Thursday, 26 September 2013

Questions (3)

Finian McGrath


3. Deputy Finian McGrath asked the Minister for Health if he will provide an update on the crisis in disability services in St. Michael's House; and if he will make a statement on the matter. [40365/13]

View answer

Oral answers (6 contributions) (Question to Health)

St. Michael's House received more than €70 million in 2012 in funding from the HSE to provide a range of services to approximately 1,660 children and adults with an intellectual disability in more than 170 centres in the greater Dublin area and in Navan, County Meath.

The HSE and St. Michael's House work in close collaboration in regard to the funding and delivery of services to people with an intellectual disability. As a voluntary agency, St. Michael’s House is obliged to work within the resources available to it and in that regard has introduced significant efficiencies over recent years to remain within budget. The HSE has advised that these changes to date have not resulted in service contraction.

The Haddington Road agreement sets out measures relating to productivity, cost extraction and reform which together intend to achieve a required pay bill reduction of €150 million identified in the HSE Service Plan 2013. The agreement provides a framework and opportunities for managers within the health services, including agencies such as St. Michael's House, to reduce their costs associated with agency and overtime and a wide range of other pay costs, in particular through measures such as additional working hours and revised rates in respect of overtime.

The HSE has advised the Department of Health that the recent application of additional budget cuts under the Haddington Road agreement has presented a significant challenge to St. Michael's House. A process is now under way between the HSE and St. Michael's House to identify the impact of these budget reductions on services. In this respect, I understand that the following are under discussion: St. Michael's House proposal of Sunday closing and revised transport arrangements are under consideration in consultation with those families who may be in a position to accommodate this; the HSE is unaware of any issues concerning respite; appropriate staffing levels and skill mix are under consideration in line with the Haddington Road agreement; and patient charges are being reviewed by St. Michael's House in line with national regulations.

The HSE is working with St. Michael's House and other service providers to fully address the needs of school leavers in 2013 by reconfiguring existing resources. The Department of Health has received assurances from the HSE that both organisations are committed to working within the terms of the Haddington Road agreement to ensure that services are impacted upon only as a measure of last resort.

I thank the Minister of State for his response. I am glad he accepts St. Michael's House is experiencing major challenges in the current economic climate. There is a huge crisis in regard to the services in St. Michael's House. All summer families came to my clinics and they have contacted me about day care services, transport issues and respite. They even contacted me from the constituency of the Minister, Deputy Reilly, because of the lack of services. The reality is that €12 million has been taken out of St. Michael's House services over the past two and a half years.

St. Michael's House has 1,663 service users and 454 residential places and those people are frightened. The parents of adults with severe physical and intellectual disabilities are worried about the transport issue in that they will not be able to get to their centres in the morning. Some parents have told me they might have to give up their jobs to try to facilitate their children.

The Minister of State spoke about productivity and efficiency. St. Michael's House has taken major cuts and has carried out reforms and has cut administrative costs by 34%. Absenteeism is down to 3.5%. It delivers an efficient service and yet the Minister has withdrawn money from it and now the services are in crisis.

I cannot disagree with the Deputy. There are real challenges here. Everybody understands that and, as public representatives, we are all aware of the incredible work St. Michael's House does. In circumstances where costs are being reduced, no one can deny but there is an impact. As I said, the HSE is trying to ensure services are impacted only as a very last resort. A concerted effort is being made by all concerned, including St. Michael's House, to ensure we minimise the impact on services.

I accept the interest the Deputy has expressed in this regard. There are real challenges but they are being addressed in a sensitive way which ensures the undoubted reduction in finance has the least possible impact on services.

When dealing with adults with an intellectual disability, stability and routine are very important. When one disrupts that stability and routine in terms of services, it causes a huge crisis which is what the families have told me. I am disappointed the Minister of State, Deputy Kathleen Lynch, is not in the Chamber because disability is her specific reasonability.

The Minister of State mentioned the challenges, including the Sunday closing, which is a disgraceful cut. He also mentioned transport. Parents have been told to transport their children with physical and intellectual disabilities to the centres themselves which some cannot do.

We are coming up to the budget and I urge the Minister of State, Deputy White, the Minister, Deputy Reilly, and the Minister of State, Deputy Kathleen Lynch, to ensure disability services are top of the agenda. They promised they would protect the vulnerable and now is their opportunity to do so. I urge the Minister to listen to the parents and to look at the savings which have already been made by St. Michael's.

I will take note of what the Deputy said in his rejoinder. The Minister of State, Deputy Kathleen Lynch, is genuinely indisposed on this occasion and no offence should be taken by the Deputy.