Deputy Ferris gave me notice of his intention to raise on the Adjournment the need for speech therapists at Scoil Cormac and Scoil Aonghusa, Cashel.
Adjournment Debate. - Cashel, Tipperary, Schools Staffing.
I should like to thank the Chair for permitting me to raise this matter on the Adjournment. For the schools in Cashel this is an important matter because there is an urgent need for additional speech therapists. The number of speech therapists required is usually determined by screening or assessment which is carried out on the prevalence rate of need according to the level of handicap. There are certain critera laid down which state that in mildly handicapped people the prevalence rate is about 87 per cent, in moderately handicapped people it is 94 per cent and in severe or profound cases it is 100 per cent. Nationwide, the number of handicapped in the special schools is about 22,000, leaving about 19,000 or 20,000 requiring intervention by speech therapists. Those figures were used in determining the needs in the three schools in Cashel, Scoil Cormac, which has 127 pupils, 122 of whom need the special attention of a speech therapist; Scoil Aonghusa which has 40 students all of whom need intervention and the special day care centre, which has been the subject of urgent attention by Ministers and others because of the staffing crisis there, which has 28 children all of whom need attention.
In all, 190 pupils in those three schools are in need of intervention and assistance by speech therapists. Those figures do not take into account the other needs of handicapped people in the county, particularly those attending workshops like the Dan Breen Workshop in Clonmel and the Tipperary Workshop for the Handicapped in Tipperary town. However, I shall confine my remarks to the schools I have mentioned.
In these schools there are people with mental handicap and communication disorder. Research has shown that in the three schools mentioned they are receiving only 10 per cent of the professional's opinion as to their requirements to give them a proper service of speech therapy. That leaves a deficiency of 90 per cent in the service. In other words, they have a half day per school per week, or one and a half day's between the three schools which gives them three sessions, that is 27 sessions short in the working week in which they should be receiving attention, care and training from speech therapists if they were available.
These figures have been given to me by the representatives of the parents. They have indicated that, on all the figures available throughout the country, there is a need for three full-time speech therapists to give 30 sessions to the three schools over a five-day period; 15 sessions in the mornings and 15 in the afternoons. These parents represent families from all over the county; 14 families from Tipperary Town, nine families from Fethard, 13 families from Cashel, 22 families from Clonmel, six families from Cahir, 35 families from Thurles, six families from Mullinahone, seven families from Ballylanders — on the boundary of Counties Tipperary and Limerick and in the catchment area of Cashel — and ten other families from other parts of County Tipperary. Some of these families — there are 122 families involved in that survey — have two or more children attending these special schools. In the area of capitation grants these children are discriminated against vis-á-vis the capitation grant paid to normal children of £1,400. When a child is handicapped the capitation grant is £1,200.
We have tried to establish, through parliamentary questions and otherwise, the need for speech therapy in the south-east region generally. In reply to a parliamentary question on 13 March 1990 the Minister indicated that this was a matter for the South-Eastern Health Board. We pursued it at that level and they have communicated to us that the Minister has recently made funding available for additional speech therapists for services for the mentally handicapped. This funding will enable the health board to provide an additional 20 sessions per week, which is equivalent to two full-time speech therapists for the south-east region which consists of five counties, Waterford, Carlow, Kilkenny, Wexford an south Tipperary. The funding which the Minister has made available through his Department allows only for two additional speech therapists in the South-Eastern Health Board region when, in fact, these two speech therapists are required for Cashel alone, to give the service that is identified by experts, following assessment, as being the need of these pupils professionally and medically. we have vacancies throughout the country for 370 speech therapists. In Cashel we need three speech therapists; we would need two to bring us up to any standard, yet the Minister has made funds available for only two speech therapists for the whole south-east region.
These children are being neglected at a time when speech therapy could make all the difference to their being able to carry out any semblance of normal life, to be able to communicate with their parents and the other members of their family. These are special children. They are the children of special families who have special responsibilities. They are a category of children whom the Minister said would have his priority. In all the health board cutbacks he indicated that he wanted the mentally handicapped category not be included in any cutbacks. Unfortunately, they suffer because, as is the case with every other group, they have to fight for their cause within the overall funding available. This is an urgent and serious matter. The Minister and the Department have not addressed the problem properly. I hope that having raised the matter in this way the Minister can assist us in alleviating some of the problems as soon as possible.
I am well aware of the concerns which have been expressed regarding the need to increase the provision of speech therapy for people with a mental handicap.
Representations have been made to both the Minister for Health, Deputy O'Hanlon, and I in this regard, by several Members in general and by Deputy Davern on behalf of the Cashel schools in particular. These representations have arisen largely from the publication of a discussion document entitled "Communication Needs", which was produced by the special interest group of speech therapists in mental handicap, with the help of a special grant from my Department. That document recommended an increase in the number of speech therapists in the mental handicap services, as well as improvements in the organisation of services.
As the House will be aware, the Government and the Minister for Health have accorded a special status to services for the mentally handicapped in the allocation of funds and a special allocation of £2 million extra was made available in the current year to develop these services. As a result of this additional budgetary allocation, 15 extra residential places, 15 extra day places and two extra respite care places have been allocated to the South-Eastern Health Board, the board in whose area these two special schools are located. The additional allocation also includes the employment of two extra speech therapists, specifically for mental handicap, within the South-Eastern Health Board area.
The Minister for Health has also reconstituted the co-ordinating committees in each health board area to ensure that resources are deployed in the most efficient manner and each of the committees has been asked to prepare a five year plan to meet existing and emerging needs in a systematic planned and prioritised way.
In advance of these plans the co-ordinating commitees identified the immediate priority needs to cater for people who have either no service or a completely inadequate one and the special provision of £2 million extra provided in the 1990 Budget has been allocated for this purpose.
I know that the South Eastern Health Board, following consultation with the co-ordinating committee, has identified the need for speech therapy as one of its priorities in mental handicap. Their recent budget allocation included a sum of £20,000 specifically for this purpose. The full-year cost of this extra provision has been estimated at £30,000 and I would emphasise that this is only one element in a total package of developments in mental handicap in the region totalling £270,000 extra in a full year.
The South Eastern Health Board are now in the process of deciding how best to allocate the additional speech therapy provision in the region.
Scoil Cormac and Scoil Aonghusa, which are both located in Cashel, are two of the schools to be catered for. The South Eastern Health Board has offered considerable support to these schools by way of financial contribution towards non-teaching staff and the preparation of school meals. In addition, the health board has succeeded in providing further supports, including a psychological service and a physiotheraphy service, at these schools.
With regard to speech therapy, I am aware that there has been a particular problem at these two schools arising from the temporary absence of the health board's speech therapist. However, I am pleased to be able to inform the House that as from this week Scoil Cormac, which has 121 mildly mentally handicapped children, will have four speech therapy sessions per week and that three sessions per week will be provided at Scoil Aonghusa, which caters for 43 children, who have a moderate mental handicap. I am confident that this will bring about a significant improvement in the position.
With regard to the Deputy's contribution, I should say to him that capitation grants are a matter for the Department of Education. I want to state categorically that the extra funds in the budget being transferred to the South Eastern Health Board will allow for the employment of two extra speech therapists in that region. This is in addition to the existing complement of staff. I should further point out that our total expenditure for health in 1990 is projected at £1.408 million or 21.7 per cent of our budgetary provision this year. This is proof positive of the Government's total contribution to providing services for all our people especially the handicapped.
I had the pleasure today to be in the South Eastern Health Board region to open two new excellent facilities in Waterford for mentally handicapped people. I trust this is to the satisfaction of Deputy Ferris and to his colleagues, particularly Deputy Davern, who made incessant and consistent representations on this matter, and indeed to all the people involved with the mentally handicapped in County Tipperary and throughout the South Eastern Health Board region. The Government, the Minister for Health and I deeply appreciate the commitment and the concern of so many people working professionally with the mentally handicapped and the people who work on a voluntary basis with them. We will do what we can at all times to have the necessary resources in place in order to ensure that an adequate level of service is available for this special group.
The Dáil adjourned at 12 midnight until 10.30 a.m. on Friday, 30 March 1990.