Dáil Éireann Debate, Wednesday - 5 December 2018
38. Deputy Pat Buckley asked the Minister for Health the respite care services available for parents and guardians of children with intellectual disabilities in CHO 4; and if he will make a statement on the matter. [50600/18]
View answerMy question is about the respite care services available for the parents and guardians of children with intellectual disabilities in CHO 4.
I thank the Deputy for raising this issue regarding the Government's ongoing priority to safeguard vulnerable persons in the care of the health service.
This Government’s ongoing priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives. As part of its ongoing service provision, this year the HSE will provide more than 182,500 overnight and 42,500 day respite sessions throughout the country.
I am informed by the HSE that, in the context of respite services in Cork and Kerry, it is recognised that the expansion of respite services for people with disabilities is essential to support families to continue to care for their family member with a disability, and in particular those with significant disabilities. In Cork, respite services are provided by COPE, the Brothers of Charity, CoAction, St. Joseph’s Foundation and Enable Ireland. This year community healthcare organisation, CHO 4, has been able to develop a respite house in west Cork from within existing resources. This house will open on a phased basis from next week and will be open to referrals for respite across County Cork. A number of alternative respite services have been very successful in Cork, with more than 800 children and adults benefiting.
In Kerry, the HSE funds adult respite services for people with intellectual disabilities, which are provided by Kerry Parents and Friends Association and St. John of God services. Kerry Parents and Friends opened the Kilmorna house on a phased basis from the end of March 2018 and has been operating at full capacity since the beginning of July 2018, giving 1,460 bed nights per year. This year, HSE CHO 4 has provided in excess of 17,000 respite nights and 2,000 respite day services to people with a disability. More than 900 people with a disability have accessed respite services across CHO 4.
We are acutely aware that families need support to care for their loved ones at home and, therefore, the Government is committed to providing a range of accessible respite care supports for people with a disability and their families. We will give families more choices as we develop respite services.
A reply to a parliamentary question which we submitted states that, from 2017 to quarter 2 of 2018, service hours have gone down. I am interested to hear that the Department is fully committed and the reply we received stated that there were targeted actions to improve supply. However, there is no mention of Cork or of Kerry - it is Dublin, Dublin, Dublin. It seems to me to be an alternative plan. The reply states that the provision of residential respite services has come under increased pressure in recent years. It does not say weeks or days but years, so the Department has known about it for some time. We are getting the same answers over and over again but why is nothing being done? The services are being cut but the demand is increasing.
The funding for disability services has not been cut. Anybody who says that is misleading people.
I said the hours had been cut.
An extra €150 million is being put into disability services in 2019. Respite services are being developed and an additional €10 million has been provided in 2018 for services. I have visited the 12 new houses, the last of which will be completed in the next week or two. They are in each CHO area, with three in the greater Dublin area, and ten new respite centres have been opened to date.
There are issues over the need to develop more services and I will be working with organisations such as COPE in Cork, the Brothers of Charity, St. Joseph's Foundation and Enable Ireland. Additional funding allocated to Cork-Kerry community healthcare has been utilised to progress the development of a respite house in west Cork, which will be open on a phased basis from December 2018. It will be open to referrals for respite across County Cork. We have started investing in services but we are catching up, and I accept the point that there was underinvestment in these services. The reforms have begun and we have begun to put the focus on the person with the disability when we allocate funding.
The question relates to CHO 4 in Cork and Kerry, and I mentioned CHOs 7, 8 and 9, which are Dublin. The Minister of State mentioned money but I am talking about hours. The HSE's reply to the parliamentary question we submitted was that there are a number of factors which impact on the increased demand for respite, and an increasing number of children and adults who are seeking to access respite care. It states that this is a reflection of the general population increase but we have known about the increases in population for several years, yet there is still no forward planning to deal with it. It states that there has been an increase in the levels of complexity across the sector due to improved healthcare and an increase in the age of the population with a disability, resulting in the people presenting with challenging and changing needs. We have known this all along but there has been no forward planning to deal with this either. Finally, it states the HSE is fully committed to delivering much-needed new respite services and supports by the end of 2018. I do not think anything will be ready in the next five weeks to help these people.
I recognise that funding for disability services has increased and nobody is denying it but there is a fundamental issue here. There is more money going in but fewer services being delivered. There are more people on waiting lists but fewer hours are being provided. Something is not working and we need to get to the bottom of it. The transition from child services into adult services is a disaster, and people who have day services and respite services lose them as soon as they reach 18 and are put back on a waiting list. We need care paths, and it is not just about the money. It is about good management and good strategies being put in place.
On the subject of respite care, the Minister of State mentioned St. Joseph's in Charleville. How many extra nights were made available for respite by that organisation in 2018 compared with 2017?
I wish to focus on the number of places available for overnight respite. In CHO 1, which includes my county of Donegal, there was a cut of one third in the number of overnight facilities for respite between quarter 2 of 2017 and quarter 2 of 2018, amounting to 400 nights being taken out of the system. The Minister of State can talk about increases in budget, something we do not dispute, but for parents on the ground the services are getting worse. The Minister of State can shake his head all he wants but the figures are there to prove it and they show that there was a reduction from 1,334 to 900 in that period. How the Minister of State can claim that represents improvement, or even stabilisation, is beyond me.
This year the HSE will provide 182,500 overnight and 42,500 day respite sessions throughout the country. CHO 4 has provided 17,000 respite nights and 2,000 respite day services to people with a disability, while in excess of 900 people with a disability have accessed respite services across the CHO. Deputy Jonathan O'Brien's point is very important. We are putting €1.8 billion into our social care for 2019 but there are issues with the funding. I often ask, in the course of my discussions with the HSE and the Department, why not enough of this filters down to people on the ground. I have set three objectives, which include investing in services and reforming services. I have spoken to parents in Kerry, Cork and Donegal and I will push those points because if there are gaps, they have to be dealt with. There has to be a change in mindset in this House, the HSE, the Department of Health and everybody else so that the focus is on the person with the disability. That is my job as Minister of State and it has been my focus for the past three years.
