Deputy Ferris was in possession. He has 12 minutes remaining. I anticipate his question: this includes two minutes which he may have thought he was being deprived of.
Private Members' Business. - Services for the Mentally Handicapped: Motion (Resumed).
The following motion was moved by Deputy R. Bruton on Tuesday, 10 December 1991.:
That Dáil Éireann condemns the Government's neglect of persons with a handicap and their carers, and calls for an immediate five year programme to deal with the enormous gaps in services which would be based on the recommendations of the report of the Working Party on Services for the Mentally Handicapped, and making similar provisions to meet the outstanding needs of those with other forms of disability.
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
notes the Government's commitment in theProgramme for Economic and Social Progress to the provision of adequate and appropriate services for persons with a mental handicap (based on the report of the Review Group on Mental Handicap Services) and those with other forms of disability. That Dáil Éireann also endorses the Government's proposals as outlined in the joint Programme for Government to provide improved services for people with mental handicap and other vulnerable groups and notes the Minister's firm intention to progress this stated Government commitment.
—(Minister for Health.)
I appreciate your generosity as time is precious. I welcome the Minister to the House tonight for the debate. Last night, I mentioned that 325 residential places are required in the Eastern Health Board area for people with a handicap. Both the Minister and her predecessor have failed to realise that there are elderly people who are no longer able to cope in providing full-time care for their adult handicapped children at home. There are about 600 families in this plight, many of whom are at breaking point and crying out for residential places for their children. At present respite care facilities are very limited and availability is not guaranteed.
It is rather ironic that some of the parents who are now under enormous pressure may have turned down the offer of a residential place when both they and their child were younger. Yet, their life spent in caring not to mention the considerable amount of money saved for the State, seems to count for nothing at a time when they urgently need a residential place. The Government appear to be oblivious to the fact that these families are in crisis and have nowhere to turn. In their recent policies the Government have done nothing to provide these families with back-up services. Instead, they are forcing parents to carry this burden alone.
According to the report of the review group set up by the Government entitled "Needs and Abilities", over 600 people are officially listed on acute waiting lists for residential care, the problem being most severe in the Dublin area. In addition, 1,000 day places for people with a mental handicap, who urgently need services, are urgently required. Given the growing number of people with a handicap, according to this report, an extra 40 residential places and 200 day places will be needed each year for the next five years. In practical terms, the Government will have to be prepared to invest £15 million in capital facilities during a five-year period and increase current spending in staffing the new centres at a cost of £4.65 million in the first year of the programme and eventually an extra £20 million a year by the end of the five-year period.
The Labour Party firmly believe that it is time a charter of rights was enacted to provide both children and adults with a mental handicap with an equal opportunity of gaining access to education, training and of playing as full a role as possible in society. With this as a priority, during the past few days the Labour Party have published a Private Members' Bill entitled the International Law (Rights of Persons with a Mental Handicap) Bill, 1991 which sets out to confer a range of positive rights on people with a mental handicap. It would write into Irish law the United Nations Declaration on the Rights of Mentally Retarded Persons which was adopted by the United Nations in 1971 but never before written into Irish law.
We had two reasons for introducing the Bill, first, to change the perception of the area of mental handicap which presently is seen too often as an area where charity has an exclusive role and not often enough as an area where fundamental rights are involved and, second, to exert pressure on the Government to take the appropriate policy initiatives to give expression to those rights.
The rights contained in the United Nations Declaration are as follows: (1) the mentally handicapped person has, to the maximum degree of feasibility, the same rights as other human beings; (2) the mentally handicapped person has a right to proper medical care and physical therapy and to such education, training, rehabilitation and guidance as will enable him or her to develop his or her ability and maximum potential; (3) the mentally handicapped person has a right to economic security and to a decent standard of living and he or she has a right to perform productive work or to engage in any other meaningful occupation to the fullest possible extent of his or her capabilities; (4) whenever possible, the mentally handicapped person should live with his or her own family or with foster parents and participate in different forms of community life, the family with which he or she lives should receive assistance and if care in an institution becomes necessary it should be provided in surroundings and other circumstances as close as possible to those of normal life; (5) the mentally handicapped person has a right to a qualified guardian when this is required to protect his or her personal wellbeing and interests; (6) the mentally handicapped person has a right to protection from exploitation, abuse and degrading treatment and if prosecution for any offence he or she shall have a right to due process of law with full recognition being given to his or her degree of mental responsibility; (7) whenever mentally handicapped persons are unable, because of the severity of their handicap, to exercise all their rights in a meaningful way or it should become necessary to restrict or deny some or all of these rights, the procedure used for that restriction of denial of rights must contain proper legal safeguards against every form of abuse and this procedure must be based on an evaluation of the social capability of the mentally handicapped person by qualified experts and it must be subject to periodic review and to the right of appeal to higher authorities.
This Bill, if adopted by the Dáil or preferably, by the Government, would inevitably require the Government to take a range of actions to give effect to the rights contained in the Bill. Many of the actions required are already set out in the policies adopted by most of the political parties in the Dáil and, more importantly, in the Government's own review body's report which was published earlier this year.
When we attended the launch of a policy document in the Mansion House today by parents of people with a mental handicap they begged us not to turn this into a party political issue. They urged us to reach a consensus across the floor of the House. I join with them in making that call. Indeed, in my previous statements on this subject matter, I indicated that I would support the Government in seeking the funds required to protect the rights of people with a handicap. For this reason we are hopeful that the Bill which we published recently will be moved at the earliest possible opportunity and receive all-party support.
Finally, the measures outlined in the Bill should not be seen in isolation. The Labour Party have also published another Private Members' Bill, entitled the Equal Status Bill, which would, among other things, prohibit discrimination in a wide range of areas against people with a mental handicap. In addition, we will shortly publish a Bill which is wider than the present one, which will be aimed at giving legal effect in Ireland to a number of United Nations Declarations and Conventions. Taken together, these initiatives and the policy measures which must flow from them would, finally, address the situation in which too many people with mental handicap and their families, who have given them all the love, care and attention that they require, find themselves. I felt ashamed that anyone in public life would have allowed the parents who addressed us today to put up with some of the problems they have to put up with, given the inadequate service delivered by the Government and by their predecessors. None of us is exempt because we have never made sure that priority would be attached to the need to provide sufficient funding for this area.
We heard about children — who are now adults — who have been cared for by their parents for years. We learned that there are almost 1,500 adult handicapped people in psychiatric hospitals although they do not have a record of psychiatric illness. These are the only facilities available to house these unfortunate people. It is an indictment of all Members and I hope that the Bill I suggest will be addressed specifically by the Minister.
Last night, in the absence of the Minister, I mentioned a health agency whose officials want to meet the Minister because it is going bankrupt. I hope she will address this problem. We are not surprised that the agency who deal with the handicapped are seeking an urgent meeting with the Minister. I will convey the name of the institution to the Minister afterwards in case she is unaware of it. I hope that there will be a consensus in regard to this issue and that there will not be a necessity to vote. I am sure there will be an acceptance by all that we have a responsibility to those who voted for us, and to those unfortunates who cannot vote but still need us to take care of them, to address this matter.
I wish to give ten minutes of my time to Deputy McDaid, with the permission of the House.
Is that agreed? Agreed.
I am very glad of the opportunity to speak on the Private Member's Bill because it will give me an opportunity to study the whole matter in as much depth as time allows. It will also give me a chance to respond to points made and to declare my commitment, that of my party and the Department of Health, to this matter. I apologise for my absence last night but I will obtain the transcripts of Members' contributions. I should also be interested to learn the name of the agency to which Deputy Ferris referred.
In my short time as Minister for Health — and in my previous career as Minister for Education — I have been acutely aware of the needs of people with mental handicap. I have a difficulty with the term "mental handicap" as I had got into the way of other terminology when I was in the Department of Education. However, the motion is couched in particular words and I will follow its terminology.
The Government are committed to meeting the needs of people with mental handicap and it is my firm intention to translate this commitment into enhanced services for people with mental handicap. I want to outline to the House the extent to which the Government intend to strengthen their support for people with mental handicap and their carers. I want the House to reject the motion and to support my amendment and my efforts to enhance services for people with mental handicap and their carers.
Last night in the House, the Minister of State at the Department of Health, Deputy Flood, referred to the the fact that, under successive Governments, services for people with mental handicap have improved beyond all recognition. These services have been built up over the years, mainly by lay and religious voluntary agencies. At the foundation of the State there was only one centre specifically caring for people with mental handicap but now there are nearly 70 voluntary agencies providing a wide range of services.
The key contribution of voluntary agencies was simple but radical. They believed in the dignity of the person and that, with extra help and love, children with mental handicap could develop their personalities and skills far beyond the bounds of what many thought possible. Initially those agencies received little support from the State for their efforts. However, today the State provides almost the entire funding for services. The voluntary sector continues to play a leading role in pioneering new services and new approaches to service delivery.
Mental handicap services have changed radically and for the better over the last 20 years. High standards of service have been achieved, notwithstanding the fact that our country's economic resources are lower than those of most of our European partners. This is in itself an achievement due to the efforts of various Governments as well as the sustained efforts of the voluntary sector.
A substantial amount of money is being spent on a range of services to people with mental handicap. In 1991 over £170 million will be spent on these services. Of this, £138 million is being spent on the provision of day, residential and support services. A further £33 million is being spent on cash allowances. The domiciliary care allowance is being paid to 3,500 families and over 10,000 people with mental handicap are receiving the disabled person's maintenance allowance.
Relative to other public services, funding for the mental handicap service has been protected. The allocation to agencies funded directly by the Department of Health increased from over £39 million in 1981 to over £77 million in 1990. The increase demonstrates the commitment of the Government to people with mental handicap. I pledge that this commitment will be contained and strengthened.
Of course problems exist and they must be faced. We all sympathise with an elderly parent caring for an adult child with a mental handicap; Deputies referred to this. I understand the concern of such parents about the future welfare of their son or daughter. These parents made great sacrifices to keep their mentally handicapped children at home and the least they expect from society in return is the reassurance that the person they love will continue to be cared for when they have passed on. It is an aspiration with which this House can readily identify and I am committed to making it a reality.
Before outlining what I intend to do to meet the existing needs I should like to look at what is available at present and demonstrate that these are excellent services.
There are about 25,000 people with mental handicap in this country. These people have a mild, moderate, severe or profound degree of mental handicap. Some have additional physical handicaps and the kind of service they need varies with their age, degree of handicap, dependency level and the kind of home support available. Some lead independent lives and need little or no special assistance. People with severe or profound handicap and a physical disability require most care.
Services currently being provided include the early identification of infants whose development is delayed. Services for children up to age three are delivered mainly in the home. After this children attend pre-schools to develop their abilities and prepare them for school. There is a growing and welcome trend of children with mental handicap attending local pre-schools.
During the school-going age, educational services for nearly 8,000 children with mental handicap are available in 81 special schools and 162 special classes. Over 600 teachers are employed in these services. Child educational and development centres cater for children who are unable, because of the severity of their handicap, to attend a special school or class. In addition to those attending special schools and classes, 950 children attend these centres throughout the country.
Vocational training assists school leavers to acquire selfcare, social and work skills. These skills are essential to maximise the young adult's potential to lead an independent life. Long-term training centres cater for people who have not been able to find work after vocational training or who are not suited to open employment. Over 4,500 adults attend training and activation services.
These services enable people with mental handicap to continue living in the family home. However, it is not always possible for the person with a mental handicap to live at home. Alternative accommodation may be provided in group homes or in foster homes. Almost 1,500 people live in this type of accommodation. At present most residential services are provided in domestic scale accommodation, often in bungalows in the grounds of a residential centre. As the more independent people move to the community, these centres will mainly accommodate people with the highest levels of dependency. At present, 4,548 people live in these residential centres.
The value of respite care has been overwhelmingly demonstrated in recent years in supporting families who want to care for their son or daughter but who find the burden of caring without a break too much. Respite care takes many forms. It may be in a residential centre, a hostel in the community or in another family which has offered to care on a short term basis.
As Minister for Education, I had responsibility for and took a particular interest in the education of children with special needs. This experience will prove valuable in my new role as Minister for Health. During my term as Minister for Education, I became keenly aware of the need for a radical review of special education provision, both for children with disabilities and for those with other special needs. The Primary Education Review Body, chaired by Dr. Tom Murphy, recommended that a detailed analysis of the issues involved. As in many other countries, separate educational provision for a variety of categories of children has evolved over the years. Numerically, children with mild and moderate mental handicap form the largest single group.
In recent years, the trend both nationally and internationally has been towards a policy of integration. The policy of the Department of Education is now one of integration of children with handicaps, where this is possible, while retaining the option of separate teaching where necessary. However, it became clear to me that the time had come to take stock of the situation and to develop an appropriate policy framework for the future.
Last September, I acted on the review body's recommendation and established the Special Education Review Group under the chairmanship of Mr. Declan Brennan, former secretary of the Department of Education. The committee include representatives of school managements, the teachers' associations, the National Parents Council and the Departments of Education and Health. Their role is to make recommendations on the best arrangements for meeting the educational requirements of children with special needs, including the provision of remedial and other teachers and support services. I understand that the committee are working very actively and I am confident that they will produce a blueprint for the future direction of educational provision for these children.
I do not like to pre-empt the findings of any committee but when this committee were set up I spoke with them at an inaugural meeting and it seemed that, certainly in the education and health spheres, there was a greater need for a bringing together of the services on offer. Often in education one finds — I understand that Deputy McCormack spoke about this last night although I did not hear him — that when one inquires about child care assistance from one Department one is told that it is not their responsibility and that they should contact a different Department. It was Dr. John Murphy, in his review, who pointed to his fact, and that is one of the reasons for setting up the committee. I hope that one of the recommendations of that committee will be that the services should be co-ordinated in a more practical and sensible fashion. The services which have been developed are of a high standard but I recognise clearly that there is much to be done.
Since becoming Minister for Health, I have taken a particular interest in the needs of people with mental handicap. I am aware of the major challenge facing our services. The nature of this challenge has been outlined by the federation of bodies providing services to people with mental handicap. It has been outlined by the National Association for the Mentally Handicapped of Ireland. It has been addressed in the report of the Review Group on Mental Handicap Services, Needs and Abilities.
The fundamental problem which we face is that the number of people with mental handicap has been growing faster than the capacity of services to meet their needs. In 1981, a census was carried out of the mental handicap population in this country and 23,000 people were identified as having a mental handicap. It is estimated that this population have increased by 2,000 ten years later. The number of people with mental handicap is increasing and people with mental handicap are growing older. Between December 1981 and December 1991, the number of people with mental handicap over 15 years of age in receipt of services increased by more than 50 per cent. Nearly 90 per cent of clients in receipt of mental handicap sevices at pesent are over 15 years of age. The population of people with mental handicap is going to continue to grow and to age. It is the increasing population of people with mental handicap that is putting pressure on our services.
Up to 20 years ago, the life expectancy of children with mental handicap was low. Many died in infancy and few survived their twenties. Thanks to improvement in medical care, I am glad to say that the life expectancy of people with mental handicap is approaching that of the general population. We must ensure that this increase in life expectancy is matched by a corresponding increase in the quality of life of these people and their carers.
The increasing population of people with mental handicap is affecting our services in other ways. The number of people with mental handicap receiving services funded by my Department increased by 34 per cent in the past ten years. This increase shows that mental handicap agencies have responded to the need for more residential and day places. However, their capacity to provide additional places within their resources is now extremely limited. They find themselves unable to respond to crisis needs which they could easily have met in the past. In some centres, adults are occupying places intended for children. As a result, children in some areas are not receiving as full a service as they should. I am sure that everyone in the House would agree that every child with mental handicap should receive as comprehensive a service as possible. Experience shows that if the full potential of the child with mental handicap is developed, the child becomes much more independent as an adult. The quality of life for the child and the family is greatly enhanced.
There is one other challenge in services for people with mental handicap to which I would like to refer. I attach great importance to the decline in the use of psychiatric hospitals — Deputy Ferris referred to this in his speech — as centres for the care of people with mental handicap. One of the implications, however, of this policy is that parents and mental handicap centres have to cope with an increasing amount of disturbance within their own resources. I accept the need to develop specific expertise in relation to the care of people with mental handicap who are also disturbed.
The nub of the challenge is to develop services for people with mental handicap in the way that matches their needs and promotes their abilities. The Government have outlined their commitment in the Programme for Economic and Social Progress to the provision of adequate and appropriate services for people with mental handicap as recommended in the report, Needs and Abilities. It is my task as Minister for Health to make progress towards implementing this commitment. The ideal to which we aspire is the provision of a residential and a day place for people with mental handicap who have been assessed by professionals as in need of such places.
I recognise the need to accelerate the provision of additional residential and day places to meet the backlog of need for services. Most of these places will be offered to people on the priority lists in each health board area. The remaining places will be used to expand respite care to families caring for a person with mental handicap at home.
I recognise the need to provide, as a matter of urgency, additional support to families caring for a person with mental handicap where that person is waiting for a day or residential place. I would like to see these families receive much greater assistance with the burden of caring. Assistance could be in the form of a respite break on a regular basis. It could be a home help or a nurse to help change and feed the person with mental handicap. It could be someone to babysit to allow the family shop together or go to the cinema. For others it could mean someone to bring the person with mental handicap out of the home so that he or she can participate in a recreational activity. I would like to see these home care services meeting the needs of the carers and people with mental handicap in as flexible a way as possible.
I also want to put in place a service to deal with emergencies arising from family breakdown. If family caring breaks down because of death, illness or fatigue, the emergency service would provide a place until a permanent place becomes available. This service will help to reassure the elderly parents of whom I have already spoken that, if the unexpected happens, their child will be cared for.
It is also my intention to improve services for people with mental handicap who are disturbed. A small number of special units with specialised staff is required to provide intensive treatment and therapy. The team would try to manage the disturbance in the home or in the residential centre in the first instance. The special unit would provide a residential service for those clients requiring intensive treatment. Even then, it would be the intention that every client would return to his/her home or centre following the intensive treatment.
I am also conscious of the need to enhance early intervention and development services for children with mental handicap as recommended in "Needs and Abilities", It would be my intention to increase the number of intervention teams to improve assessment and support services. These services will help parents cope with the trauma of having a child whose development is delayed and guide parents how best to nurture their child's progress. I would also like to see an expansion in the number of child education and development centres.
The centres have been extraordinarily successful in maximising the development of children with a mental handicap and achieving their potential for independence.
I hope also to initiate next year a genetic counselling service. This service will be of great benefit to couples who have already had one child with a mental handicap or where there is a person with a mental handicap in either partner's family. It is vital that we give couples in this situation the information on which to plan their families.
There is a need to develop the services about which I have spoken throughout the country. However, I recognise that for historical reasons and because of the size of the population particular problems exist in the Eastern Health Board region. I understand that speakers referred to this last night and tonight. It would be my intention to make special provisions for the eastern region in measures to expand services.
The Minister of State at my Department, Deputy Flood, referred last night to the Government's policy in relation to services for the mentally handicapped. I would like to emphasise that this policy is based on the recommendations of the report of the review group on mental handicap services, Needs and Abilities. This report is the first major report since the 1965 review. The review group believe that with adequate support services the overwhelming majority of people could be catered for within their own community. The Government agreed to the recommendations of the report in principle and are committed in the context of the Programme for Economic and Social Progress to their implementation.
In the 1990 budget my predecessor allocated an additional £2 million for services for the mentally handicapped. This enabled approximately 150 residential places and 21 respite places as well as other services to be provided. It was because of the particularly serious situation in the Eastern Health Board region that half of the £2 million was allocated to the region in order to provide extra places. This year a further £1 million was allocated in the budget to build on those developments. This will enable 20 places to be commissioned in Cheeverstown House and has funded the opening of 25 places in Aras Attracta, Swinford, as well as additional places in each health board area.
I am well aware that there is a gap between the policy and the developments. I am conscious of the great burden which families carry in caring for a mentally handicapped member. Neither do I underestimate the challenge I face in providing for those needs.
I would like to assure the House that in each health board area plans are being prepared in response to the recommendations of the report, Needs and Abilities and the commitments in the Programme for Economic and Social Progress. These plans are being prepared in consultation with the voluntary bodies providing services in each area. The voluntary organisations are keeping apace and carry out their work with great commitment and dedication to the task in hand.
I do not have time to go through the rest of my speech, but it is available for those who wish to read it. Let me state emphatically — I know that Deputy Bruton would have said it with the same fervour last night as Deputy Ferris said it this morning — that there is a need for across the board co-operation and consensus on matters such as this. There will always be political difficulties in supporting a Bill presented by the Opposition but that will not stop us having a consensus thrust in our proposals. The general feeling shared by all Members is that no matter what services we provide in the different areas be it social, economic or any other policy area, the needs of those in greatest need should be addressed first. I always felt that when I was in the Department of Education and the same will hold true in the Department of Health. I have set myself on this path and have expressed what I hope to do as best I can but I hope to be able to develop it further in the year, when I will be coming back to the House with my ideas and plans. We should put all our energy into helping those who can least help themselves. I welcome the chance to put on record our social commitment. I welcome also the opportunity to respond to the Fine Gael motion, the Labour Party amendment and the opportunity to comment on the Fine Gael charter for the disabled and the Labour Party Bill. I commend my amendment to the House.
At the outset may I say that I have a personal aversion to the words "mentally handicapped" in the context in which they are generally used. This description has too often been applied to a range of conditions which includes, for example, cerebral palsy. Victims of cerebral palsy are afflicted with severe physical disabilities, including a lack of co-ordination, frequent spasms and a marked inability to communicate and so on. Not many years ago such people would have been confined to what was then known as a lunatic asylum in spite of the fact that there was no mental disability involved. This fact was dramatically highlighted in the case of two of our most distinguished writers, the legendary Christy Brown author of My Left Foot and the award winning author, Christopher Nolan. Both had cerebral palsy and they had to go through a tremendous amount, yet with their caring mother's support they were able to cope. However, most people watching these young men grow up would have regarded them as being mentally retarded. I would prefer to see the word “disabled” being used to describe all those who are handicapped either physically or mentally. The Oxford English dictionary defines “disability” as “physically or mentally impaired”. The word “disabled” does not imply a stigma in the same way as would “mentally handicapped”.
I have no intention of claiming that everything in the garden is rosy as far as these services are concerned. Having listened to Deputies Bruton and Ferris, I have to say I agree with a great deal of what they had to say. However, I do not agree with Deputy Ferris' implications that all the shortcomings in this regard must be laid at the door of the Government or their immediate predecessor.
I said the opposite.
This smacks too much of political point scoring. I could, just as easily examine the record of the Fine Gael-Labour Coalition Government and come up with practically the same speeches but I would prefer to deal with it in the spirit that the House approaches this serious matter in a positive frame of mind. Too many of us are handicapped because we have been handicapped by our blindness to the real plight of the disabled in our society for far too long. It is not that we lack compassion, as Irish people as individuals are among the most generous in the world in subscribing to every good cause under the sun. When we dig deep into our pockets at the Church gates or whatever, perhaps we assume too easily our contributions mean that the particular group have been taken care of for another year by the voluntary organisations and the use of State grants. Things are not that simple unfortunately. We are a small and relatively poor country and the provision of extra resources is always a major problem. It is cynical in the extreme that Members, when in Opposition should demand large amounts of money for just about everything. All parties have been guilty in that respect. This is supposed to be good politics but I think it is quite the opposite. Even if we could pick a further £100 million out of the hat in the morning it would not guarantee that the problems we are discussing could be solved to any great extent. What we need to do, as Deputies Bruton and Ferris said, is to establish our priorities and do our best to ensure we get value for money.
The Constitution charges us with the responsibility of cherishing all the children of the nation equally. If we have to discriminate, we should have positive discrimination in favour of the disabled rather than discriminating against them. Those of us who enjoy good health would have no objection to that way of thinking. Therefore, I agree with those speakers who have referred to the multitude of Departments involved one way or another in this area. Apart from the Department of Finance, the Departments of Health, Education, Labour, Social Welfare and the Environment are involved. I could supply the Minister with details from my constituency where resources have been needlessly wasted because of the duplication or overlapping of services between the health boards and various Departments. Therefore I was delighted to hear the Minister say that one of her priorities will be to achieve co-ordination between all of those various bodies. It seems that we could certainly put the money available to better use. The services involved provide for a wide variety of conditions including mental impairment of varying degrees, from a mild condition to very profound disability. All people with disability are entitled as a matter of right to the maximum education possible in each case and to the opportunity to work to the limit of their capabilities in either the public or the private sector. There are also those who are physically disabled for whatever reason, and in particular those who are confined to wheelchairs or who are of very small stature.
As individuals, when we meet disabled persons we must never treat them as morons by ignoring them and talking over their heads. In some instances the person concerned has full or at least partial use of his or her mental faculties and it must be a shattering experience to be treated as a vegetable. All of the money in the world could not compensate for that kind of experience. We are not dealing with statistics, we are talking about sensitive human beings who should not have to experience further hurt on top of their already tragic circumstances.
I should also like to comment on the involvement of the Department of the Environment. Access is a very important factor and I wish to speak very briefly about the access group, which was formed several years ago. I congratulate the former Minister for Health, Deputy O'Hanlon, on introducing legislation on 5 December.
Unfortunately, I have run out of time. The Minister is new to the health portfolio but I know her to be a very capable and caring person and I am fully confident that she will tackle the massive problem with her customary zeal and the compassion that she has shown in the past.
I wish to share my time with Deputies McCartan and Byrne.
Is that agreed? Agreed.
The hallmark of any civilised society is the way in which it treats the weakest and most vulnerable of its members — the old, the very young, the ill, the infirm and the handicapped. Judged against that yardstick, the policies of cutbacks in health pursued by successive Governments in recent years cast grave doubts over our right to describe this as a civilised society because it is those categories of people who have suffered most from Government economic policies.
It is hard to think of a more vulnerable and defenceless group in society than the physically and mentally handicapped, who are generally not in a position to defend themselves or to fight for better conditions or medical care. It is to our eternal shame as a society that not even the mentally handicapped have been spared the lash of the cutbacks.
The fact that mentally handicapped people have not suffered even more is due largely to the love and care lavished on them by their families and the Trojan work done by the many voluntary organisations active in that field. What causes the most anger and frustration to those voluntarily involved in the care of the handicapped, whether they be families or groups, is that the more work they do and the harder they try the more content the Government seem to be to wash their hands of their obligations and load even more work and responsibility on to families and the voluntary sector.
In Cork there are 140 young, chronically sick, disabled people — and there were 140 three years ago — and there is an urgent need to provide a better home help service for those who care for them. Has that been provided? No. There is a need to increase the number of respite care beds so as to give relief more frequently to those caring for disabled people. Has that happened? No.
A separate scheme is operated by the Irish Wheelchair Association, who pay home care attendants to visit and help mothers of children with physical handicap. In the Cork area the operating costs of the scheme for the three years 1989, 1990 and 1991 was about £25,000. Of that cost, £5,000 was provided in the past three years by the Southern Health Board and £20,000 was raised by voluntary contribution. The Southern Health Board contributed only £5,000 towards the cost of having people available to go out and help the mothers of physically handicapped children and give them relief. As a result, the number of hours' help available has been reduced and relief has been taken from those mothers who so badly need it.
Fundraising, which provides the bulk of funding for voluntary organisations, has become more difficult since the advent of the national lottery. It is contended that more funds from the national lottery should be provided and redistributed to voluntary organisations by an umbrella body. There seems to be a clearly strong consensus for that opinion.
The reality is that the extent of the problem is so great that families and voluntary organisations alone simply do not have the capacity or the resources to deal with the problem and the level of handicap suffered by some people is just so severe that institutional care will always be required. Of course, the cost involved in caring for the handicapped and ensuring that they receive the treatment they need is enormous and requires substantial central funding; the core funding must come from the Exchequer.
As any parent can confirm, bringing up children is a demanding task even when one's children enjoy the full bloom of good health. When a child suffers from a handicap, either mental or physical, the task and the commitment required are altogether more daunting. For most of us the responsibility and commitment required ends when our children grow up, leave the family home and start to earn their own living. For parents of many of the handicapped, however, the responsibility, worry and financial and emotional commitment required go on and on until they or their children go to the grave.
As an understanding of mental illness and mental handicap has improved we have, thankfully, moved away from the 19th century attitude that viewed people with mental handicap as a public threat and who should be locked up. In recent years the trend has been to move away from institutional care where possible and practicable and towards the provision of care in the community. The Green Paper on Services for Disabled People: Towards a Full Life, published in 1984, described the broad objective of services for those with physical, mental or sensorial handicap as being "to equip them to realise their full potential and to participate to the greatest extent possible in the life of the community."
A document published by the Eastern Health Board in 1986, Specialist Services for the Mentally Handicapped, put it this way:
A handicapped person should develop in an environment as normal as is practicable. In this regard it is appropriate that the mentally handicapped person should be maintained in his home as long as is possible, with appropriate support services and that facilities as near as possible to the domestic environment are available when the handicapped person can no longer be maintained at home.
It is in regard to persons who can no longer be maintained at home that the main difficulties arise. There are simply not enough places available to meet the demand. The Government's own report published last year, Needs and Abilities: A Policy for the Intellectually Disabled — Report of the Review Group on Mental Handicap Services, estimated that there was a need for 600 residential places and 1,000 day places for people with mental handicap to meet a backlog of urgent need for services for those with none. It suggested that growing numbers would mean that an extra 40 residential places and 200 day places would be needed every year for the next five years to cope with emerging needs.
Unfortunately the response of successive Governments in the crisis has been totally inadequate. For example, the cutback in the eighties came at a time when continued growth was necessary to avoid a disastrous build-up in waiting lists. Instead of expansion of services there were cutbacks, which is the basic cause of the terrible position in which many parents now find themselves. "Health Cuts do Hurt the Handicapped" a poster produced today by the parents Association of People with Mental Handicap sets out the scale of the financial commitment required to deal with the crisis. They are seeking a commitment over the next five years of extra capital expenditure of £22.5 million and a phased increase in current spending to reach an extra £27.5 million annually on the mental handicap services. Of course, these are substantial sums of money but the level of need is so great on the part of the handicapped themselves and of their parents that the expenditure of such money is not alone justified but essential.
We are happy to support the Fine Gael motion. The Labour Party addendum is also commendable and worthy of support. The Government amendment is a totally inadequate response and takes no account of the urgency of the overall position. The commitments given in The Programme for Economic and Social Progress and the review of the Programme for Government are vague and unspecific. Parents of the handicapped have wisely learned from previous experience that promises not backed up by firm commitments of cash are of little value. We regularly hear the Government pay lip service to the principle of providing community care for the handicapped. That is often advanced as an excuse for not developing institutional care. Institutional care is being starved of resources and the community care services are not being developed to compensate for that. We must support the concept that the provision of adequate support services for those with handicaps, and those who look after them, is not a charity but a right. They are not asking for any favours but simply that their particular and unique needs as citizens be met.
In that context I particularly welcome the call of PAM in their document published today calling for the introduction of a charter of rights for those with mental handicaps which would guarantee to every person born with a handicap that appropriate services will be available as and when needed. These should include a right to early assessment and a place in an appropriate school or centre for every child with a mental handicap, a right to a day care or training place on leaving school, a right to employment or a day care place on leaving training, a guarantee of a suitable long term residential place as soon as needed in a group home, foster care or special centre, as appropriate; and services for people with a handicap should be structured around consumers' needs, respecting the dignity of every individual.
If the Minister or other members of the Cabinet were unaware of the extent of the problem confronting the handicapped and their families they cannot claim that in the light of this debate. The obligation is now clearly on the Government to act quickly and decisively. I have no doubt that, if they do so, they will have the support of every Member of this House.
I do not want to go into any great detail because most points have already been covered about the plight of people with a physical or mental handicap and their carers, since, very often, people must care for those suffering from both.
Were it not for groups like PAM, the Walkinstown Association for Handicapped People or the Action for Mobility campaign, very many politicians would not be conscious of the terribly inadequate resources available in this area. It is fair to say that the shocking reality of the types of lives led by people caring for the disabled are highlighted for many politicians only when they have seen, spoken to and been lobbied by those campaigning for a better deal for the disabled and their carers.
As a recently elected member of the Eastern Health Board I have been exposed for the first time to the plight of handicapped men, women and children who are being cared for, ranging from the mildly handicapped to the profoundly physically and mentally handicapped. For example, I visited St. Raphael's in Celbridge run by the Brothers of St. John of God. One can say, without fear of contradiction, that the staff building, equipment and training workshops there are good as can be found anywhere worldwide. Meeting the staff of the Eastern Health Board, people like Mr. Harmon and Mr. Walsh, the programme manager for the special hospital care programme and familiarising ourselves with their work, dedication and sincerity, we become aware there are caring bureaucrats. In addition, reading the report of the Review Group on Mental Handicap Services, Needs and Abilities, we realise there are people who know how to go about solving the problem. However, the sad reality for those of us who are getting to know and understand the services is that, for every child or adult in St. Raphael's, there are 10 or 20 more seeking admission, that even taking into account the energies of the officials of the Eastern Health Board, their dedication and sincerity, they cannot provide the requisite service without adequate funding. Bearing in mind the good intent of the report to which I have just referred, without political goodwill and determination coupled with a plan to implement the recommendations of that report, no progress can be made.
Sadly, people like Brother Leo Clancy of the Order of St. John of God, Sr. Angela Magee, Mr. John O'Gorman of NAMMI, Br. Aloysius Shannon of St. Raphael's House and officials like Mr. Michael Walsh of the Eastern Health Board, all of these professionals at the coalface who speak with dependants daily, with desperate and distraught parents, are slowly but surely moving away from a position of agonising in quiet desperation over the inadequacies of the service to one of unrestrained anger, frustration and fear for and on behalf of the people with disabilities and their carers.
I appeal to the Minister not to reject their legitimate demands but to begin a planned implementation of the recommendations of that review group report.
I want to give the remainder of my time to Deputy McCartan.
I thank Deputy Sherlock, spokesperson for The Workers' Party in this area, for allowing me a few moments to contribute to what is an important debate, taking place at a time of year when we should all be smitten with a sense of charity and fair play. However, I fully agree with the campaign of the Parents Association of People with Mental Handicap on two points: first, that they are not seeking charity but their rights, which have been fully identified in the recently published report of the Review Group on Mental Handicap Services, Needs and Abilities, that had been with Government for over a year before being published because of the condemnation, by implication, written into their findings.
The other aspect on which I agree with the parents of the mentally handicapped is that they have no embarrassment or hesitation about the name they ascribe to their loved ones, namely, the mentally handicapped. I do not see why anybody in this House should question the use of that term in any debate other than perhaps to create a framework within which one can establish a concern above and beyond that of all the Members of this House at the problem we are endeavouring to address. Therefore, like the report referring to the mentally handicapped and the Minister's amendment to the motion before the House, I have no difficulty referring to the people on whose behalf I make this short contribution as the mentally handicapped, those who probably more than anyone in this society are looking to this House this evening for a lead and some hope.
I commend the Fine Gael Party, and Deputy Richard Bruton in particular, on tabling what is a timely and reasonably-worded motion, seeking no more than a five-year planned response to the findings and recommendations of the Government-commissioned report referred to time and again by other speakers. What can be wrong with such a proposition? I can see no difficulty in supporting it and The Workers' Party will be doing so.
I wish the Minister well in her new portfolio and I hope that the aspiration she expressed in regard to the development of services for the mentally handicapped will be carried through to the full. If the Minister was responsible for the drafting of the Government amendment to the motion, I am a little worried. The Government amendment looks to that very dubious document, the Programme for Economic and Social Progress, as the basis of a commitment to providing services adequate to meet the needs of the mentally handicapped. The Programme for Economic and Social Progress is in tatters and amounts to no more than aspirations. I appreciate that the Minister did not have a direct input in regard to the health area but if this amendment is the best the Government can do in meeting a reasoned proposition by the Opposition, I am dismayed.
I welcome the Minister's intention to introduce a programme of genetic advice services for parents who may already have a mentally handicapped child or a person within either or both families suffering from a mental disability. I would ask the Minister to put the house before the cart to provide us with a reasonable system of family planning legislation before beginning to talk about advice services for any sector of the community, least of all the mentally handicapped. Having given education and advice, I wonder how the Minister would hope to equip a large number of people to go out into the Community and make use of that advice and education. The Government seem to be in a quandary.
I represent a Dublin constitutency and I wish to address in particular the problems in the Dublin area as highlighted to me by parents of the mentally handicapped. We have the single greatest concentration of population in the country and likewise the single greatest concentration of parents who have to deal with the problems of mental handicap in the absence of the requisite services. Is the Minister aware that possibly 700 places are currently required to accommodate people with mental handicap who need residential placement? Does she accept that figure for the Dublin region? I should like to hear her response so that we would know whether the Department are aware of the extent of the problem. The Minister's predecessor had a very much more provincial view. Whenever one argued the cause of the greatest centre of population, he seemed to have little or no concept of or regard for those problems. There is a need for 534 day care units within the EHB Dublin region alone.
On the north side of Dublin, which I consider to be the blackest of the national black spots, there is an urgent need for speech therapy services. There are two speech therapists at St. Michael's in Ballymun, covering the entire north Dublin area as far as Balbriggan. One other speech therapist at St. Mary's is employed by the Mater Hospital. Two public speech therapists and one private speech therapist are required to cover the entire area. The result is that nobody gets adequate speech therapy. Nobody needs to be told how this impacts on parents and their children who have a major difficulty in speech communication. It is a harrowing experience to visit homes, as many of us do in the course of our work, and see parents literally imprisoned because of their love and care for their children. They are obliged to be available 24 hours a day, seven days a week. There is not adequate community support to give a respite on a weekly or monthly basis to allow them a break. Such services do not exist in the north Dublin region for a vast number of parents.
I would urge the Minister to look into the domiciliary care allowance which amounts to £85 or £86 per week to parents supporting at home children suffering from disability, including mental disability. All those cases are being systematically assessed and re-assessed by the Department. There seems to be a vindictive, penny-pinching attitude towards people who have problems enough without enduring prying investigating officials trying to cook the books and make the picture somewhat better. The Minister should investigate this as a matter of urgency and as a practical response to the problems being aired in this House.
The motion asks the Government to respond in a concrete and planned way over five years by implementing a most pressing programme of work. The question has been raised as to how the funding can be obtained. It is very difficult for people who have these problems to look at the excesses of expenditure in the aggrandisement of a Government. They can spend millions in improving offices for the Taoiseach and Ministers and then find that so little can be made available to meet the recommendations made in a Government-commissioned report. It is time to bring before the House concrete proposals to meet the Government's commitments. It should be a matter of priority. There would not be criticism from any quarter if the Government were to act as called upon in this motion, having been informed by the report completed by experts in this area. If there cannot be an acceptance of the motion or of the Labour Party addendum, I call on the Minister to signal that the Government accept the spirit of the motion and intend to act urgently.
I have listened with interest to the various speakers and I have read the motion, the amendment and the addendum put down tonight by the Labour Party. I have met people of all political persuasions and people involved in the provision of services for persons with a disability. Most Members who met those people with me on an ad hoc basis are present in the House tonight. This is an indication of their commitment to try to upgrade, enhance and provide a better service for people with a handicap.
I have an indepth knowledge of the workings of the Eastern Health Board. I am Chairman of the Eastern Health Board and I was involved in the special hospital care programme run by the health board. I can honestly say that the Eastern Health Board have made major strides over the past five or six years in the provision of services for people with a handicap. Of course, I can only speak for the Eastern Health Board. However, having met with the parent associations, Members of this House and others on an ad hoc basis I am more aware of the need to improve the services provided not alone by the Eastern Health Board but also by the other seven health boards.
I know — I was somewhat surprised at the comments made by the previous speaker in this respect — that the people who care for those with a handicap believe that this issue should not be politicised. Public representatives have heard this at public meetings. Even more importantly, the people we have met do not want to hear that language. I have not spoken to them but — I say this with respect to the Labour Party — it is my belief they do not want a motion or an amendment to it. They would prefer if there was no motion or amendment before the House. I know they would like to see the provision of a proper and adequate service.
Reference has been made to the policy document launched today by the PAM association. Deputy Ferris referred to the message given to the political representatives who attended the launching of that document, that they do not want this issue politicised. They do not want this issue to be addressed tomorrow. Deputy McCartan stressed the need to provide money for buildings and mentioned a figure of £500 million. These people do not want to hear that type of language. Even though they know it will not be achieved in 12, 24, 36 or even 48 months they want a policy.
Acting Chairman
The Deputy has one minute.
They know that this will take time——
Will the necessary finance be provided?
Acting Chairman
The Deputy has less than one minute. No interruptions, please.
It is not just a matter of finance. They accept that finance plays a very important role but they want proper co-ordination of the services provided by the statutory and voluntary organisations and the development of the present services. This House would be better off if it withdrew the motion and the amendment instead of putting them to a vote. We have made some progress in this area and if we implemented some of the recommendations contained in the report of the review group on mental handicap services, Needs and Abilities, over the next number of years the people from whom we have received correspondence would be very happy.
That is what the Fine Gael motion says. A five year plan would enable the recommendations in that document to be implemented.
The Government should withdraw their amendment.
I should like to thank my colleague, Deputy Bruton, for giving me five minutes of his time. I should like to commend him for tabling this motion and on the policy document launched this week. I welcome the Minister to the House. While I was very pleased at the detail of her speech I was disappointed at the lack of practical action contained in it. We need a breath of fresh air in this area and I trust the Minister will be the one to bring this about.
I listened to the speech of the Minister of State last night and to say that it was tired and much used material would be complimentary. He seemed to hope that this problem would yet again disappear and that the subject of this motion would go away. This problem will not go away and the sooner the Minister, and the Government, take the needs of the handicapped and their carers seriously the better.
For years these people have been paid lip service by various Governments mainly because they were part of the hidden silent Ireland. Handicapped people had no voice and their parents and carers were so exhausted and stressed that they did not have any energy to mount the kind of political campaign they now seem to be able to put together. Under our parliamentary system they were treated as a low priority and were not regarded as deserving of any special treatment. An army of voluntary workers, members of religious orders and women, mothers in the home, gave up their lives to care for our handicapped population. We are talking about people with severe and profound handicaps who require 24 hours a day, seven days a week care and nursing. This care is not required only for children. It is also required for adults up to 35 years of age who may weigh 10 stone or 12 stone or heavier. The burden of responsibility borne by such families is a disgrace in any civilised society, and, particularly, in a society which supports and voted overwhelmingly for a pro-life environment.
This means in practice that a higher proportion of children born here will have a congenital handicap than children born in other countries where pregnant women can undergo amniocentesis tests to identify whether there are any abnormalities, where there is proper genetic counselling and where abortion is available. We have to be consistent and follow through on the electorate's expressions of value for human life. It is wrong that a minority of relatives should have to carry the burden of care for those who are physically and mentally handicapped.
Reference has been made in the debate to statistics, the cold hard realities of need such as the need for 200 residential places and 400 day care places and that fact that 1,500 people have been wrongly placed in psychiatric institutions. Today at the launch of the PAM policy document, Health Cuts Do Hurt the Handicapped, held in the Mansion House, we heard the human side of the statistics when the mother of a seven year old handicapped girl gave us details from her diary for the past year. This was a chronicle of desperation, constant nursing, visits to emergency out-patient departments, wakeful nights and constant screaming for three weeks.
It is time this problem was articulated in the House and that everyone here shared the responsibility for past neglect and the duty to take realistic action. It would be better if the Government did not have to be shamed into action. Members on this side of the House will pursue this issue to a proper resolution. We have had sufficient studies and reports; we now need action.
It is a pity the Minister missed the launching of the PAM document this afternoon as she would have heard in a very practical way what it means to be a carer of a person with a mental handicap in Ireland today.
I know from close family circumstances exactly what it entails and I have great sympathy with them.
It must be said that the services are not there to match the needs of those persons for whom the Minister has expressed sympathy. We heard today about how a carer was strained beyond breaking point and could no longer cope and how there was no service to accommodate her child. Contrary to what Deputy Callely said, people who care for people with a handicap are angry, bitter and frustrated.
The contributions we had last night from the Minister of State was extremely poor. There was little preparation undertaken by the Department and the Minister of State for this debate. We heard repeated last night what we had heard a thousand times before about developments in the services. The Minister went back to the foundation of the State to talk about how services had improved. Bright eyed and bushy tailed he came in here and recited the Programme for Economic and Social Progress document and quoted at length from it and from the Needs and Abilities document and expected us to accept those as tokens of the goodwill of the Government. He did not mention that the Government reneged on the commitments in both the Programme for Economic and Social Progress and the Needs and Abilities document immediately on their publication.
In 1991 only one-quarter of the residential places required as outlined in that document, were provided by Government. None of the 450 day places, indicated as required, was provided. He had the gall last night to boast of a £2 million allocation in 1990 and a £1 million allocation in 1991 from the national lottery. There was no mention of the fact that the national lottery itself had siphoned off £50 million from the resources of voluntary agencies providing assistance for those with disability. There was no mention either of the fact that the minimum requirement set out in those documents, on the recommendation of their own officials and advisers, was £30 million if we were to meet our responsibilities to existing policy commitments in that area. We heard a very tired recital of what we have heard a thousand times before.
I was disappointed tonight that the Minister did not make the sort of break I had hoped for. The Minister seems unaware of the extent of the crisis in the services for people with a disability, unaware of the deterioration in the last few years in the Eastern Health Board area — of which Deputy Callely speaks so highly — where the waiting lists for residential places have doubled. There are twice as many people now waiting for residential places than there were in 1989 when the Needs and Abilities document was drawn up. The same is true, as Deputy McCartan cited, of day centre places.
We have a far better placement record.
I was glad to hear expressions of concern from the Minister tonight but those expressions of concern were heard from her predecessor as well but he came back and produced budgets that did not match those concerns. The Minister will be judged not by the expressions of concern, which are deeply meant, but by her actions and her willingness to confront this issue in a meaningful way. As Deputy McCartan said, we do not get great hope from the amendment in the name of the Minister of State. She again cited the joint Programme for Government of the two parties. In 1989 the programme made no mention whatsoever of the needs of persons with a disability. The review of that document in 1991 made one single mention of the needs of persons with a disability and that was the need for day centres.
That is not a commitment to the Needs and Abilities document which has been on the Minister's desk and that of her predecessor since July 1990. The review of Government carried out a couple of weeks ago did not recognise that document and did not mention a commitment to honouring it. As the Minister is aware, her predecessor indicated, as soon as the document was published, that he would not honour its five-year programme, that he would push out to 1999 the date on which he would hope to achieve some of those commitments and not 1994 as was suggested in the document.
I was disappointed that the Minister in her contribution made no mention of the needs of persons with a physical handicap. It was as if the motion was solely devoted to the needs of persons with an intellectual disability. That is not the case, there are large scale unmet needs of persons with a physical handicap also. There are 300 persons with a physical handicap who are in urgent need of placement. They are the realities, and the needs of persons with both physical and intellectual disabilities must be confronted in a coherent plan.
A coherent plan must have three crucial elements which we have not seen up to now: it must have a clear commitment to the funding which has never been honoured; it must have a legislative basis, a legislative charter for people with a disability. As we have said repeatedly on this side of the House, we are talking about people's rights — not chance occurrences that a vacancy would come and that one might get a suitable place — that must be underpinned legally in a charter. We are talking also about the need for a coherent framework. As Deputy McDaid rightly pointed out, we have services scattered throughout six or seven Departments, supposedly providing service for people with a disability. There is no framework within which we can know that the needs of those persons are being met as they go through life. That is why Fine Gael and the Labour Party believe it is so important to have a Minister with overriding responsibility stretching across those different Departments to provide that coherent response. The time has long passed when persons with a disability will accept a token sum from the lottery in next year's budget as a measure of the commitment and the response to the crisis today.
The demands that have been laid before Government on behalf of persons with a disability — demands for education for their children, for therapy when it can ease a disability, for a break from the task of caring, for placement when the task of caring is no longer bearable, for access to public buildings, for a chance to ride on our public transport, for financial support commensurate with the extra costs to be borne by carers, for an end to discrimination which is so rampant for persons with a disability — are all demands for basic rights and are not for discretionary extras. It is not acceptable that it be left to the vagaries of the lottery to provide the funds to underpin a five-year coherent plan for the needs of persons with a disability. The only response that can be accepted from this Government is a clear commitment to a five-year programme to deal with this problem. It is sad that we are not getting that commitment from the new Minister tonight.
We now have on the table renegotiation of the Programme for Economic and Social Progress but let no one here forget that the Government reneged on the Programme for Economic and Social Progress commitment to persons with a disability within seven days of its signing. When we came into the House seven days after the Programme for Economic and Social Progress was signed and listened to the Budget Statement read out by the Minister we discovered that £90 million which was to go to the development of community services was not to be provided in 1991. There was not even to be a first start in 1991; we saw instead in the budget provision a reduction of £10 million for community services for elderly persons with a disability. Persons with a disability had their hopes dashed 12 months ago and do not have to be told about renegotiating those terms. It will not be accepted in this House if that happens again. We believe it is important that people with a disability must be included as equal social partners in the negotiation of programmes, social and economic, for this country — partners who participate in a coherent plan to meet their needs, partners whose rights are underpinned in a charter and enshrined in law, partners who get first call on available moneys, not the crumbs that fall from the table, when the stronger groups have finished.
Amendment put.
The Dáil divided: Tá, 68; Níl, 61.
Tá
- Ahern, Bertie.
- Ahern, Dermot.
- Ahern, Michael.
- Andrews, David.
- Barrett, Michael.
- Brady, Gerard.
- Brennan, Mattie.
- Brennan, Séamus.
- Briscoe, Ben.
- Browne, John (Wexford).
- Burke, Raphael P.
- Calleary, Seán.
- Callely, Ivor.
- Clohessy, Peadar.
- Connolly, Ger.
- Coughlan, Mary Theresa.
- Cullimore, Séamus.
- Daly, Brendan.
- Davern, Noel.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Ellis, John.
- Fahey, Jackie.
- Fitzgerald, Liam Joseph.
- Fitzpatrick, Dermot.
- Flood, Chris.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Hillery, Brian.
- Hilliard, Colm.
- Jacob, Joe.
- Kelly, Laurence.
- Kenneally, Brendan.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leyden, Terry.
- Lyons, Denis.
- Martin, Micheál.
- McCreevy, Charlie.
- McDaid, Jim.
- McEllistrim, Tom.
- Molloy, Robert.
- Morley, P.J.
- Nolan, M.J.
- Noonan, Michael J.
- (Limerick West).
- O'Dea, Willie.
- O'Donoghue, John.
- O'Kennedy, Michael.
- O'Leary, John.
- O'Rourke, Mary.
- O'Toole, Martin Joe.
- Power, Seán.
- Quill, Máirín.
- Reynolds, Albert.
- Roche, Dick.
- Smith, Michael.
- Stafford, John.
- Treacy, Noel.
- Wallace, Dan.
- Wallace, Mary.
- Walsh, Joe.
- Wilson, John P.
- Wyse, Pearse.
Níl
- Ahearn, Therese.
- Allen, Bernard.
- Barnes, Monica.
- Bell, Michael.
- Belton, Louis J.
- Boylan, Andrew.
- Browne, John (Carlow-Kilkenny).
- Bruton, Richard.
- Byrne, Eric.
- Carey, Donal.
- Connaughton, Paul.
- Connor, John.
- Cosgrave, Michael Joe.
- Cotter, Bill.
- Creed, Michael.
- Currie, Austin.
- Deasy, Austin.
- Deenihan, Jimmy.
- Doyle, Joe.
- Durkan, Bernard.
- Enright, Thomas W.
- Farrelly, John V.
- O'Keeffe, Jim.
- O'Shea, Brian.
- O'Sullivan, Gerry.
- O'Sullivan, Toddy.
- Owen, Nora.
- Pattison, Séamus.
- Quinn, Ruairí.
- Rabbitte, Pat.
- Reynolds, Gerry.
- Fennell, Nuala.
- Ferris, Michael.
- Finucane, Michael.
- Flaherty, Mary.
- Flanagan, Charles.
- Gilmore, Eamon.
- Harte, Paddy.
- Higgins, Michael D.
- Hogan, Philip.
- Howlin, Brendan.
- Kavanagh, Liam.
- Kenny, Enda.
- Lee, Pat.
- Lowry, Michael.
- McCartan, Pat.
- McCormack, Pádraic.
- McGinley, Dinny.
- Mac Giolla, Tomás.
- Moynihan, Michael.
- Nealon, Ted.
- Noonan, Michael.
- (Limerick East).
- Ryan, Seán.
- Sheehan, Patrick J.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emmet.
- Taylor, Mervyn.
- Taylor-Quinn, Madeleine.
- Timmins, Godfrey.
- Yates, Ivan.
Tellers: Tá, Deputies D. Ahern and Clohessy; Níl, Deputies Flanagan and Boylan.
Amendment declared carried.
Amendment No. 2 not moved.
Question, "That the motion, as amended, be agreed to" put and declared carried.