I welcome the Minister of State to the House. This is a serious matter, although it may not appear to be. We should have adequate residential facilities for people, particularly for male adults whose behaviour is challenged and challenging and whose severe mental handicap makes them, at times, boisterous and violent. There is no institution available to cater for such persons in the Republic, but in Northern Ireland such accommodation exists and caters for the needs of six or seven people from the South. Such accommodation is also found in Great Britain. It is not good enough that provision is not made for those people and their parents. They need respite, an overnight period of care and rehabilitation and these can be provided only when the facilities are in place.
Parents are told that the only facilities available are outside the country in places such as Blackburn and Manchester. The journey to these cities and the cost of residential accommodation are costly. I know of a case where people from Blackburn come to Ireland to assess a young male adult at an annual cost of £95,000 to his parents for the provision of facilities in Blackburn. How will these loving parents be able to visit him? In terms of the provision of care, they are at their wits' end in trying to cope.
There are proposals that there be a structure provided in St. Loman's Hospital to deal with the matter but we do not know when they will be implemented. Will the Minister of State give some information about this facility? There do not appear to be any facilities in the Twenty-Six Counties for someone with behavioural problems. This is embarrassing. The Minister for Finance does not know what to do with the surplus of funds created by the Celtic tiger economy. The disabled sector should have priority with regard to the additional Exchequer funds. There is a limited amount of respite care but no residential care. What is needed is a combination of both that is easily accessible to the families and friends of the few people in this category. Much intensive care is needed. Will the Minister of State inform us of the current situation and verify that to receive such care a person must travel to Northern Ireland and Great Britain? When will such a facility be available? For what numbers of people will it cater and what will be the level of educational care and rehabilitation provided?
Minister of State at the Department of Public Enterprise (Mr. Jacob): I thank Senator Costello for raising this important matter. On behalf of the Minister for Health and Children, Deputy Cowen, I want to tell the Senator that this Government is committed to the continued development of services to persons with disabilities and their families. This year the Minister was able to provide additional funding of £12 million, with a full year cost of £18 million in 2000, for the further development of services to persons with an intellectual disability as well as £6 million that was allocated to the services in 1999 to meet identified needs in existing services. The total additional funding provided in 1999 for the services is £18 million, with a full year cost of £24 million in 2000. An amount of £10 million capital funding has also been made available to the services in 1999 to support these developments.
Some persons with an intellectual disability, including those with challenging behavioural or mental health needs, require more specialist or intensive intervention on an ongoing or intermittent basis. This includes persons who present challenging behaviour or mental health needs. It would include residential services in a more secure environment, more intensive support in day services, specialist and multi-disciplinary support on both an outreach and in-service basis and access to planned respite breaks to assist their families. Planning for the needs of this group is included by the health boards in their overall consideration of the needs in their region. Of the additional revenue funding provided this year, £1.5 million has been allocated for provision of specialist and additional support services, primarily for this group. This funding is being allocated for specific projects in a number of health board regions. In addition, persons with challenging behaviour will also benefit from the additional funding provided for increased day, residential and respite services this year.
Details of the precise services to be put in place in the health boards' regions from their additional funding and the individuals who will benefit from these services are agreed by the regional intellectual disability co-ordinating committees. These committees are representative of the health boards, the voluntary intellectual disability service providers and the parents or families of persons with an intellectual disability. The committees' role is to identify priorities for service developments, to agree plans for the development of services for the region and to recommend plans for the provision of services as resources become available.
The additional services which have been put in place to date nationally have made a significant difference. However, their impact on the waiting lists for both residential and respite services has been reduced due to the number of emergency admissions which have been made. This is a major problem for most health boards. These admissions affect both the planned management of the waiting lists and the availability of respite care. The expansion of the residential services must, therefore, be tackled on three fronts: provision must be made for the management of emergency cases; provision must also be made for new residential places for those who have been assessed as requiring this service; and the level of respite care available must be increased.
As part of this process, funding has been set aside by the eight health boards for the management of emergency cases which will arise during the year. This gives the boards some flexibility in dealing with crisis situations as the need arises. At the request of the Minister, Deputy Cowen, the health boards' planning for emergency cases has been further enhanced this year and the Minister intends to further develop it as additional resources come on stream.
Pressure on residential and respite services is also increased by the changing age profile of those with intellectual disability. The national intellectual disability database confirms that there are now more adults with an intellectual disability than at any other time in our history. The figures also reveal an ageing population in the more severe range of disability. The increased number of young adults now requiring services means that there are pressures on day and respite services for these young adults, and as this group grows older this pressure will continue in respect of residential care, particularly for more intensive and high support places.
I am aware of the anxiety which exists among both families and service providers regarding the future development of services. It is clear from the 1998 preliminary data from the national intellectual disability database which the Minister recently released that an ongoing investment programme will be required if we are to provide an appropriate response to the needs of people with an intellectual disability and their families. It is also clear, however, from this data that the impact of the additional services, and in particular the additional day services, provided in recent years is coming through.
I acknowledge the work which families and carers of persons with an intellectual disability undertake in caring for their relatives, particularly those with challenging behaviour. I understand the frustration of families whose relatives are on waiting lists for services and the toll which both the caring and the waiting can take on their health. I assure Senators that this 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 clearly identified. Subject to Government agreement, and taking account of the competing demands which are made on resources allocated in any given year to his Department, it is the Minister's intention to continue to invest significant funding in these services to deal with the needs which have been identified for this population group. The evidence of his commitment to these services is clearly demonstrated by the level of additional funding which the Minister has provided since his appointment as Minister for Health and Children over two years ago. The additional funding allocated in 1999 brings the overall amount of both capital and revenue funding made available by the Minister to the intellectual disability services to £53 million in 1999, increasing to £59 million in 2000.