Dáil Éireann díospóireacht -
Tuesday, 2 Jul 1991

Vol. 410 No. 2

Written Answers. - Facilities for Mentally Handicapped.

Willie O'Dea

Ceist:

178 Mr. O'Dea asked the Minister for Health if he will consider, in relation to people with mental handicap, (1) increasing the number of speech therapists and (2) making medical cards available to all persons with a mental handicap without recourse to means testing, age or place of residence.

Willie O'Dea

Ceist:

180 Mr. O'Dea asked the Minister for Health if he will provide extra speech therapists for people with a mental handicap to ensure that the number of speech therapists is adequate.

Minister for Health (Dr. O'Hanlon)

I propose to take Questions Nos. 178 and 180 together. Under the Programme for Economic and Social Progress, the Government are committed to the development of services for people with mental handicap. The need to expand speech therapy services in this respect is recognised.

Plans are being prepared in each health board area to develop mental handicap services which will be implemented in line with the resources made available under the Programme for Economic and Social Progress.

My Department are currently examining the difficulties being experienced in the recruitment of speech therapists and the number of training places is being reviewed with the educational authority.

Persons with mental handicap are eligible for any health service on the same basis as for other applicants.

Under the 1970 Health Act, medical cards are issued to persons who, in the opinion of the chief executive officer of the appropriate health board are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependents. Income guidelines are available to assist chief executive officers in the determination of a person's eligibility and, even though a person's income exceeds the guidelines, that person may still be awarded a medical card if the chief executive officer feels that this is necessary in the light of the individual's circumstances.

In view of the discretionary powers of the chief executive officers to issue medical cards, I am satisfied that no one is denied essential health services due to inability to pay.

I have already announced that a statutory medical card appeals system is being introduced. When this system is in place any person who feels aggrieved in relation to a decision not to grant a medical card can have the problem addressed under the appeals procedures.

In addition, hospital in-patient and out-patient services are provided without charge for all children under 16 years of age who are mentally handicapped.

Willie O'Dea

Ceist:

179 Mr. O'Dea asked the Minister for Health if he has any plans to provide (i) additional residential care facilities, (ii) additional day care centres and (iii) additional workshops within easy reach for people with mental handicap; if he has any plans to provide special units to cater for those with behaviour problems who are not mentally ill to prevent them from being placed in psychiatric hospitals; if he will ensure that staffing levels are adequate in all areas of mental handicap provision; and if he will make a statement on the matter.

Minister for Health (Dr. O'Hanlon)

It is the policy of my Department that people with mental handicap should live as normal a life as possible and that services should facilitate this objective.

I recently launched the report of the review group on mental handicap services, Needs and Abilities — A Policy for the Intellectually Disabled. The report endorses the overall approach of our services. It estimates the number of additional residential and day places required for people with mental handicap and recommends special facilities for those with behavioural problems.

The recommendations have been adopted in principle by Government and theProgramme for Economic and Social Progress includes a commitment to their implementation over the seven year period of the programme. The £2 million made available by the Government in 1990 to develop services for people with mental handicap has been repeated this year. In addition, £1 million was made available in the budget this year to implement the recommendations of the Needs and Abilities report under the Programme for Economic and Social Progress.

Deputies will be aware that I have reconstituted the mental handicap co-ordinating committees in each health board area. The function of these committees is to bring health board and voluntary mental handicap agencies together to plan how best to develop services for persons with mental handicap in each area. Each committee have been asked to prepare a plan to quantify the need for additional residential and day places (including facilities for those with disturbed behaviour), in each area as part of a national strategy to improve services for people with mental handicap under theProgramme for Economic and Social Progress.

It has been the policy of my Department for many years that persons with mental handicap should not be admitted to psychiatric hospitals unless they cannot receive psychiatric care in any other way. Where they have been admitted to a psychiatric hospital in the past, health boards have been encouraged to care for them in separate accommodation and to develop programmes of activity suited to their needs.

In some cases health boards, with my Department's agreement, have separated their care entirely from the rest of the hospital and transferred responsibility to the community care programme, which is responsible for mental handicap services generally in the areas concerned. I am aware from the reports of the Inspector of Psychiatric Hospitals that a high standard of care is being provided for people with mental handicap in some psychiatric services.