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Dáil Éireann díospóireacht -
Tuesday, 10 Mar 1998

Vol. 488 No. 4

Adjournment Debate. - Mental Handicap Services.

The 1998 allocation for the development of services in the mid west region for those with a mental handicap is totally inadequate. It does not meet the immediate and urgent needs of persons in the region with a mental handicap. I call on the Minister to immediately increase the allocation as the funds available for the provision of residential services are pitiful.

There is an immediate and urgent requirement for the provision of 31 residential places but the Minister's allocation will only provide nine places. In 1997 the agencies suggested as a strategy that for an extra outlay it would provide for more clients than was indicated by the Department of Health. The strategy was implemented by the agencies but the additional funding was not forthcoming. The additional outlay of £110,000 has been transferred into the 1998 allocation giving a net allocation of a mere £390,000. It is most regrettable the agencies are unable to continue such initiatives given that the merits of any such actions will not be recognised.

The provision of services to children in the region is totally inadequate, particularly in the area of assessment and advice in pre-school services. The services will remain inadequate, even to answer the basic needs of parents and children in the foreseeable future. Last Friday, the Taoiseach and the Minister for Health and Children met the representatives of the parents and friends of the mentally handicapped. The meeting was requested by the parents and friends to discuss the crisis in services in the mid-west where 31 people require residential care and 42 require day care services. The Taoiseach was informed of the ongoing anger and frustration of the parents who await services. Detailed discussion took place and the friends and parents outlined that approximately £2 million — revenue and capital — is required to provide the necessary services for the people involved.

The friends and parents of the mentally handicapped received a letter from the Minister, Deputy Cowen, today. Regrettably, his reply was most disappointing. He restated a number of plans and expenditure items already in the pipeline and which are well known to the friends and parents. Unfortunately for those in urgent need, he made it clear there will be no additional funding to address the immediate problem. Yet again those unfortunate people and their families must wait. Will the Minister re-examine his stance? If the political will exists, the money will be provided.

The Taoiseach, in identifying needs, said that an additional £500,000 was provided. I question this figure as £110,000 was taken from the agencies to provide services; therefore, the net figure is £390,000. The Minister's letter confirmed the Mid-Western Health Board has identified that 73 people are in urgent need of care. He outlined his capital programme of £30 million over four years but revenue must be included for staffing and services, buildings are useless without services. There is an urgency to outline the revenue to service the capital programme.

In his letter, the Minister confirmed the major building project at Lisnagry is at stage 3 of the planning and design process and will commence later this year. However, I remind him that his predecessor, Deputy Noonan, announced this last year and it has been in the pipeline since. This will facilitate the transfer of 36 people from St. Joseph's psychiatric hospital to the new centre at St. Vincent's in Lisnagry. The Minister stated he was fully committed to the allocation of £30 million for the capital programme nationally, of which £2 million is required in the mid-west.

There have been many announcements over the past number of weeks, all of which dealt with projects already in the pipeline. The parents and friends of the mentally handicapped in the mid-west ask that the same be done for them. They want the project and the money allocated to it brought forward so that they can get over the difficulty facing the 73 people with immediate needs. Will he treat these services similar to sport and community projects in the area, which are also welcome?

I thank the Deputy for raising this important issue. My Department published "Assessment of Need for Services to Persons with a Mental Handicap 1997-2001" last year based on figures from the national intellectual disability database. An analysis of the database shows a requirement for 1,439 new residential/respite places and 1,036 new day places over the period. It is estimated the cost of providing these services will be approximately £63.5 million over that time. The Mid-Western Health Board has identified a current requirement for 31 residential places and 42 day care places for the region.

To continue the process of delivering the services identified in the assessment my colleague, the Minister for Health and Children, Deputy Cowen, was pleased to be able to allocate additional funding of £16 million this year for services to persons with a mental handicap. This funding includes £10.75 million revenue and £5.25 million capital. The Mid-Western Health Board region received a total of £1.455 million from the additional revenue funding for the improvement of local services, of which £500,000 was allocated for the provision of new residential/respite and day care places in 1998 and £955,000 was provided to meet identified needs in their existing services, largely due to increased levels of challenging behaviour and the increasing age and dependency among patients in services.

Details of the precise services to be put in place in the Mid-Western Health Board region and the individuals who will benefit from these services are to be agreed by the regional mental handicap co-ordinating committee in line with the priority needs identified for the region. Proposals for the expenditure of this additional funding, as agreed by the regional co-ordinating committee, will shortly be submitted to my Department.

The capacity of existing facilities to absorb the additional places in the coming years and to provide the specialist services for disturbed patients is now limited. A programme of building is essential to deliver the volume and quality of service required. Late last year, the Minister also announced a new major capital programme of £30 million which he has put in place to run over four years beginning in 1998 in tandem with the service developments in the assessment of need and the Mid-Western Health Board region will benefit from it; the details are currently being discussed with the health boards and voluntary mental handicap agencies.

As well as the provision of new services, there is also need to improve the quality of life of people with a mental handicap who are inappropriately placed in psychiatric hospitals. I confirm that the major building project at Lisnagry is currently at stage 3 of the planning and design process, and it is expected building will commence later this year. This development will provide purpose built residential and day care facilities at St. Vincent's Centre, Lisnagry, for 36 persons with a mental handicap from St. Joseph's Hospital, Limerick. These services, which are being developed by the Mid-Western Health Board in partnership with the Daughters of Charity, form a major part of the board's overall plan for the provision of services to persons with a mental handicap. This capital project will cost over £2 million.

As outlined in "Partnership 2000 for Inclusion, Employment and Competitiveness" and "An Action Plan for the Millennium", the Government is committed to the ongoing development of services to persons with a mental handicap.

The Taoiseach and the Minister, Deputy Cowen, met representatives of the Limerick Parents and Friends Association last week and explained to them that, in fulfilling the Government's commitment to meet the identified needs for the services over the period outlined in the assessment of need, there is a requirement to allocate capital money in the first instance to provide the basic infrastructure which can attract further continuing funding on an annual basis thereafter. This capital funding, as I have already stated, is now in place.

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