Dáil Éireann Debate, Thursday - 29 February 2024
11. Deputy Rose Conway-Walsh asked the Minister for Health what assistance can be given to a person who is living in full-time care in a nursing home, registered disabled, non-verbal, and has no family assistance and requires transport for various treatment at different hospitals; who is responsible for transport costs to and from medical appointments; and if he will make a statement on the matter. [9701/24]
View answerWhere does the responsibility lie for people who are in long-term nursing care and have to access vital hospital services or orthodontic services. I have a case of a person who has been given a bill of almost €2,500 to get the necessary services. The person does not have an income, is on the fair deal scheme, topped up by his disability payment and his family does not have any means either. Who is responsible in that case?
It is an important question. I will not comment on the individual case, but it is important to state that nursing home residents, whether younger people or older adults with disabilities, should enjoy the same level of support and access to services for which they are eligible as when they lived in their own homes. It is acknowledged that the reason they require 24-hour support is their level of dependency, which, in turn, may cause them to require access to clinical services, including hospital and other healthcare appointments in the community.
I spoke to the Minister of State, Deputy Rabbitte, about this question last night because there is a crossover of responsibility. She said that, generally, people who live in nursing homes because of a disability and because they are not able to look after themselves would normally have had access to supports in a day centre run by the Brothers of Charity, St. John of God or whoever is delivering that support. Transport would always have been provided in such cases and those pathways should be utilised. That is what she tells people. He or she would be known to services and that is where her or she should go.
In my constituency, Waterford, we have also used LocalLink, which is all over the country. Once LocalLink services are given appropriate notice, they have a small discretionary budget that can be used to support people who have no other means of transport to attend appointments. I have used the service, but notice must be given. It is not possible to ring them up and ask for something the next day, so an emergency appointment would be different. The HSE provides a number of intermediate care vehicles, which are used predominantly for non-emergency transport, but they are not everywhere. They are reserved for those who need specific support in transport.
Much more clarity needs to be brought as to where the responsibility lies so that we can avoid a situation where invoices are being sent to the home of someone who is non-verbal, aged in their 40s and does not have the means. Parents become distraught in thinking they have to somehow find this money they do not have.
I commend LocalLink because it is a key to this issue but it does not have the resources. The Minister of State said it has a small amount of resources. Much greater resources must be given by the HSE to LocalLink to take up the possibility, because its staff know a lot of the people involved. That is one option. This is also relevant to ambulance services. Ambulances come from Galway to north Mayo to bring a patient to Castlebar. That is a waste of people's money. I ask the Minister of State to sit down and work this out with the other Ministers so that something like this does not happen again and people in rural areas have transport to get to services.
If the Deputy sends me the details of that case, I will have it looked into because it is not appropriate for the family of someone who is non-verbal, living in a nursing home and dependent on disability allowance and the fair deal scheme to be sent a bill of €2,500. As she said, we need to bring more clarity to this area. I deal with it myself.
LocalLink has been helpful, especially for people who need wheelchair accessible vehicles to transfer them. It is not always possible for people with disabilities to sit into an ordinary taxi to be brought to an appointment or for their families to bring them. I agree that we need clarity on this issue, as it does pop up.
If the Deputy sends me the details of that case, I will work with the Minister of State, Deputy Rabbitte, to see how we can resolve it.
I appreciate that because this is a good example of how we can change things for others. We are not talking about people who can hop on a bus and get to where they need to go. Transport is such an integral part of people being able to keep appointments and get the services they need, and there are not any funds to help people. I am happy to work with the Minister of State to try to solve the problems, not only in this case, but in many other cases. What has happened is that services have been centralised. In some cases, that has been good, such as in cancer care, but without transport, more and more are being disadvantaged. A good service is available, but without transport, people cannot access them. Denying people access to vital dental care and vital healthcare is not acceptable in this day and age. Solutions are available, some of which we have discussed and we will continue to develop them.
The response, which the Deputy will get a copy of, states that under the Social Welfare Consolidation Act 2005, an exceptional needs payment can be made, but that is not always appropriate for a person who may not have family backup and may not be able to communicate. It can be used in some instances, but we need a stronger solution to support people. The CEO of the HSE, Bernard Gloster, has been clear about this, as have the Minister, Deputy Donnelly, and I. Those living in nursing home care should be afforded the same rights as they would be afforded if they were living in the community. I will work with Deputy on this. We get these individual cases every so often, but the Minister of State, Deputy Rabbitte, was very clear that there should always be a previous pathway that can support people and we can also work with her on that.
