asked the Minister for Health the total number of places available for mentally handicapped children at the latest date for which figures are available.
Ceisteanna — Questions. Oral Answers. - Care of Mentally Handicapped.
30.
At the 31st December, 1969, the number of places available for mentally handicapped children under the age of 16 years was 2,431.
In reply to previous Parliamentary questions, I gave particulars of schemes in course of construction or in planning which will provide about 1,500 extra places in the special residential centres for the mentally handicapped over the next few years. These schemes include about 500 places for children and 1,000 for adults but the provision of these adult places will in the main result in the release of accommodation for children and the programme when completed will meet the target set up by the Commission of Inquiry on Mental Handicap for special residential accommodation for severely and moderately handicapped children and adults in need of such care.
Can the Minister say how many mentally handicapped children are awaiting entry?
That is in the next question.
31.
asked the Minister for Health the total number as of the latest available date of mentally handicapped children awaiting entry into approved institutions; and if he will make a statement on the progress to date on this matter.
I would refer the Deputy to my reply to his previous question of 14th July last about this matter. The position is that on 31st March, 1970, the latest date in respect of which information is available, there were 869 mentally handicapped children under 16 years of age awaiting admission to residential centres. I have already outlined the steps which are being taken to provide additional residential places. When these additional places are available the waiting period for admission to residential care should no longer be a problem.
Does the Minister accept the position that there are now 869 mentally handicapped children in the country, many of whom have been waiting for several years to gain entry into approved institutions, and that this is a public scandal? Would he also accept that there is an urgent need to make the five-year programme to which he referred a two-year programme in order to expedite the matter and to reduce this appalling figure which is a national disgrace?
I would completely deny that it is a national scandal.
It is a national scandal.
I have made inquiries in regard to the position of mentally handicapped children in Europe as a whole and we are well in advance——
I am concerned with Ireland.
——of many countries. On the other hand I agree with the Deputy that it is urgently necessary to find this accommodation. Everything that can be done is being done in the matter. Religious orders and lay associations are playing their part. It takes time to plan the buildings, to arrange for the training and teaching of nurses and other personnel. There is nothing in my Department in relation to financial stringency which prevents this campaign from proceeding as fast as it can taking into account the difficulties of planning the whole operation.
(Cavan): Is the Minister aware that the parents of these 869 children are extremely worried in regard to getting these children into suitable institutions? Would the Minister not also agree that in five years time many of these children, if not the majority of them, will be beyond treatment and would he not do something urgently to get these children housed and into suitable institutions, even if they are not perfect institutions, and thus relieve the parents and other members of these families of this worry?
Most institutions will not accept a child after 12 years of age; all of them I think would not accept children after 14 years of age, and eventually when the child reaches 18 he is destined to end up in a mental hospital. This is the criminal position, not so much the waiting list but the fact that boys and girls now reaching the limits may not get into an institution in two or three years' time. What steps are being taken by the Department to change regulations and encourage managers of institutions to accept boys and girls at an age at which they are not now accepted? This is the terrible part of the problem.
I have already given full particulars of the whole programme in regard to this.
Would the Minister state the position in regard to the allocation by Paul Dwyer of New York of his home in Mayo, six acres of land and a voluntary contribution from America to set up a residential home for mentally handicapped children which the Department of Health refused to sanction? We have collected £24,000 in County Mayo for mentally handicapped children. Were it not for voluntary organisations throughout the country there would be very little done in regard to this problem. The Department have fallen down on this important matter.
I cannot remember the exact details but there were very good reasons why the proposal was not accepted. If the Deputy asks a question I will give him the reply.
Question No. 32.
(Cavan): Surely the——
I am calling Question No. 32.
32.
asked the Minister for Health if he will make a statement about the strong representations made in late July, 1970 to his Department by the Dublin Health Authority arising from the acute need for additional suitable accommodation for the adult mentally handicapped and for geriatric cases; and if he accepts the validity of the proposition of the authority that there should be appointed a category of nurse equivalent to that of State enrolled nurse in Britain for a high proportion of the nursing care required by patients in the authority's hospitals.
On 16th October, 1970, I received a deputation of members and officials of the Dublin Health Authority to consider the authority's proposals relating to (1) accommodation for psychiatric, including mentally handicapped patients; (2) accommodation for geriatric patients; (3) the establishment of a grade corresponding to the State Enrolled Nurse grade in England.
I informed the deputation that I was prepared to approve of new building at St. Ita's Hospital, Portrane, which would contain 170 beds for mentally handicapped persons, together with a new physiotherapy unit.
With regard to the accommodation needs of geriatric patients, this depends in the first instance on the level at which community services are available. Such services include special housing for the aged, home visiting by public health nurses and social workers, and the provision of meals for persons unable to cater for themselves. The provision of welfare homes providing living accommodation for elderly persons close to the community and to the various communal facilities is an important part of the total geriatric service. I informed the deputation that I would be prepared to agree to the provision of new welfare accommodation provided that the homes could be suitably located. I also stressed that the health authority should satisfy themselves that the various domiciliary services were fully developed so that institutional care would be confined to those who were strictly in need of it.
With regard to the grade of State Enrolled Nurse, An Bord Altranais, having examined this matter at some length, have decided against the introduction of this grade of nurse at the present time. Certain measures have been taken by my Department and by An Bord which should help to ease any nursing shortages which have arisen in geriatric institutions. These include the payment of a special allowance of £40 a year to nurses employed full-time on the institutional care of the chronic sick, the granting of increments to married nurses and the making of an arrangement whereby general nursing students will do part of their training in geriatric units or institutions. It is too early yet to say what effect all of these measures will have on areas where shortages have arisen. At the discussion with the deputation from the Dublin Health Authority, I agreed that the question of how to meet the staffing difficulties which have arisen in the authority's institutions would be further examined.