Seanad Éireann debate -
Thursday, 25 Mar 1999

Vol. 158 No. 16

Adjournment Matters. - Mental Handicap Services.

Mr. Cosgrave

I welcome the Minister and hope he will pass on my concerns to his colleague, the Minister for Health and Children.

I wish to raise the crisis which has arisen in services for the mentally handicapped and people with learning difficulties in the south-east Dublin and east Wicklow regions in particular.

There was an important debate on this subject in the Lower House some months ago. We are all aware of the problems in the heath service but any debate on this issue should be constructive and not on a party political basis; it is too serious for any one party to make political capital from it. That may be in order for other matters but not this. I ask the Minister to take my points on board and to pass them on to the Minister, Deputy Cowen.

There are unacceptably long waiting lists in this area at the moment, a problem which must be addressed. At present there are 97 people on waiting lists for residential places, 180 people waiting for respite care and many more waiting for day care assistance.

There must be an immediate injection of funds to meet the capital costs, which are in the region of £7 million, £2.5 million of which is made up of current costs. That is a large amount of money on top of that spent already. It is easy for us, as the Opposition, to say "come up with the money". However, in a time when we can spend money on pet projects and put aside millions of pounds for Army deafness claims, the Minister and his colleagues could go further to pursue funding for the mentally handicapped.

I attended a meeting about this matter a few days ago. On the night in question there were 20 parents present but probably no two parents were from one home for the simple reason that one parent had to stay home to look after their handicapped child. There is much anguish about parents growing old. They wonder what will happen to their children as they grow up. Parents were nearly saying that they would prefer their child to die before them because they are not sure what the future holds for them.

Although it is not just a case of flippantly throwing money at the problem, more is needed. The Minister will know these people in his constituency and need help. In these days of economic success it is disheartening to see families waiting for basic inexpensive items.

We must look at the broader picture. At a time when Croke Park is given £20 million – and I do not begrudge that – we must examine our priorities. We must do more for the mentally handicapped because their lobby is not as vocal as others. It was put to me at the meeting that there are not many votes in helping people with a mental handicap. However, this is an issue which affects Members of all parties; we all know someone who is in this position.

The Minister or his officials should meet some of the people in Dunmore House or St. John of God to discuss their problems. I am not asking that the world be turned upside down, but some money should be found. If this cannot be done immediately, there should be a commitment in principle that some of the problems will be addressed as soon as possible and that a long-term way of dealing with this will be found.

Further problems for service planning are also caused by the changing age structure among those with moderate, profound and severe disabilities.

I am aware that this does not come within the remit of the Minister for Social, Community and Family Affairs, but he is next door to the Department of Health and Children and will be aware of many of these problems.

Minister for Social, Community and Family Affairs (Mr. D. Ahern)

I thank the Senator for raising this important matter and wish to reply on behalf of the Minister for Health and Children, Deputy Cowen. In Opposition and as Minister, Deputy Cowen has been and is very committed to the issue of mental handicap. In devising our policy on this issue, Deputy Cowen was adamant that we should be positive in this area. Since his appointment as Minister for Health and Children, and despite the many competing demands which are made on the resources available to his Department, the Minister has consistently identified as one of his priorities, the provision of the additional residential, respite and day services outlined in the document Services to Persons with a Mental Handicap – An Assessment of Need 1997 – 2001 .This assessment of need is based on information from the national intellectual disability database and provides details of the current and future needs of persons with a mental handicap. It has also identified the amount of funding required to meet these needs over the period 1997-2001 as £63.5 million. This year the Minister was pleased to be in a position to provide an additional £12 million, with a full year cost of £18 million in 2000, for the further development of new services in line with the needs identified in the assessment of need. This £12 million is in addition to the £6 million already allocated to the services in 1999 to meet identified needs in existing services. This brings the total additional funding provided in 1999 for the services to £18 million, with a full year cost of £24 million in 2000.

Additional capital funding of at least £10 million is also being made available to support this year's developments. This funding is part of the £30 million national capital programme for services to persons with a mental handicap which the Minister put in place towards the end of 1997. Of the additional revenue funding, £3.635 million has been allocated to the Eastern Health Board, with a full year cost of £4.61 million in 2000. Details of the precise services to be put in place in the eastern region from this additional funding, including services in south-east Dublin and east Wicklow, and the individuals who will benefit from these services, are agreed by the Central Mental Handicap Planning Committee. This committee is representative of the Eastern Health Board, the voluntary mental handicap service providers and parents and families of persons with a mental handicap.

As a result of the committee's deliberative process, services in south Dublin and Wicklow are to receive additional funding of £585,000 in respect of 21 new residential-respite places and an initial allocation of £310,000 in respect of 31 day places. Further discussions are taking place to finalise the overall position regarding day services in 1999. The agencies benefiting from this funding include St. John of God services, Cheeverstown House, Stewart's Hospital, Peamount Hospital and Sunbeam House.

In addition to the funding mentioned above, £1 million has been set aside by the Eastern Health Board for the management of emergency cases which will arise during the year. This will give the board flexibility in dealing with crisis situations as the need arises. Officials from the Department of Health and Children have had an initial meeting with the various voluntary mental handicap agencies in the eastern region, including some of the agencies providing services in south-east Dublin and east Wicklow, to identify priority issues within existing services which are of concern to them. These discussions are taking place in the context of the transfer of responsibility for the direct funding of certain voluntary mental handicap agencies from the Department of Health and Children to the new Eastern Regional Health Authority in 2000.

I acknowledge the work which families and carers of persons with a mental handicap undertake in caring for their relatives. I understand the frustration of families whose relatives are on waiting lists for services and the toll which the caring and waiting can take on their health. I assure the House that the Government wishes to be of assistance to those families in working with them and the service providers to meet the needs which have now been identified.

While the additional services which have been put in place to date have made a significant difference, their impact on the waiting lists has been reduced because of the number of emergency admissions which had to be made, particularly to the residential services. These admissions affect both the planned management of the waiting lists and the availability of respite care. Given the age profile of clients and carers and the general unavailability of planned respite breaks, the expansion of the residential services must be tackled on three fronts – provision for the management of emergency cases; provision for new residential places for those who have been assessed as requiring this service and provision for an increase in the level of respite care.

This process began last year and has been further enhanced this year. The Minister intends to further develop it as additional resources come on stream. The funding provided in 1999 will bring the total additional revenue and capital funding allocated by the Minister to these services to £53 million in 1999 and £59 million with effect from January 2000. It also underlines the Government's commitment to meeting the needs outlined in the assessment of need for 1997-2001 within the specified timeframe.

The Government looks forward to working in partnership with health boards, voluntary mental handicap services providers and carers, including those in the south-east Dublin and east Wicklow regions, for the further development of services for persons with a mental handicap. Senator Cosgrave's comments will be brought to the Minister's attention.