Adjournment Matters

Garda Stations

I welcome the Minister to the House and thank him for taking this Adjournment matter which relates specifically to a well manned Garda station. Obviously he has had to make decisions about Garda resources, the restriction in opening hours at Garda stations and the closure of other stations.

I ask specifically about Malahide Garda station which serves 25,000 in the Malahide-Kinsealy-Portmarnock area. The Department of Justice and Equality and the Garda Commissioner's report have recommended that the hours be restricted. What was the rationale for that recommendation? I note the Minister's response to my colleague, Deputy Dara Calleary who asked if the Minister would confirm that this is a Cabinet decision, as opposed to a Garda Commissioner's decision because it had to be ratified by the Government. This is an area in which I grew up, which has expanded greatly and the Garda provide an excellent service. Residents are extremely concerned at the restrictions in opening hours at Malahide and Howth Garda stations. It means that 50,000 people in the Howth-Malahide local electoral area are without a full-time Garda station. I seek clarification on how it is proposed to operate these stations after 10 p.m.

Our concern is that crime does not stop at 10 p.m. In the north Dublin area we have the closure of Rush Garda station which up to now was a part-time station. I am also concerned that placing a restriction on the opening hours of the station affects the status of the Garda station, that effectively it is a second class station and that we would be on a slippery slope towards closure at some time in the future. Will the Minister confirm that will not be the case? How is it envisaged the station will operate? Will the station be manned? Will telephones be answered in the station post 10 p.m.? How will it operate at weekends and during the tourist season?

While the Minister resides in the southside and I am in the north county, I am sure it is an area that attracts many thousands of tourists each year. Everyone is genuinely concerned. I am not trying to over-politicise the point, I am concerned as a resident of the town. There are further restrictions at Howth Garda station with which other colleagues will deal.

In a growing area such as this where there are approximately 38 gardaí, if these changes occur, Swords, which is the nearest full-time station, will have to deal with all incidents from Kinsealy, Portmarnock, Baskin, Malahide, and all the way to the peninsula in Howth, encompassing Sutton and Baldoyle. I hope this issue can be looked at again and the decision revised in order that 24 hour, seven day a week cover can be provided at the station. I am opposed to the decision. I do not think it will result in any savings. I would be interested to know if there are any financial savings accruing from this decision.

Given that part-time stations, such as Rush in north Dublin, are now closed, I cannot see how any financial savings can be made with the closure of that station and the restrictions at Malahide Garda station. As the Minister is aware, it is our duty as Oireachtas Members to ensure our citizens are safe. I do not believe that restricting the opening hours and closing public access to a Garda station such as at Malahide, will do anything to improve people's safety, and I ask him to improve Garda presence.

I thank the Senator for raising the issue. I appreciate that as a public representative he is concerned about the matter. I sometimes wonder whether some of the Fianna Fáil Senators and Deputies are living in a parallel universe. The Senator will recall that the last Government entered the European Commission, ECB and IMF bailout agreement, having managed to totally destroy the economy and overspend to a degree that was extraordinary. As a consequence, the Government entered into an agreement which requires a reduction in Garda numbers and the reduction will be effected in the coming years and is part of the agreement to reduce the numbers in the public service. The steps taken must be seen in the context of the comprehensive review of expenditure, conducted not just by the Department of Justice and Equality but by the Garda Commissioner to ensure that resources are used efficiently and to the maximum benefit of the community.

As the Senator knows I recently laid before this House the policing plan for 2012. This plan, prepared by the Garda Commissioner under the Garda Síochána Act 2005, sets out the proposed arrangements for the policing of the State during the coming year. Under the plan, 31 Garda stations will be closed in 2012, and a further eight Garda stations, which are currently non-operational, will be formally closed. In addition, the public opening hours of ten Garda stations, including Malahide Garda station and two in my constituency, will be reduced. These stations, currently open to the public on a 24-hour basis, will in future be open to the public from 8 a.m. until 10 p.m. each day. It is important to emphasise that we are talking about closing the access to these stations during the night, not closing the stations. The stations will still be used for the provision of general policing services for the locality.

The purpose of this change is not to directly save money, but to make better use of resources, a crucial objective not only for the Garda Síochána but for the entire public service. Instead of having gardaí behind the public counter in these stations during the night, when few people come into the station, those gardaí will be available for front-line operational duties, which will benefit the Senator's constituents. As I said, this is the implementation of a long-promised reform measure.

The reality is that the demand for the services available at the public counter in a Garda station during the night is very limited. People who contact the Garda Síochána during the night generally do so in circumstances of operational urgency, not for the more administrative-type services normally provided over the counter. These services, such as completing forms and authenticating documents, are extremely valuable, but do not need to be available round the clock in every Dublin station, especially considering the proximity of other Garda stations which will still be open to the public on a 24-hour basis. We currently have 703 Garda stations, 47 of which are located in Dublin. I am anxious to ensure that we use the force to the best possible effect to engage in front-line activity as opposed to late night administrative duties. By freeing-up gardaí from counter duty, this change will mean that more gardaí than would otherwise be the case can be deployed on operational duties. This will be a much better use of resources and mean a better policing service. This is the professional judgment of the Garda Commissioner.

The Garda Síochána, like all public service agencies, will have reduced resources in the times ahead, and must introduce efficiencies to make the best use of those resources. This change, which is targeted for introduction in the first quarter of 2012, is just such an efficiency. I firmly believe that the Garda Commissioner should be supported in introducing such reforms. There is no reason of any nature for local concern nor for any Member of this House to foment such local concern. The Commissioner has reiterated the commitment of the Garda Síochána to provide a professional and effective policing service, and I have full confidence in the force's capacity to do this in Malahide and in every area across the country.

It is the Garda Commissioner who makes operational decisions of this nature and the policing report he furnished to me was brought to Government. Essentially, the Commissioner in consultation with the Minister for Justice and Equality makes the decisions in this area. The Commissioner makes the operational decisions and I do not wander around the country trying to identify which stations may close early or which stations should be closed. Let me reiterate that we are not on the slippery slope, as the Senator suggested. I cannot predict what future decisions may be made by the Commissioner, but let me give some examples. As the Senator is aware, Rush Garda station opened for a limited number of hours and its closure will not result in fewer gardaí in the area because there is another Garda station in reasonable proximity and in the Commissioner's judgment, gardaí will be more readily available for front-line services.

The efficiencies sought to be effected by the decisions in respect of the closure of certain stations and the shorter opening hours of others will ensure a more efficient use of Garda resources in the interests of the taxpayers. This is the first stage of a study examining the numbers of people using individual stations, and operational and policing needs. I expect the Commissioner will further revisit the issue of Garda stations for 2013.

I give the Senator's constituents every assurance that this will not affect operational front-line services, rather it will ensure that members of the force will not be sitting behind a desk late at night but will be ready to engage in front-line policing activities. That is the view of the Commissioner and I fully support the action he has taken.

I thank the Minister for his response. I hope his commitment this evening that there will be better policing in the Malahide area will bear fruit. His suggestion of Oireachtas Members fomenting local concerns is unfortunate. I was born and reared in Malahide and I have genuine concerns, which I am perfectly entitled to raise in this House. I do not live in a parallel universe, I live in Malahide and am entitled to raise the concerns expressed by friends, family and neighbours on the restricted opening hours of the Garda station. The over-politicisation of the Minister's response is another stark example——

There is another Garda station.

I asked a question, the Minister gave his answer, but we will see what will be borne out. We will see what the public think about these measures.

I thank the Minister for being in the House. I have not tried to over-politicise the issue.

Does the Minister wish to respond?

The world did not start on 9 March 2011. Many of the difficult decisions being made with regard to effecting efficiencies and use of resources are being made not only in the interests of taxpayers but by the State under pressure because of the appalling financial legacy inherited by the current Government from the Senator and his colleagues during their time in government.

It is an attitude like that which ensured the Government lost the referendum about the powers of the Houses of the Oireachtas to conduct inquiries into matters of general public importance.

The Minister to continue, without interruption.

In so far as there is an issue of a shortage of resources or reducing resources, I do not think there is anything wrong with pointing out the origin of the difficulty. I want to congratulate the gardaí in Malahide, Rush and across north County Dublin for the tremendous work they are doing both in policing the area and in preventing crime.

Frequently the focus is on investigating crimes after they have occurred but there has been a substantial reduction in crimes committed across the broad range of areas in each of the last three quarters for which we have statistics. I want to congratulate the Garda Síochána on the work its members are doing and I wish the force across the country well as we are heading into Christmas. I wish the Senator and his constituents a peaceful and, hope, a crime free Christmas.

I thank the Minister.

I welcome the Minister for Justice and Equality to the House. It is not too often that I have the opportunity to address him, but on this occasion I am asking him to explain the rationale for the proposed closure of Corrandulla Garda barracks in County Galway, and how the area will be serviced, should the closure go ahead.

The closure of 31 Garda stations was announced on 5 December 2011, and the Garda barracks in Corrandulla was included in that list. Corrandulla and Annaghdown is a rapidly expanding townland in County Galway with a population of about 3,858, and 1,300 homes. The population will continue to expand in the coming years, given the popularity of the area. It is located approximately 12 miles — an easy commuting distance — from Galway city and ten miles from Oranmore. It was previously served by Headford Garda station but owing to boundary changes is now classed as being in the Tuam area. This is significant because Tuam is quite a distance from Corrandulla. The nearest Garda stations are located in Galway and Oranmore. Not unsurprisingly, the residents are extremely upset and angry and have stated they do not feel safe, particularly in the absence of a high level of Garda monitoring. There used to be one sergeant and two gardaí in the town, but now there is only one garda who does not have fixed hours. The Garda presence in the area is, therefore, relatively minor.

I am seeking to discover the rationale behind this move and when the Minister plans to proceed with it. Why was Corrandulla barracks selected for closure? A statement has been made to the effect that it is planned to sell the barracks. Will the Minister indicate the position in this regard and state what will be done with the money which accrues from the sale? Will such money be ring-fenced and reinvested in Garda activities? How will the area to which I refer be served in the absence of a Garda station?

I wrote to the Minister about this matter on 12 December. I raise it this evening because a public meeting is due to be held imminently and I am interested in obtaining the facts from him. It is important that they be provided because Members need to be able to respond to those whom they represent. When a group of children visited Parliament today, I informed them that the Seanad was the people's House and that we were their representatives. While we might believe we are always jumping in order to give them what they want, at times that is exactly what we should do. I look forward to the Minister's reply.

I thank the Senator for raising this issue. She has stated she wrote to me on 12 December. I must inform her that at approximately 6.30 a.m on 13 December I flew to Brussels for a meeting of European Justice Ministers and only returned just before lunchtime today. I have not, therefore, had an opportunity to reply to her letter.

To put the matter in context, I recently laid before the House the policing plan for 2012. This plan, prepared by the Garda Commissioner under the Garda Síochána Act 2005, sets out the proposed arrangements for the policing of the State during the coming year. Under it, 31 Garda stations will be closed in 2012, while a further eight currently non-operational will be formally closed. The eight stations in question were all closed for refurbishment works on the watch of my predecessors. However, refurbishment works were never carried out. One of the stations has been non-operational but not officially closed since 1986. Corrandulla Garda station is one of the 31 stations due to be closed in 2012. As stated in reply to the previous matter, the public opening hours of ten Garda stations will be reduced. These stations are currently open to the public on a 24-hour basis, but in the future they will be open from 8 a.m. until 10 p.m. each day.

In reaching a decision on the closure of each of the 31 Garda stations in question the Commissioner reviewed all aspects of the Garda Síochána's policing model, including the deployment of personnel, the utilisation of modern technologies and the operation of Garda stations, both in terms of opening hours and possible closures. In addition, all divisional officers were asked to assess the level of activity in each Garda station in their areas. Based on all the evidence, the Commissioner concluded that resources could be better deployed and more effectively used on the front line if these stations no longer had to be staffed and maintained. This is a crucial point. As with every other public sector organisation, the Garda Síochána will be obliged to manage with reduced resources. Unfortunately, that is the legacy we inherited from the previous Government. The House will be aware that, under plans agreed by the previous Government arising from commitments made in the EU-IMF agreement, Garda numbers are being reduced. It is vital, therefore, that the best use be made of the available resources and, in particular, that priority be given to front-line operational duties.

It must be noted that Corrandulla Garda station is located in the Galway district which is in the Galway division. There are 257 gardaí assigned to the Galway district and approximately 600 to the Galway division. These resources are augmented, when appropriate, by gardaí from national units such as the Garda national drugs unit and the National Bureau for Criminal Investigation. The Commissioner has reiterated the commitment of the Garda Síochána to providing a professional and effective service for the community in all areas, including Corrandulla. In the coming months local Garda management in places where stations are going to be closed will consult local communities in order to determine how best to continue to deliver a policing service in their area.

I take the opportunity to pay tribute to the Garda Síochána. I have complete confidence in the capacity of the force to continue to provide an excellent policing service in Corrandulla and throughout the country. Furthermore, the Commissioner should have the support of the House as he introduces necessary reforms to ensure Garda resources will be used in the most effective way in order that the best possible policing service will be provided for the public. Instead of manning Corrandulla Garda station for brief periods during the day, the officer to whom the Senator refers will be more available to carry out front-line duties.

The Garda stations which are being closed are all owned by the Office of Public Works. The Government is considering different possibilities in respect of different stations. Some will be sold and the proceeds utilised for a variety of purposes. Discussions are ongoing as to whether these purposes will relate primarily to policing matters or whether the money will in the context of the limited funding available to the State be put to other uses. Where appropriate, some premises may be utilised by other State agencies. For example, where they are in good condition, they could be used to provide mental health services or for community purposes. However, this will only be in circumstances where the State no longer retains a liability for their maintenance and refurbishment. In the context of some of the stations being closed, a proportion of the financial savings made will derive from the State no longer being obliged to pay utility costs on an annualised basis. I accept that at some stations these costs are relatively small. It must not be the case that the State will remain liable for incurring substantial costs for the refurbishment, maintenance or, in some instances, part reconstruction of these premises in the coming years. In that context, we must ensure we use our resources more efficiently.

There is a small degree of conflict between the information provided by the Minister and that available to me. I do not know whether the information provided by him is correct. People living in the area have informed me that Corrandulla is served by the Garda station in Tuam, but the Minister has indicated that it is located in the Galway district. It would certainly be more appropriate for it to be served by gardaí from that district. Perhaps the Minister might clarify the position on that matter.

The Minister has indicated that a decision on how best to cater for Corrandulla's policing needs will be taken in the aftermath of a consultation process involving the Garda sergeant and local people. Will that process involve the holding of public meetings or will it proceed on an ad hoc basis? That is the substantive issue, on which I would be grateful if the Minister could provide some more information.

Operational matters are very much the responsibility of the Garda Commissioner and I have left it to him to decide how best to engage in whatever consultative process will be required. That process will not focus on whether stations should be closed or remain open. In the context of smaller stations, the consultative process will focus primarily on providing reassurances for local communities that they will continue to have access to the full assistance of the Garda Síochána. In so far as there may be special local issues about which communities are concerned, individuals will have the opportunity to communicate their concerns about such issues during the process in order to ensure they will be addressed. The Commissioner will be arranging for the consultative process to be engaged in by officers at local level. I expect it to get under way soon.

On the issue raised by the Senator in respect of Tuam, the information at my disposal is as contained in my initial reply. If, however, further clarification is required, I will communicate with the Senator in writing.

I thank the Minister.

Health Services

I thank the Minister for coming before the House. This matter relates to St. John's Hospital, Sligo, which has a fine tradition of providing care, particularly for those who are highly dependent. I was a patient at the hospital which is an old facility. When officials from the Health Information and Quality Authority visited it recently, the Cairde Ward had to be closed. It had 35 to 36 beds for women, many of them high dependence patients. Some of the women were moved out of the hospital and some were moved to other beds on an emergency, ad hoc basis on the understanding that the ward would be refurbished and reopened by Christmas with 19 beds, although my figures might be slightly awry in that regard. My concern now is that the ward remains padlocked. A tender does not appear to have been offered to anybody to do this refurbishment work and therefore it appears that not only will there be the loss of 19 beds in the refurbishment but potentially the loss of the 35 beds. The families and the staff are concerned. I understand also that some of the nurses who were on contracts have not had their contracts renewed in recent weeks and therefore if the ward was to be refurbished and reopened, there now appears to be a shortage of staff. There is considerable confusion and hence my request for some clarity from the Minister today.

I thank the Senator for raising this important issue. It provides me with an opportunity to update the House on this matter on behalf of the Minister of State, Deputy Kathleen Lynch, who is indisposed, and outline the background to the current situation and the action taken by the Health Service Executive. As the Senator is aware, Government policy on older people is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where that is not feasible, the health service supports access to quality long-term residential care where it is appropriate, and we continue to develop and improve health services in all regions of the country and ensure quality and patient safety.

The Health Service Executive has sole operational responsibility for the delivery of health and social services, including those at facilities such as St. John's Community Hospital, Sligo. St John's Hospital is a single-storey building which was first established in 1971. There are 165 beds at the hospital providing long-term residential care, rehabilitation, convalescence, respite and palliative care. Other facilities include an active day hospital with physiotherapy and occupational therapy, and speech and language services are provided also. In April 2011, the Health Information and Quality Authority, HIQA, noted that "the physical environment did not comply with the regulations and standards". HIQA further noted that "the residents' personal and communal space was not designed and laid out in a manner to ensure their safety, encourage and aid their independence and assure their comfort and privacy". In this context, the HSE had to review the maximum number of residents that could be accommodated to ensure the accommodation would suitably meet the individual needs of residents. In addition, the HSE needs to address fire safety issues at the hospital. On foot of the HIQA report the HSE temporarily closed Cairde Ward on 9 October 2011. A total of 24 residents were moved to other wards and staff were redeployed within the hospital. In an effort to address the fire safety issues and the challenges with the physical environment at St. John's, the HSE is considering its options regarding reconfiguration of Cairde Ward.

Residents and relatives have been and will continue to be fully consulted throughout that process. I am sure everyone in the House will agree that the safety and well-being of older people is of critical concern. Quality care and patient safety comes first, and all patients should receive the same high standard of quality-assured care.

From a national perspective, I advise the Senator that the Department of Health is reviewing the provision of public residential care in the light of the need to meet national standards and regulations, local demographic pressures and public and private provision. The review will serve as a platform for discussion and will inform the development of an overall strategy on how the HSE should continue to provide this service in future in view of current budgetary and other pressures. The review must also be seen in the light of the wider health reform programme to which the Government is committed, and the position of social care services in a future health service. It is a matter for the HSE to deliver services nationally and locally within its budget and overall health policy priorities in line with the overall resources available to it. The Executive will continue to work closely with the Department of Health in that context.

The staff, the patients and the families view the standards as being vitally important, and people welcomed the HIQA intervention at that point. I am still unclear, however, because "considering its options" might also mean that Cairde Ward could remain shut. I am no clearer as to whether the refurbishment will start or whether the commitment has been made.

The Senator will appreciate that I am substituting for the Minister of State, Deputy Lynch, who would have liked to have been present. The information I have is that the overall assessment is taking place. I do not want to say anything about the matter that could be misleading. I will draw to the attention of the Minister of State the Senator's concern about the matter to determine if greater clarity can be provided in the context not only of what is specifically being considered with regard to the various options available but also with regard to the timeframe.

I am here to express the need for the Minister for Health to give an assurance that adequate home care for a minimum of eight and a half hours per week will be provided for Mr. J.J. Ryan thus continuing the level of care he receives from the Jack and Jill Children's Foundation and allowing that charity to step back from this case, which should have happened when J.J. turned four years old on 12 September 2011. I also ask the Minister to explain the reason there are regional discrepancies in the provision of care by the Health Service Executive for children in similar cases and the reason the State still does not have a budget for paediatric home nursing care.

The key consideration that goes to the heart of this problem for the family is that the Jack and Jill care team were reminded by Mr. Pat Healy, the HSE's regional director of operations, on 21 November of this year that regarding the HSE providing a home care package, it should be noted that while the package of care for the elderly is to keep people in their own home and out of hospital and nursing homes, with children the emphasis is on ensuring that the children are provided with all the therapeutic and intervention services required while supporting the family.

I urge the Minister to help the HSE to rethink home care for children, the way it is funded and the delicate balance between keeping the child comfortable at home, particularly when the child, like J.J., is prone to infection, and giving the child access to all the therapies they require. Children like J.J. need and are entitled to both.

Mr. Healy from the HSE also reminded all concerned in J.J.'s case that none of the disability services within the HSE are demand-led, something I find difficult to believe. It is imperative in this economic climate that all services operate within their allocation. That goes to the crux of the problem, namely, the budget allocation for paediatric home nursing care and when that will be delivered in line with the programme for Government.

J.J. Ryan is from Tipperary town and was born prematurely in 2007 with a hole in his heart and chronic lung problems. A brain bleed at birth means he also suffers from quadriplegic cerebral palsy, deafness and epilepsy, and he is unable to speak.

I ask the Senator to refrain from mentioning names.

The little boy is unable to speak. His sister is healthy and well, and he also has another little sister. There are children aged three, four and under in the home. The Jack and Jill Children's Foundation supports children from birth to four years of age. The Jack and Jill Children's Foundation is struggling to meet its commitment to the children we mind, but we cannot simply drop this child whose father also suffers from epilepsy. The Dad is a porter in a hospital in Limerick. He has to get the bus to work every day because he cannot drive due to his epilepsy. He is getting an average of four hours sleep per night because this child must be tube fed.

We have to find a way to help this child. The family is looking for eight and a half hours per week, which will cost the State approximately €300. The correspondence to date was on 23 June of this year when the Jack and Jill foundation liaison nurse wrote to a senior HSE disability public health nurse with direct responsibility for J.J., and the assistant national community care director, outlining J.J.'s immediate need for home support care once he reached his fourth birthday in September. The HSE provided a wholly inadequate one additional hour under the home support service, bringing the hours provided to three. On 28 September 2011, Jonathan Irwin, CEO of the Jack and Jill Children's Foundation, wrote to the HSE and put forward solutions for the situation. First, he requested that the HSE put a carer into the Ryan home who would provide respite for the family and give them a break, just as the Jack and Jill Children's Foundation carer does today. The HSE stated that this is not an option in south Tipperary. Why not? J.J.'s current carer, who is funded by the Jack and Jill Children's Foundation, is more than happy to sign up with any agency funded by the HSE. Second, he requested the HSE to put in a home care package. It seems that home care packages in this country are exclusively for the elderly, contradicting the HSE's own policy to provide care in the home for anyone who needs it. We know for certain that caring for people at home is much more cost effective than caring for people in hospital. Again, this appears to be a no-brainer. Third, he requested the HSE to make direct payment to the Jack and Jill Children's Foundation to continue with the current arrangement. This is the last resort option and only on the table because the foundation will not abandon this family.

On 21 November 2011, the HSE south director of operations, Mr. Healy, rejected these solutions. Instead he suggested that the family consult Brothers of Charity to examine relocating resources already provided for J.J. in a different way. This means that J.J.'s parents have to make a decision every day on whether he is well enough to attend the day services. This is not a workable solution.

The Jack and Jill Children's Foundation has made a complaint on J.J.'s behalf to the Ombudsman for Children, Emily Logan, who has appointed an investigative team to examine J.J.'s case.

I thank the Senator for raising this matter. I am taking this Adjournment on behalf of the Minister of State, Deputy Lynch, because she is indisposed. I want to outline the position on the matter raised by the Senator.

I understand that the family concerned are in receipt of six and a half hours home support from the Jack and Jill Children's Foundation and three hours home support from the Health Service Executive. Following a meeting with the Brothers of Charity on Monday, 7 November, and in consideration of the fact that the family could not avail of respite services on offer due to the child's condition, the family were advised that they could utilise a total of 140 hours from one mid-week and one weekend of residential respite per annum. These hours could be used by the family on a regular basis or to increase or decrease the support in the home as required. The Brothers of Charity have written to the family and left an open invitation to the family to revert to them.

Specialist disability services are provided to enable each individual with a disability achieve his or her full potential. Services are provided in a variety of community and residential settings. Services are provided either directly by the HSE or through voluntary service providers. Voluntary agencies provide the majority of services with and on behalf of the Health Service Executive.

While there are many examples of good practice and commitment and initiative of dedicated staff and management, challenges remain in the manner in which disability services are currently configured and delivered. These services have been developed by individual service providers and reflect the individual experience and expertise of providers in meeting local needs. However, as they have developed independently and were often established to serve one specific group of children or clients only, the result is that there is wide variation in the services available in different parts of the country and for different categories of disability.

The HSE has recognised the need to increase the level of consistency and standardisation in the way early intervention services and services for school-aged children with disabilities are delivered. A major priority for the Government in the coming months will be to finalise the current value for money and policy review of disability services to ensure that existing funding for people with disabilities is spent to best effect. It is now more important than ever that large scale spending programmes of this nature are subject to detailed periodic review. The VFM efficiency and effectiveness review will make recommendations that will ensure that the very substantial funding of €1.5 billion provided to the specialist disability health sector is used to maximum benefit for persons with disability, having regard to overall resource constraints which affect all sectors at this time.

Home care packages are currently provided, on occasion, for persons with a disability. They may include home support services, nursing services and home help, with multidisciplinary supports as appropriate. This home care and support package may be an alternative to attending a day or residential service and will be provided following completion of an appropriate assessment process. Usually home support and care packages are provided when it is neither feasible nor appropriate for individuals to attend residential or day services. I note particularly what the Senator has to say about the young person in question.

The Jack and Jill Children's Foundation service is part of a range of services provided to families funded by the HSE and other service providers for children with life limiting conditions. There are approximately 1,300 children in total. Many children availing of services provided by the Jack and Jill Children's Foundation also avail of other specialist hospital and community health supports and disability services. The Health Service Executive is committed to working with the Jack and Jill Children's Foundation to ensure that all children with life limiting conditions receive services on an equitable basis and through a standardised approach to be progressed through the children's palliative care steering group. The national policy, Palliative Care for Children with Life-Limiting Conditions in Ireland, will ensure a national approach to the provision of services for children with life-limiting conditions. All services and service providers will be governed by this approach.

I personally do not regard it as appropriate that we have such wide discrepancies across the country in regard to the level of service that has been provided. It is important that home care packages, where appropriate, are made available in assisting the care of young people, such as the young person to whom the Senator refers, and not just confined to older people. I would like to invite the Senator to furnish to me copies of the November correspondence with the HSE to which she made reference. I assure her I will bring that correspondence directly to the attention of the Minister of State, with a view to seeing if there is any further assistance that can be provided by the HSE for this family and to ensuring that there is full recognition of the needs of the child concerned and the pressures under which the family operate.

I am acutely conscious that the Jack and Jill Children's Foundation is primarily concerned with children up to the age of four years, and that the foundation provides substantial additional care to children over that age, due to the current inadequacies of some of the services provided by the State. I have raised this issue on a number of occasions with the Minister for Health. He also has concerns about how we address these matters. I would be happy to hand over the correspondence mentioned by the Senator to the Minister of State.

The Minister's final words gave me great comfort, because I feel that if I pass on the correspondence, we can go a little bit further.

The Brothers of Charity is a wonderful organisation and I thank it so much for being in touch but, unfortunately, these little children do not really do well in respite. They normally end up with terrible reflux chest infections and they end up with worse problems than they started with. It sounds great in theory.

Home care is quite simple, even though these children are extremely ill and need to be tube fed. We at the Jack and Jill Children's Foundation have proved that it is a fairly simple equation. The foundation would be prepared to extend its care up to six or seven years, but we need that little bit of help with funding, because we believe we can do a good value for money job. I thank the Minister for listening to me. I really would appreciate it if he brought it further because this family are in great despair and it is a bad time of the year.

I am a great admirer of the work done by the Jack and Jill Children's Foundation. If the funding was available and I had the power in the morning, I would make it available to facilitate the service continuing up to the age of six and to relieve some of the financial pressures on the foundation. As the Senator knows, there are huge financial difficulties. There is a huge battle to meet the diversity of needs, pressures and obligations in the health service. There is a huge battle for the Minister for Health and the Minister of State, Deputy Lynch, to fund existing services, and instead of room for expansion on additional expenditure, we have to effect substantial additional expenditure reductions due to the appalling state of the national finances, with so much more spent by the State than it receives in income.

I am happy to follow up this case with the Minister of State. I do not want to make promises that cannot be kept. I draw the correspondence to her attention. I want to ensure anything that can be done will be done in so far as she has any possible room to intervene with the HSE or follow up matters.

I am very conscious there are often dangers and possible health risks in a young person such as the person described by the Senator moving out of the home environment. With all the pressures family members are under they are familiar with dealing with such a young person in the state of extreme difficulty described by the Senator. There is a huge advantage in a continuity of care from a third party who has been involved at nursing level with the young person for some time, as opposed to others who may not be as familiar with that person's condition being brought in where the more experienced person may be readily available and willing to continue, provided they could be appropriately funded.

The Seanad adjourned at 5.50 p.m. until 10.30 a.m. on Thursday, 15 December 2011.