I propose to take Questions Nos. 378 and 388 together.
My Department has, since 1997, allocated significant levels of funding across the disability sector which has resulted in very significant and unprecedented developments in the quality and quantity of the health related services which are being provided to people with disabilities. A total of €643 million has been invested in these services, of which €388 million was provided for services to persons with intellectual disability and those with autism. The overall total includes an additional €25 million in current expenditure which was made available by the Minister for Finance in the 2004 budget for services for people with disabilities. A total of €18 million is being used by services for persons with intellectual disabilities and those with autism to provide extra day services particularly for young adults leaving school in June 2004, emergency residential placements and to enhance the health related support services available for children with intellectual disability or autism.
The national intellectual disability database shows that in 2002 there were 23,050 people with intellectual disability in receipt of specialised services, representing 90.6% of the total population registered on the database. There were 468 people — 1.8% of those registered — who were without services at that time and were identified as requiring appropriate services in the period 2003-07. This number had reduced by 47, or 9%, since 2001. The remaining 1,930 people, 7.6%, were not availing of services and had no identified requirement for services during the planning period 2003-07.
Since 1996 there has been significant growth in the level of provision of full-time residential services, residential support services and day services recorded on the national intellectual disability database, reflecting, in particular, the significant investment programme in the intellectual disability sector between 2000 and 2002. Key developments noted in the 2002 report include: a 37% growth in the number of people with intellectual disability living in full-time residential placements within local communities; a 165% increase in the provision of intensive placements designed to meet the needs of individuals with challenging behaviours; a 47% reduction in the number of people accommodated in psychiatric hospitals; a continued expansion in the availability of residential support services, in particular service-based respite services, which have grown by 255%, with an additional 443 people being reported as being in receipt of these services between 2001 and 2002 alone; and increased provision in almost all areas of adult day services and in the level of provision of support services delivered as part of a package of day services to both children and adults.
Despite the significant investment outlined, demographic factors are contributing to growing waiting lists for residential services in particular even though the numbers of people in receipt of services continues to increase. For example, in 1981 some 27% of persons with a moderate, severe or profound intellectual disability were aged 35 years and over and in 2002 the proportion of this population aged 35 and over has increased to 45%.
The increased birth rate in the 1960s and 1970s has resulted in large numbers of adults in their late 20s and early 30s requiring full-time residential services. In addition, people with an intellectual disability are living longer than previously, increasing the need for services compared to previous generations. This has also been the international experience in service provision to this population.
The need to provide for additional day places for young adults leaving school in 2003 and again in 2004 also reflects the increased adult profile of those requiring support from these services in that the numbers leaving the adult day services are not sufficient to free up places for younger persons coming through from the schools.
One of the major difficulties facing the health services in delivering support services to people with disabilities, is the shortage of certain professionals such as speech and language therapists, occupational therapists, physiotherapists and psychologists. Significant progress has been achieved in boosting the number of therapy training places. Last year the Ministers for Education and Science and Health and Children announced 150 additional therapy training places in speech and language therapy and occupational therapy.
There has also been a concerted overseas recruitment drive on behalf of all health boards, the introduction of a fast track working visa scheme for health and social care professionals and the streamlining of procedures for the validation of overseas qualifications. The success of these measures is reflected in the increases in speech and language therapists and occupational therapists employed in the public health service over the three year period to end of 2002, with a 73% increase in occupational therapists and a 33% increases in speech and language therapists.
From the information outlined, it is clear that while significant progress has been made in recent years, there is a need for a continued programme of investment. I am not aware of any submission from the East Coast Area Federation.
