee, Michael displayed a resilience which is an example to us all. Obviously, Michael had a particular interest in those with a disability and strove throughout his public life to improve services for those less fortunate people.
Indeed, it is both poignant and appropriate to recall that at his last Labour Party national conference a few weeks ago, both the Minister for Equality and Law Reform, Deputy Taylor, and myself were in a position to advise him that, in response to a motion put down by his branch in relation to the rights of the blind community, the equal status Bill, which is to be published this year, and the Disabilities Act, which is to follow the report of the Commission on the Status of People with Disability, will be addressing these issues in a substantive way. Go ndeanna Dia trócaire ar a anam dílis.
Services for people with a mental handicap have changed radically and for the better over the last 20 years. The high standard of service provision which has been achieved is due to the sustained efforts of the voluntary and statutory sectors which have worked over the years to assist clients and their families. They have also worked to educate public opinion regarding the rights of persons with a mental handicap to develop to their full potential and to be integrated fully in their communities.
It is important to point out that we in Ireland have established an international reputation in the field of mental handicap. The role which the voluntary agencies have played in developing services for people with mental handicap is well known. Initially, they received little support from the State for their efforts. Today, however, the State provides almost the entire funding for the services. The voluntary sector continues to play a leading role in pioneering new services and new approaches to service delivery.
Parents and other family members play a vital role in the development of services for persons with mental handicap. It is through their demands for improved services that many of the advances have been made over the years. The Government recognises the importance of their involvement in all aspects of the services.
Since 1993, parent representatives, nominated by the National Association for the Mentally Handicapped of Ireland, are members of each of the regional mental handicap co-ordinating committees. Parents' interests are also represented on these committees through the involvement of the many voluntary parents' and friends' organisations which provide services for persons with mental handicap. In this manner, parents and families are involved in the overall development of services on a regional basis, in addition to their involvement at local level.
Further evidence of the recognition by the Government of the role of NAMHI and the interests which it represents was given in the fact the annual capital grant to NAMHI by my Department was increased by £20,000 in 1995. This will enable NAMHI to employ an additional staff member and improve services to its affiliate members.
As I have already stated, the services which have been developed in this country for people with mental handicap are of a high standard. However, I recognise that we still have much to do if we are to meet fully the needs of all persons with mental handicap who are on a waiting list. It is important to understand the background to the challenges which face us in meeting the needs of people with mental handicap and their families.
The fundamental problem which we face is that the number of people with mental handicap has been growing faster than the capacity of services to meet their needs. The growth in the numbers is a result of increased longevity of people with mental handicap rather than a rise in the incidence of mental handicap. As the life expectancy of people with mental handicap increases, fewer vacancies arise in existing residential and day care facilities.
This factor has led to particular problems in that, in addition to the requirement for new services, existing services have had to change to take account of the needs of the growing number of older persons with mental handicap. The needs of this group mirror those of the elderly in the general population. The incidence of illness, increasing infirmity and the onslaught of senility with its associated problems mean that a much higher level of nursing and medical care is required in the management and care of this group.
As the population of people with mental handicap still being cared for at home grows progressively older, so too do their carers. It is not uncommon to find parents in their seventies caring for a son or daughter in his or her forties. I understand those parents' concerns about the future welfare of their son or daughter. Those parents made great sacrifices to keep their children at home. They need and expect the reassurance that their son or daughter will continue to be cared for when they can no longer look after them.
It is imperative, given the substantial investment in the services, that we ensure that the best use is made of those resources and that new services are provided which meet the needs of clients who require them and are flexible enough to change as those needs change. To do this, we must be aware of the extent and the nature of the challenge which we face. One of the most important and basic factors required is information on the numbers of persons with mental handicap and their current and future needs. To date, this information has not been readily available. The establishment of the national data base on the needs of persons with mental handicap will provide my Department, the health boards and other service providers with accurate information which will assist them to target the resources at the areas of most need.
Since 1990, additional funding amounting to £32.58 million has been made available to develop services to persons with mental handicap. Up to the end of 1994, over 780 new residential and 1,650 new day care places had been provided. The home support services, which were initiated in 1992, have been expanded in subsequent years and are now established as an essential component in the range of services available to support and assist persons with mental handicap and their families.
Assistance has also been given to agencies in recent years to meet identified needs in existing services. These needs include the problems I have already mentioned concerning more elderly clients with greater medical and nursing requirements. Overall expenditure on the services in the period 1990-94 increased from £161 million to £238 million.
The challenge which still faces the Government, service providers and the families of those with mental handicap is to develop services in a way which matches the needs and promotes the abilities and integration of people with mental handicap. The Government has outlined its commitment to the development of services to people with mental handicap in the policy documents A Government of Renewal and the Programme for Competitiveness and Work and also in the health strategy, Shaping a Healthier Future. It is my intention, as Minister of State with special responsibility for services to persons with mental handicap, to translate this commitment into a reality.
Additional funding amounting to £12 million has been made available this year for the further development of services which will become part of the ongoing annual funding of these services; £2 million was used to improve the quality of existing services. £8 million revenue and £2 million capital have been allocated to the health board regions and will be used to provide a broad range of additional services including: 189 additional residential and respite places; 418 additional day care places; further expansion of the home support services; additional funding for the improvement of services for persons with a mental handicap who are also behaviourally disturbed; implementation of my Department's policy document on services for persons with autism; provision of hepatitis B vaccinations for staff working in the mental handicap services and client groups who are considered to be at risk; and continuation of the programme to transfer persons with a mental handicap from psychiatric hospitals and other unsuitable placements to more appropriate care settings, and £600,000 of the £8 million revenue this year has been specifically earmarked for this purpose. Autism was raised by a number of Senators. This year £300,000 has been set aside in what we might call a bid situation where we are asking health boards to come forward with worthwhile proposals in the whole area of the care of those with autism.
Senators will know the policy document was published last autumn and, rather than spread that money thinly, we are seeking innovation and better care. In effect, some areas of the country will present a headline for others to emulate, so I look forward to the responses to that extra money this year. The precise services to be provided in each region will be agreed by the regional mental handicap co-ordinating committees within the guidelines issued by my Department and approved by me.
Under the Operational Programme for Human Resources Development 1994-1999, funding is made available from the European Social Fund (ESF) and the Exchequer for training people with disabilities. A new training programme is being introduced this year. This programme, called the Training Opportunities Programme (TOP), is a prevocational programme with particular emphasis on social rehabilitation of people with significant levels of disability, such as mental handicap and mental illness. In addition, the Government is also providing funding for 600 training places which will cater for around 1000 trainees outside of the training provision in the operational programme. Both of these measures are specifically aimed at providing opportunities for those who are not suited to placement in level 1, 2 or 3 training courses funded from ESF sources.
Capital funding of £4.2 million has been allocated in 1995 for the development of vocational training centres for people with disabilities, including people with mental handicap. The programme is part of the 1994-1999 Human Resources Operational Programme (OP) under the EU Structural Funds, which provides for a total capital allocation of £33.58 million for vocational training centres for the period 1994-1999. European Regional Development Fund (ERDF) funding assistance of £18.2 million is being provided under the OP with the balance being provided by the Exchequer. This is the first time that aid from the European Regional Development Fund had been approved for infrastructural investment in training for people with disabilities. It is a welcome development which will ensure the availability of training centres of the highest quality for people with disabilities.
In 1993, the Minister for Equality and Law Reform, Deputy Mervyn Taylor, established the Commission on the Status of People with Disabilities. The commission is to ensure greater participation by people with disabilities in all aspects of life and to make recommendations setting out necessary changes in legislation, policies, practices and structures to help achieve that objective. The commission has undertaken a comprehensive review of the current situation, including extensive consultations with people with disabilities, their parents and carers as well as other relevant interests. It is currently engaged in specific consultations in the area of mental health. It also established a working group on health with the specific purpose of bringing forward proposals with regard to the health needs of people with disabilities.
The Government will take specific action to end discrimination and to ensure equal opportunity for participation by all citizens in Irish life. In this regard, when the commission has reported, the Government is to introduce a Disabilities Bill to set out rights of persons with a disability, including persons with mental handicap together with means of redress for those whose rights are denied.
As we approach the final years of this century, it is becoming increasingly clear to us all that disability and matters pertaining to it are no longer fringe issues. Thankfully, disability is now very much centre stage, both nationally and internationally.
The establishment of the Commission on the Status of People with Disabilities has given a new impetus to everyone in this country concerned with disability. It is my belief that the work of the commission will turn out to be revolutionary in its impact on the lives of Irish people with disabilities.
The two year period for its deliberation, which the commission was given in December 1993, has just a few months to run. The listening exercises which the commission held throughout the country last year were a great success. The Commission for the Status of People with Disabilities offers us the best hope yet to have the place of our fellow citizens with disabilities acknowledged and to have their needs catered for as a valued and essential part of Irish life. The Government is totally supportive of the commission and the work it is engaged in. When its final report has been made, this Government will take its recommendations on board very seriously and will follow up with whatever actions required.
The Department of Equality and Law Reform's legislative intentions insofar as disabilities are concerned are well known. Late last year it published proposals which will significantly impact on the lives of people with disabilities. In both employment and non-employment areas, the Minister for Equality and Law Reform is bringing forward legislation to extend legal redress against discrimination over a wide range of grounds, including disability. Our intention is that this legislation will make discrimination unlawful in the work place but also in education and in the provision of goods, facilities and services. The legislation will comprise of two Bills: a new Employment Equality Bill, updating the 1977 Act which will deal with discrimination in the workplace and will provide protection for those with disabilities, among a number of other categories; and an innovative and far-reaching Equal Status Bill, which will cover discrimination in non-employment areas. With the enactment of these two pieces of legislation and the publication of the findings of the Commission on the Status of People with Disabilities, the lives of Irish people with disabilities in the 21st century will hopefully be far more diverse and will provide far greater opportunities for pursuing a fuller lifestyle than has been the case in the past.
In implementing the health strategy, the Government is making the clearest statement yet that our health services should first and foremost help those whose health needs are greatest. The health strategy, Shaping a Healthier Future, outlines the way forward for the health services and emphasises three important principles: equity, quality of services and accountability. This last principle, accountability, is especially important in the context of the necessary reorganisation of health structures and the strategy sets out the decisions which the Government has made in relation to structures.
As part of these structural changes the independent identity of voluntary agencies, which play such an important role in the provision of services to persons with mental handicap, will be fully respected and they will benefit from formal agreements with the health authorities which clearly set out their service requirements and the associated funding. This will permit the development of services for persons with a mental handicap to be undertaken in an agreed, organised manner.
Partnerships between the voluntary and statutory sectors must be strengthened, with recognition and respect on both sides for the other's point of view. It is only in this context that we will be able to provide services which are available when required, which meet the needs of the clients who use them and which are flexible enough to change as their needs change.
To conclude, I reiterate this Government's intention to continue the development of services to persons with mental handicap, our commitment to the implementation of the recommendations of the Commission on the Status of People with Disabilities and the enactment of the necessary legislation to ensure all people with disabilities will be enabled to participate and contribute to the communities in which they live.
