On behalf of all Members I welcome back Deputy Theresa Ahearn and I am pleased to see the Deputy looking so well after her recent illness.
Private Members' Business. - Mental Handicap Services: Motion.
I thank you, a Leas-Cheann Comhairle, for your words of welcome. I take this opportunity to say a heartfelt thanks to colleagues from all sides of the House for their support and kindness to me over a difficult year. I will always appreciate that kindness and support the memory of which will remain a big part of my political life. I wish to share my time with Deputies Shortall and McManus.
Is that agreed? Agreed.
I move:
That Dáil Éireann, conscious of the fact that people with mental handicap continue to live at the outer margins of society, and that their families frequently suffer great stress and hardship as a result of the denial of basic rights; aware, from Government-commissioned reports, that more than 1,000 people with a mental handicap live in completely inappropriate surroundings, and that thousands more are on waiting lists for essential services; believing there is a continuing and growing crisis in the legitimate demands of people with a mental handicap for residential services, respite care, training, education and employment; conscious that the Government and Dáil Éireann have welcomed the publication of a number of critical reports in this area, notably the Strategy for Equality, which contains 402 recommendations about the rights of people with disabilities, and Services to Persons with a Mental Handicap — An Assessment of Needs, which establishes a scientific database illustrating the gravity of the problem facing thousands of families; aware that the Programme for Government and Partnership 2000 both accord significant priority to the needs and rights of people with a disability; believing that the current strong state of the Exchequer finances provides a unique and unanswerable opportunity to make significant inroads into the unacceptable waiting lists; calls on the Government to mount a front-loaded assault on the problems in the context of this year's budget, and, in particular, to allocate a minimum of £30 million in capital funding to enable the residential and respite care crisis to be addressed, with a further amount of at least £30 million in revenue funding for new services and places in education, training and sheltered and supported employment.
This House recently debated and called for action to address the scandal of the growing public, in-patient waiting lists in hospitals in every health board region. It is scandalous that more than 34,000 people are waiting, some for over two years, for pain relieving, corrective or life-enhancing surgery or treatment. People are rightly out-raged by this delay in the provision of treatment or surgery which can cure a condition or relieve pain.
This motion concerns the scandal of yet another waiting list. The people on this list do not require medical intervention. Their condition will not be cured by the provision of corrective surgery or treatment. They have waited a long time and must not be made to wait any longer. The State's commitment to provide services for those with an intellectual disability must be ongoing. A lifetime commitment is required for every child and their families.
Every day the parents of a child with a mental handicap are faced with the painful reality that their child's quality of life will always be decided by others. Far from benefiting from a comprehensive, seamless service, parents and families may face a lifetime of struggle and delay. An extract from one of the submissions to the Commission on the Status of People with Disabilities included in the report of that body, A Strategy for Equality, graphically illustrates this point. It indicated how the parents of a disabled child face a lifetime of fighting each and every agency and Department for their rights and those of their child.
The Department of Health and Children's document, Services to Persons with a Mental Handicap/Intellectual Disability — An Assessment of Need 1997-2001, added a new dimension to the development and planning of a comprehensive service for people with a mental handicap. It comprehensively describes the essential needs of those with a mental handicap. It provides us with real information on the need for additional services and on the quality of services currently being provided. This document is the means to an end.
All parties in this House welcomed the publication of that report. We might ask how there can be any room for complacency when there is such apparent consensus. For those with a mental handicap, their families and carers, it is "payback time", to borrow an infamous phrase.
An additional £56.8 million was provided between 1990 and 1996 for the development of services for persons with a mental handicap. However, the data available in the assessment of needs document, proves that a further substantial investment is required to provide even the most basic care and meet current needs. The intellectual disability database identifies 26,694 people with a mental handicap, of whom 604 receive no service from the State. Some service is being received by 22,804 people. Of the 26,694 men, women and children, 1,439, one in every 20, are waiting for residential and respite care and 1,036 are waiting for the provision of day care. Analysis of the data shows that, due to medical advances, the adult population in the database has increased by 31 per cent since 1974. Of the 26,694 people on the database, 61 per cent, 16,453, are aged 20 or over. Of those 16,453 people, 8,283 are aged 35 or over and 2,203 are over 55. The Department of Health and Children states that the average age of those requiring residential placements is 31.6 years, and 35.9 years of age for those requiring day places.
The principal carers of persons with mental handicap are their parents. The age profile of those identified as requiring a service has a significant implication. There are many elderly parents caring for middle-aged and older sons and daughters. Parents in their 70s and 80s are looking after adult mentally handicapped sons and daughters. For all of these people, quite apart from the daily physical and emotional demands, their is the fear of what will happen to their child if they die or become incapacitated.
As a society, we claim to value our elderly people and the Minister of Finance has said that he will concentrate resources in this year's budget on pensioners. Based on the figures I have put forward it is clear that there are more than 8,000 old age pensioners caring for a dependant, mentally handicapped son or daughter. What will the Minister do for them? Will an increase in their old age pension, welcome though it would be, relieve the pressure of caring? Will it provide the residential day or respite care they so desperately need for their children? Will it end the sleepless nights or provide the peace of mind?
In a submission to the Commission on the Status of People with Disabilities, the parents of a mentally handicapped adult stated that parents do not expect the State or society to take over their responsibilities. They are prepared to make whatever sacrifices are necessary, but with the best will in the world, they cannot do it beyond the grave.
The decision to avail of residential care for their mentally handicapped son or daughter, even if it was available, is not an easy decision for parents. However, in certain cases there is no choice. The death or incapacity of a primary carer, usually the parent, forces this issue. We have all felt the pain of losing someone close to us. How more acute would that pain be if we were sent away from home to totally unfamiliar surroundings while still grieving? Unfortunately, this is the nightmare scenario facing many people with a mental handicap. They are denied the opportunity to adjust to residential care while their parents are still living. While many parents may have mixed feelings about residential care, many would realistically prefer that their son or daughter would have the experience of living away from home, even in short-term respite care. This would help prepare them for the day when, through death or incapacity, they can no longer be cared for in the family. Neither they nor us can afford to wait any longer. The Minister will have the wholehearted support of Members of this House if he agrees to this motion. We have the resources; we just need to prioritise the manner in which they are used.
The Minister is on record as saying in December 1997 that it was unacceptable that a parent of a son or daughter with a mental handicap should have to worry about who would look after their child when they were no longer able to care for them and that he intended to ensure their fears would be allayed. If the Minister is serious about allaying those fears, he can give this House a commitment this evening. The Government can guarantee that in this year's budget, provision of £30 million capital funding will be made to wipe out the waiting lists for residential and respite care. The Government can accelerate the process and provide peace of mind for the families of the 1,439 people who are in need of residential and respite care. A total of 6,971 people will require alternative day services over the next five years. It is estimated that 2,359 adult day places will be required over that period. We already know there is a shortfall of 1,430 day places and we know what it will cost to provide those additional places.
The motion has already had one very positive effect. Yesterday, the Minister for Health and Children announced the provision of an additional £7 million from the Department of Health and Children and £4 million from the sale of lands for the development programme at St. Ita's Hospital in Portrane. The Minister somewhat disingenuously announced again the provision of £5 million in capital funding which had already been committed in August. However, such advances are welcome. Those in St. Ita's who, in spite of the best efforts of committed, skilled and dedicated staff, have had to exist in accommodation and facilities which were totally inappropriate to their real needs, can now look forward to an enhanced quality of life. The Strategy for Equality document described facilities such as those at St. Ita's as "unacceptable and degrading" and urged they be among the first to be replaced.
Sectional improvements such as those in the Eastern Health Board area only go a small way towards eliminating the unacceptable and degrading conditions endured by people with a mental handicap who are inappropriately placed in other psychiatric hospitals countrywide. The assessment of need document estimates that of the 970 people with a mental handicap currently accommodated in psychiatric hospitals, 310 have been classified as being inappropriately placed. The National Association for the Mentally Handicapped of Ireland estimates far exceed that number. It must be noted, however, that while the funding announced by the Minister will at long last address the needs of those already in full time residential care in St. Ita's, it will not provide one extra day care, residential or respite place. A total of 2,457 people and their families will still be waiting.
It is the Government's responsibility to support the members of those families who, for too long, have had to shoulder an unfair burden and it is everyone's responsibility to ensure quality of treatment for those who cannot speak for themselves. It will be an indictment of all of us if, at the end of a period of unprecedented prosperity, we fail to provide the necessary resources to vindicate the human rights of people with a mental handicap who require improved and additional services.
There is, in effect, no real disagreement in this House on this matter. Government and Opposition parties are agreed on the action which must be taken. The assessment of needs document indicates that the State needs to provide £36 million for residential places, £10.36 million for day places, £14.14 million for changes in services and £3 million for home support and additional support services. This issue should not be turned into a cynical party political football.
Hear, hear.
We, on this side of the House, and those on the Government benches, cannot claim to be holier than thou. All the major parties in the House have been in Government in recent times. All parties did their best in Government; we all tried and failed, mainly for budgetary reasons, to put in place the required support services. This Government is in a different position; all the groundwork has been done and it is fortunate to have available to it the resources to achieve what we all recognise needs to be done. We will not begrudge the Government the opportunity to deliver the range of services it is its duty to deliver. We all agree that £63.5 million is required to provide appropriate, comprehensive and equitable services and support to persons with a mental handicap and their families.
Partnership 2000 states that services to people with a mental handicap will be developed within the overall resource parameters based on the needs identified by the national intellectual disability database. Added to that, the Government's programme, An Action Programme for the Millennium, states that Fianna Fáil and the Progressive Democrats are committed to radical change to ensure the needs and aspirations of people with disabilities, their families, carers and advocates are comprehensively addressed. Each of these commitments was made before it became clear that Exchequer receipts would exceed all of even the most optimistic forecasts and before the budget surplus for this year was announced. There is no reason for delay. The anger and frustration of the parents and families of adults and children with a mental handicap is reaching boiling point.
While substantial funding has been invested in services in the past, much more needs to be done. Conditions were never more favourable than at present. The parents, carers and advocates of adults and children with a mental handicap are right to be cynical. They already fear that the National Disability Authority will not be given the necessary powers recommended in the Strategy for Equality document. Why should they wait again when there is no need? People should not have to take to the streets to demonstrate their right to day care, respite care, education and training. We should be ashamed of ourselves if we fail to address those needs now.
We have all the information, planning and evidence we require. We simply need funding. We have agreed that money is required; all that remains to be agreed is the date on which it will be provided. Why should the House approve the Government's commitment to provide funds over a four year period when they could be provided this year? How can any Deputy in this House justify asking those people who for years have put up with inadequate and inappropriate services for themselves and their children to wait any longer?
The Commission on the Status of People with Disabilities states that its report is an ambitious one which, when its recommendations are implemented, should change the world for many people with disabilities, their families and carers. That is no less than people with disabilities deserve, nor what they, as equal citizens of this State, are entitled to. We are committed to changing the world for people with a mental handicap but let us do it now.
The reason behind this all party motion is quite clear. For the first time in the history of the State we have the resources to make a real and substantial difference to the lives of thousands of families and we now need the Government to demonstrate it has the political will to make the necessary investment. We, on this side of the House, are determined to ensure that people with a mental handicap attain full equality in Irish society. We recognise that this will entail significant investment and we are deeply concerned that the Government will not have the courage to make this investment. Therefore, the Labour Party, Fine Gael, the Green Party, Democratic Left and some of the Independents have tabled this motion in an effort to concentrate the Government on the legitimate needs of people with a mental disability in advance of the budget.
Successive Governments have a shameful record in their response to mental handicap. We have been remiss in the practicalities of caring for the needs of people with a mental handicap. In the past, as in so many areas of the social services, religious orders did their best. In more recent times the parents of people with a mental handicap have banded together in various organisations to campaign for basic services where the State has failed miserably in its responsibilities. The main burden has always remained with the parents and families of those with a mental handicap.
One of the greatest worries for parents of a child with a mental handicap is the total lack of respite care. These parents are saving the State many millions of pounds each year by their commitment to the care of their children. This entails enormous extra burdens on parents. Family life can be totally disrupted, usually requiring at least one parent to forgo their choice of a career outside the home. There can and often is extra stress in homes where parents try to balance the demands of the child with a mental handicap with the emotional, physical and financial needs of their other children. Many such families need structured respite care for their children at regular intervals to maintain the integrity of their family. While the rest of us take for granted such things as a night out or a weekend away, for the parents of children with a mental handicap such events entail enormous pre-planning and effort, if possible at all.
Respite care must be made available as a right. It is essential so that parents and families can continue to give loving care and affection to all their children, especially those with a mental handicap. It must be provided on a regular basis and not just in crises. It is needed so that parents can have time to themselves and can spend quality time with their other children. It also helps the child with a mental handicap to get used to the idea of residential care outside the home, a situation which may arise in the future if the parents die or become too old to look after their child. Such facilities should be provided in community or village type settings and not in decaying Victorian mental hospitals which are reminiscent of an age that many of us believed to be long gone.
In this respect I welcome the announcement yesterday that the Department will provide part funding for the Eastern Health Board's redevelopment plan for St. Ita's. It is long overdue and welcome development. However, it is important to bear in mind that the development will not provide one single additional place.
The urgent needs of the mentally handicapped and their families should be self-evident. Until recently the extent of the problem was unknown. However, it is now known that over 1,300 people with a mental handicap are without residential or respite care and that a further 1,000 people require day care services. In the Dublin north region of St. Michael's House, for example, there are 413 people on the waiting list for residential care, 235 of whom need places urgently.
Recently, Karen Canning, Chairperson of the Parents' Future Planning Group, St. Michael's House, said:
The only way to get a residential place for any of our children is for both parents to die. Fear of the future is what we all worry about. We want our children settled in a suitable residential place before we die, not an unsuitable place after.
That fear and the determination of parents to ensure their mentally handicapped children are given their basic rights has led to the setting up of the National Parents' Alliance. Recently parents from around the country gathered in Dublin to establish this new organisation to campaign for a fairer deal for their children. Central to their purpose is the securing of the necessary funding for the required respite and residential services. However, issues such as the lack of choice of service, the exclusion of parents from management boards and the absence of independent advice and information are also critically important. As politicians we must respond to these legitimate demands and be prepared to take the necessary action.
To begin providing the necessary services an allocation of £60 million will be required in next month's budget. This is a small sum in the context of the £1 billion in additional tax receipts this year. The halving of capital gains tax in the last budget represented a gift of at least £50 million to those who are already among the wealthiest members of society and highlighted the priorities of the Government.
Recently the Minister for Finance, Deputy McCreevy, has been speaking about repaying the national debt. I put it to him that it is now time for us to repay the national debt to the mentally handicapped.
In addition to residential and day care places there is an urgent need for investment in education and training opportunities for people with a disability. I welcome the Government's decision to accept a key recommendation of the recent Report on Employment for People with Disabilities and transfer responsibility for training to the Department of Enterprise, Trade and Employment. However, the real import of that report, namely, the call for an immediate investment of £11 million in sheltered training and employment, has not been acted upon by the Government and the motion before the House this evening demands that the Government provide funding for this in the current year.
The motion also calls for significant investment in education opportunities for people with a disability. In relation to this aspect of the motion I call on the Minister for Education and Science to ensure provision of equal treatment for all special needs children. Currently a child with special needs who is fully integrated into the mainstream school system receives less capitation support than a child who is not integrated into our mainstream primary education system. This policy actively discourages integration. It effectively imposes a severe financial disincentive on schools which actively strive to integrate special needs children. The policy does not serve the interests of children with special needs, their parents or the schools they attend.
The Labour Party is in favour of a system that provides financial support to a special needs child regardless of the type of education he or she receives. This grant would remain with the child throughout his or her education regardless of the setting or type of class in which he or she is taught. Neither the school nor the child would be penalised were the child to be fully integrated into the mainstream school system. If the Minister and the Government are serious about encouraging integration in our education system it is imperative that the Department of Education and Science's funding system be immediately reformed.
Also in this regard it is essential that funding be made available to provide classroom assistance for children attending mainstream schools. It is all very well to pay lip service to the idea of integration, but unless we are prepared to put money where our mouth is and provide the necessary support, staff integration is simply not possible.
It is obvious that, unless current attitudes change, the position of the parents of those with a mental handicap can only deteriorate and this is simply not acceptable in a developed and caring society. It is time to act before we reach that stage. What is needed to assist people with a mental handicap and their families is not an enormous sum when we consider the demands that have been placed on public coffers by other sections of society. Such a commitment would be a welcome and long overdue recognition of the rights to full citizenship for all and of the unstinting care given by many parents and their families to children with a mental handicap.
I specifically call on Deputies Fox, Healy-Ray and Gildea to support this motion and vote for it tomorrow night. These Deputies have used their considerable influence over the Government on a number of issues in the past. This motion is of the utmost importance. It concerns the civil rights of a substantial number of citizens. To vindicate the rights of these citizens it is essential that £60 million be invested in services this year. We now have a unique opportunity to do this: what is necessary is the political will. The passing of this motion tomorrow night will place considerable moral and political pressure on the Government to progress the equality agenda and advance the cause of people with a mental disability. The support of these three Independent Deputies is critical to the success of the motion. I call on them to seriously reflect on their position this evening. Is there one constituent of theirs who is opposed to the wording of this motion? Is there a single cogent argument against using part of our new found and considerable wealth to give decent treatment to people with a disability and their families? The answers to these questions are self-evident. The decision rests with these three Independent Deputies. I hope after tomorrow night's vote they will be proud of the decision they took.
I welcome the fact that a range of Opposition parties and Independent Deputies could agree on the tabling of this motion on the needs of those with mental handicap. Few other issues could have brought together such a range of parties and individual Deputies, and I particularly thank Fine Gael for being so willing to make its Private Members' time available for this unique initiative.
All Governments in recent times have tried to do something for the needs of the mentally handicapped and their families, but no Government has done enough. This motion is not a political attack on the current Government but rather an attempt to focus attention on the growing needs of this sector and to ensure that at a time when revenue is available on a scale never before experienced, a real effort is made to provide the residential and care places required. As stated in advertisements placed in newspapers yesterday by the federation of voluntary bodies providing services to people with mental handicap, it is Ireland's chance of a lifetime.
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 this yardstick, our treatment of the mentally handicapped raises questions about our right to describe ourselves as a civilised society. We have simply failed to provide the level of services required and at the speed required. This has resulted in unnecessary suffering for those with a mental handicap and has placed great pressure on their families. Thankfully, as our understanding of mental illness and mental handicap has improved, we have moved away from the 19th century attitudes which saw these people as some kind of threat who had to be locked away from public view. Most can now enjoy a warm and loving relationship with their families and many can play a happy and fulfilling role in society.
The Green Paper on Services for Disabled People, Towards a Full Life, published 15 years ago, 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". Our failure to provide adequate services means that many people with mental handicap are not being allowed to realise their full potential and are being denied an opportunity to participate fully in the life of the community.
That mentally handicapped people have not suffered even more has been largely due to the love and care lavished on them by their families. I welcome the families who have taken the trouble to come here this evening to listen to this debate. It is important that they listen but it is equally if not more important that they be heard. It is also due to the Trojan work undertaken by many voluntary organisations working in the area. What causes most anger and frustration to those voluntarily involved in the care of the handicapped, whether families or groups, is that the more work they do and the more they achieve, the more content the State seems to be to wash its hands of its obligations and to load even more work and responsibility on families and the voluntary sector.
The reality is that the scale of the problem is so great that families or voluntary organisations alone simply do not have the resources to deal with the problem. While the trend has been to move away from automatic institutional care, the level of handicap suffered by some is so severe that institutional care will always be required. The costs involved in caring for the handicapped and ensuring they get the treatment they need are enormous and will require substantial central funding.
There are particular requirements for families caring for a person with a mental handicap at home. In many cases it is simply not possible to provide the level of care required on a 24-hour basis every day of the year. Day places are needed to provide training and support employment. With improvements in medical care people with mental handicap are, thankfully, living longer but this in turn means they need care for a longer period. Many parents who are getting on in years are caring for sons or daughters in their 30s or 40s. Their main fear is what will happen to their sons or daughters when they are too old to care for them or when they are dead.
As recently as December 1997, the Minister for Health and Children, Deputy Cowen, stated:
It is not acceptable that a parent of a son or daughter with a mental handicap should have to worry about who will look after their child when they are no longer able to care for them. I intend to ensure that their fears are allayed.
I hope this is one commitment that will be honoured in full and without delay.
The needs of this sector were identified in a series of reports, the most recent and detailed of which was Services to Persons with Mental Handicap: An Assessment of Need 1997-2001. The work is done and we know the extent of the problem. There is little dispute about the number of places required — approximately 1,400 additional residential or respite places and approximately 1,000 day care places. The estimated cost of providing these places is approximately £60 million. It is a substantial sum of money but today the Minister for Justice, Equality and Law Reform introduced a Supplementary Estimate of more than £90 million, including an additional £56 million for Garda pay. Imagine the difference the commitment of a similar amount would make to the quality of life not just of those with a mental handicap but also that of their families. The Government has already made a commitment to provide the resources to meet the needs set out in the assessment of needs. In this motion we are seeking a commitment to speed up the programme of spending.
I note the newspaper reports today of the Minister's announcement about St. Ita's in Portrane, although I accept the point that some of this money has already been announced. It is a welcome and important step forward on the part of the Minister but it should highlight for us the difficulties experienced by people with mental handicap and their families in getting initiatives from any Government. This is a long and tragic saga which we, particularly the Minister, must examine and learn from. It is unfair and unkind to people who are struggling to have to put up such a battle as that fought in the case of St. Ita's.
We should be more compassionate when we are living in such prosperous times. For the first time we are in a position to make a real and significant difference to people in our community who for so long have been discriminated against and forgotten.
I, too, urge the Independent Deputies to live up to that name. One of them comes from my constituency of County Wicklow and I have no doubt she believes the mentally handicapped should be cared for and supported. This is the choice Deputies have to make and it is not always easy. There are families in County Wicklow struggling to do their very best for their children — some are now adults — whom they continue to love and cherish. As Members of this Parliament we have an obligation to assist those families in the valuable work they do. I call on all Deputies, particularly those who claim to be independent, to use that independence in a way that will bring real meaning to the lives of those families.
I move amendment No. 1:
To delete all words after "That" and substitute the following:
"Dáil Éireann recognises the need for the further development of services to persons with a mental handicap and approves both the Government's commitment to put in place an enhanced level of service provision in line with the commitments outlined in the Programme for Government and Partnership 2000 and the actions taken by the Government to date in meeting these commitments which include:
— the provision of additional funding of £25 million;
— a £30 million National Capital Programme, over four years, to put in place appropriate infrastructure to support the services."
I am pleased to have an opportunity tonight to speak on issues related to the provision of services to persons with a mental handicap and to outline what the Government is doing to meet the needs which have been identified for this population group.
The philosophy which underpins the development of services to persons with a mental handicap is that people with a mental handicap should be given the opportunity to live as full and independent a life as possible, and to live with their families and as part of their local communities for as long as possible.
Since the 1970s the main thrust of service provision has been towards the development of community based services designed to provide a range of services for both the individual with a mental handicap and his or her family.
This principle has been endorsed over the years by a number of policy documents. In particular, the 1990 report of the Review Group on Mental Handicap, "Need and Abilities", and more recently in the report of the Commission on the Status of People with Disabilities, "A Strategy for Equality", which adopted three guiding principles in carrying out its work: equality, maximising participation, and enabling independence and choice.
These principles are at the core of the planning and delivery of services to persons with a mental handicap. While there has been a substantial investment in the services in recent years, and the overall level of service provision has been greatly enhanced, there has also been a corresponding increase in the numbers of persons with a mental handicap in Ireland. This has led to a change in emphasis for the services with the main focus for future planning now clearly on the development of services for adults and the growing number of elderly persons with a mental handicap.
Since my appointment as Minister for Health and Children, despite the many competing demands which are made on the resources available to my Department, and in particular in relation to waiting lists for services in the acute hospital sector, I have consistently identified as one of my priorities the provision of the additional residential, respite and day services outlined in the "Services to Persons with a Mental Handicap — An Assessment of Need 1997 -2001". I have, in the past 12 months or so allocated an additional £25 million to the services. This is more than double the additional funding allocated by Deputy Bruton's Government in 1997. I have also put in place a £30 million national capital programme, to run over four years in tandem with the assessment of need, to provide the infrastructure necessary to support the services.
The availability of data both on the services currently being provided and on current and future needs has enabled us to identify clearly, for the first time, the level of unmet need over a five year period and to plan to meet those needs. The national intellectual disability database is now providing us with this information and while the picture which has emerged does not surprise us, it provides confirmation of the growth in the adult population and illustrates for us how the demographics of this population group are now mirroring that of the general population, including a growth in the number of elderly people.
There are a total of 26,694 persons with a mental handicap on the database. This represents an increase in the numbers ascertained across all categories of mental handicap since the last census of mental handicap was carried out in 1981. Of the 26,694 persons with a mental handicap on the database in 1996, 22,804 persons were receiving a service, 604 persons had no services and required either a residential and day service or a day service only, while 3,286 persons had no current service requirements.
While our main concern must be to meet the needs of those who are waiting for placement in either residential or day care services, we must not lose sight of the fact that nearly 23,000 persons are already in receipt of a significant level of services. My Department will spend approximately £271 million in 1998 on services to persons with a mental handicap and while acknowledging what still needs to be done, it must also be seen in the context of the existing level of expenditure. The figures from the database reveal an ageing population in the more severe range of disability. This changing age structure among those with moderate, severe and profound disability has major implications for service planning. Decreasing numbers of children will have implications for the educational services. The higher numbers of young adults and increased life expectancy, however, will mean that the pressure currently being experienced by adult day services will increase as this group ages and requires residential services. This is reflected in the current waiting lists for services and the changing pattern of care towards a more intensive range of service provision.
Another implication of ageing and the increase in the severely disabled population will be a demand for a higher degree of support within the residential services and the need to develop specific geriatric support services. The database has identified 4,152 persons in the 35 to 54 age group and a further 1,434 aged 55 and over. So we already have a sizeable number of people for whom issues related to growing old are becoming or have become a reality.
The Assessment of Need 1997 – 2001, which was published in April 1997, identified a need for 1,439 new residential-respite places and 1,036 new day places at an estimated cost of £63.5 million over the period in question. This Government is committed to putting in place these additional services. Between 1997 and 1998, more than 500 new residential and 760 new day places have been provided, leaving a balance of more than 900 residential-respite and around 300 day places to come on stream over the next three years.
While the additional services which have been put in place have made a significant difference, their impact on the waiting lists has been reduced because of the numbers of emergency admissions which had to be made to the residential services. My Department carried out a review of the emergency admissions to residential care in 1997. The average age of the 107 persons admitted to residential care as emergencies that year was 31 years. More than half of these admissions were as a direct result of the carer's inability to continue to care for a relative with a mental handicap. The age profile of those admitted as emergencies clearly demonstrates the change to a predominantly adult population.
Examples of the situations which led to these emergencies included cases where the ill-health or death of the primary carer meant that their relative could no longer be cared for at home; the primary carer could no longer cope with increased behavioural problems; individuals with a mental handicap who required specialised care because of medical problems; and individuals who were considered to be at risk in their home or in other situations.
I acknowledge the work families and carers of persons with a mental handicap undertake in caring for their relatives. I understand the frustration of families whose relatives are on waiting lists for services and the toll which both the caring and the waiting can take on their health. We wish to be of assistance to those parents in working with them and the service providers to meet the needs which have now been clearly identified. We are really only now getting into a situation where we can develop the services in a planned and co-ordinated manner.
The management of emergency admissions to residential care presents a major problem in most health board regions and will become an increasing feature of the services over the next decade as the population ages. This problem was particularly acute in 1996 and 1997. A reduction in the level of additional funding made available by Deputy Bruton's Government in 1996 for service development to £3 million upset the delicate balance achieved in previous years in managing the various demands on the residential and respite services. As a result, there was a large build-up of emergency cases within the services which were unfunded and which subsequently had first call on the resources provided in 1997. This in effect meant that the ability of service providers to deal with both cases on the waiting lists and emergency cases was severely restricted in both day and residential services, but in particular in residential services. This also affected the respite services in that those services became blocked by emergency cases. The knock-on effects of this drop in additional funding in 1996, when the Opposition was in office, are still being felt today.
It is against this background that we should welcome the Opposition's new-found commitment to the development of the mental handicap services. In allocating the additional funding provided for new services this year, I asked health boards to begin to put in place measures to enable them to manage emergency cases. Most health boards have now set aside funding to assist with the cost of emergency admissions. The boards will be requested to develop these measures even further next year. The provision of additional respite services is vital if families are to be supported in caring for their relatives at home. As well as the provision of additional residential places for respite, this also involves the enhancement and expansion of the various "share a break" or "breakaway" schemes and the home support services. This approach will build in both a flexibility in responding to individual needs and an element of choice for carers.
Since the service was initiated in 1992, the home support services have provided a variety of responses designed to meet individual needs. In 1997, more than 2,200 children and adults benefited from this service. The services provided fall within three main categories: provision of home help, enabling carers to take time off and facilitating attendance at social activities.
Given the age profile of clients and carers and the general unavailability of planned respite breaks, the expansion of the residential services must be tackled on three fronts: provision for the management of emergency cases; provision for new residential places for those who have been assessed as requiring this service; and provision for an increase in the level of respite care. I have already begun this process and intend to further develop it as additional resources come on stream.
In addition to providing funding for new services, it is necessary to ensure existing services can continue to provide an appropriate level of care for their clients. The changing age profile has meant the needs of many of those in residential care have changed. There is an increasing need for more intensive levels of support as the numbers of persons who are terminally ill or suffering from Alzheimer's and other health problems associated with growing older increases. I provided additional funding to assist with these issues this year and I hope to be in a position to continue this work in 1999.
In the case of some of the smaller voluntary service providers, many of which are parents and friends' associations, the historic base funding is inadequate. I am tackling and will continue to tackle this issue.
In recent years there has been a substantial development in the number of residential-respite and day places available to persons with a mental handicap. These have been provided either by adapting existing accommodation, by purchasing and adapting other accommodation or by building suitable facilities. The existing facilities are stretched to capacity. Some of these facilities are inadequate and must be upgraded. A programme of new building is essential for the delivery of the services required.
In late 1997 I put in place a major capital programme of £30 million for mental handicap services to run over four years in tandem with the assessment of need report. This is the first time we had a muti-annual designated capital programme for mental handicap services. During the next four years this capital programme will provide for: new residential and day care facilities and the up-grading of existing facilities; the provision of alternative accommodation for persons with a mental handicap who are accommodated in St. Ita's, Portrane, St. Raphael's, Youghal, and other psychiatric hospitals and the up-grading of existing facilities which will continue to be used in the medium to long-term future; and the provision of facilities for persons with a mental handicap who require specialist services in a secure environment.
Yesterday I announced the first of a number of measures which are being taken to fulfil the commitment I made, as part of the national capital programme, to provide alternative and refurbished accommodation for persons with a mental handicap in psychiatric hospitals and other inappropriate places.
A £13 million project, which will be funded jointly by my Department and the Eastern Health Board, will provide alternative and refurbished accommodation for persons with a mental handicap accommodated in facilities on St. Ita's campus. The plan provides for the development of two bungalow complexes on sites located off St. Ita's campus in Oldtown and Lusk, Dublin, and a further two bungalow complexes on the campus. The day and other therapy services will be relocated on campus and up-graded. Some of the existing units on the campus are to be refurbished to provide appropriate accommodation for the remaining elderly clients.
I understand Deputy Shortall stated earlier today that the development project for St. Ita's was in the pipeline for some time and that there was an inevitability about it happening. It has been a priority for the Eastern Health Board for many years but this is the first Government not only to fully appreciate the need for this development but to provide the necessary funding to make this a reality. This development project will be the biggest such project ever undertaken in relation to mental handicap services. I am particularly proud that this Government is providing the necessary resources to make it happen.
I was the first Minister for Health and Children to visit St. Ita's in recent years — I visited the entire campus. Following my visit, I asked my officials to initiate discussions with the Eastern Health Board regarding the inclusion of this project in the public capital programme. The final plan was submitted earlier this summer and I responded with a comprehensive funding package within a matter of months, not because Deputy Ahearn put down a notice of motion.
A Deputy
On Good Friday.
Because of the by-election.
I am not sure it had anything to do with the by-election. This shows how cynical the Deputy is about mental handicap.
It has everything to do with it.
The Deputy should not be cynical. I did not interrupt.
When did the Minister's visit take place.
In November 1997. When was the writ moved? I will not accept that type of nonsense. Where was the former Minister for Health and everyone in the Deputy's party when the Labour Party was in office? They never took the trouble to visit the place.
The Minister should give us the money now.
Funds were available in 1995, 1996 and 1997 but nothing was done. After my visit and on receipt of the board's most urgent needs for the development of the mental handicap facilities, I allocated £550,000 for the upgrading of the admission-assessment unit and commissioned the development of an acute psychiatric unit in Beaumont. Earlier this year I provided £250,000 for the mental handicap services in St. Ita's for a special maintenance programme for the hospital. On the occasion of my visit to St. Ita's I did not get a PR machine to inform everyone I was there, I merely went out and did my duty.
This investment is further evidence of the Government's commitment to the development and enhancement of services to persons with a mental handicap generally and for those persons who, due to lack of suitable services in the past, were accommodated in inappropriate facilities such as psychiatric hospitals. It is also in line with the recommendation of the Commission on the Status of People with Disabilities regarding the general replacement of sub-standard facilities for people with disabilities and for those in St. Ita's hospital as a matter of priority.
I am also providing a capital grant of £200,000 to enable the Eastern Health Board to purchase a holiday home for the clients in St. Ita's hospital. Many of those resident in the mental handicap services have not been able to enjoy holiday breaks and this is a facility which the board and the parents and friends' association are anxious to provide.
In addition to announcing the St. Ita's project yesterday, I also announced details of the allocation of the additional £5 million capital funding which I made available some weeks ago. The £500,000 to be provided for St. Michael's House and for the Brothers of Charity in Limerick, announced in Kilrush, were the only specific projects announced out of the extra £5 million I have decided to allocate over and above the £30 million multi-annual programme, the first ever provided for mental handicap services. I do not need to take lectures from the other side of the House.
The Minister had already announced it in August.
I announced I was going to provide an extra £5 million for mental handicap services. Yesterday I announced the details, with the exception of two projects.
It was not a new announcement.
They are the facts. When the Deputy was in office, an extra £3 million was allocated for mental handicap for new development services. The Deputy was on this side and had nothing to say about it.
The Minister announced it twice.
I will stand over my record which compares favourably with measures taken by the previous Government. While it is not enough — more needs to be done — I am the first to recognise the need and I am in a position to do something about it rather than talk about it.
I hope the Minister will do something about it.
I had previously announced two of the agencies which were to benefit from this funding. This funding has been allocated to assist a wide range of services, including health board and voluntary services, across the country. These agencies include among others: Stewart's Hospital, Dublin; Children's Sunshine Home, Dublin; The Irish Society for Autism; Daughters of Charity, Limerick; St. Senan's Hospital, Enniscorthy; St. Raphael's, Youghal, and Grove House, Cork; North Western Health Board's services, including Cloonamahon, County Sligo; County Longford Association for the Mental Handicapped; various Camphill communities; the L'Arche Community, Cork; Western Care Association; Galway County Association; Cregg House, Sligo; Kerry Parents and Friends' Association and St. John of God's, Drumcar.
As I have already stated, I have provided additional funding amounting to £21 million this year for services to persons with a mental handicap. Revenue of £10.75 million was used to meet identified needs in existing services and to put in place new residential, respite and day care places. Capital funding of £5.25 million, which is the first phase of the four year national capital programme, was provided to support new developments, and a further £5 million capital, over and above the national capital programme, was provided to meet the maintenance and refurbishment costs, some of which I have already mentioned. This £21 million, together with the £4 million capital allocated by me late last year, brings the total additional funding provided to £25 million. In the three year period from 1995 to 1997, the previous Government allocated a total of £36.22 million in capital and revenue funding, or on average just over £12 million per year. This should be compared to the £25 million I have made available in the past 12 months or so.
In the past, because of the lack of multi-annual budgets, there was a much more haphazard approach to the planning of services. The introduction of multi-annual budgeting has meant that a more co-ordinated approach can now be taken, with the facility for forward planning in respect of both revenue and capital. The national capital programme is visible evidence of the fact that this approach is facilitating the planning process.
Additional residential, respite and day places have been put in place in 1998. By the end of 1998, approximately 250 new residential places, when account is taken of the emergency cases, and over 300 day places will have been provided. A number of health boards have also put in place additional health related support services for children with autism who are being placed in the special classes which my colleague, the Minister for Education and Science, is establishing around the country. I also welcome his recent announcement in respect of the additional supports which are to be provided for children with special educational needs, in particular those in the more severe categories of mental handicap and those with autism.
It is important that, in addition to putting in place new services and strengthening existing services, we evaluate the outcome of those services for the individuals and their families availing of them. We must endeavour to ensure that the services are targeted to meet the specific needs of individuals or groups of individuals.
At the request of my Department, the Mid-Western Health Board is currently undertaking a project to look at the early intervention services for children with physical or sensory disabilities and/or delayed development. The purpose of this project is to examine the processes of referral and access to support services, beginning with the earliest stage in maternity hospitals, and working through the roles of the various other multidisciplinary inputs which these children may need and the services which they provide. This would include paediatricians, directors of community care, counselling nurses, public health nurses, community based multidisciplinary staff and specialist diagnostic and treatment services in the acute hospital system.
Particular emphasis is being placed on the importance of the initiation and maintenance of the lines of communication necessary to enable parents to freely access the various services which their child requires, and on the provision of information regarding their entitlements, the support which may be available to them to enable them to access that support. I expect to have a report on the outcome of this project towards the end of this year or early in January 1999. It is my intention to circulate this information to the other health board regions with a request that they use it as a basis for examining the practices in their regions.
Given the level of development which has already taken place in the area of residential services and the planned enhancement of those services over the coming years, it is important that we develop mechanisms for evaluating the outcomes for individuals of the various types of residential care. As a first step, my Department has commissioned the Centre for the Study of Developmental Disabilities in UCD to undertake a research study on residential services for persons with a mental handicap. The study will look at issues related to the quality of life and outcomes for clients residing in both community and campus based accommodation. The study will assist both my Department and service providers to begin to develop evaluation tools which will enable us to monitor and evaluate the improvements in services on an ongoing basis. As well as being a first step in developing management evaluation tools, the research will also enable us to evaluate how successful we have been in implementing the policy of community based residential services.
The level of additional funding provided to date has given clear and concrete evidence of the Government's commitment to meeting the needs identified in the assessment of need. We have demonstrated how much more serious we are about addressing these issues than was the previous Government. This commitment, together with the multi-annual budgeting framework, will facilitate a very significant development of services for those with a mental handicap in a well planned and orderly way. This will represent a huge improvement on the ad hoc stop-go approach to such development in the past.
The £25 million additional funding and the national capital programme which is already being implemented have made a significant impact in the short period in which this Government has been in office. While at this point I am not in a position to give details about specific resources which may be made available to my Department in 1999, I have, to date, clearly demonstrated my commitment and that of the Government to meeting the identified needs as set out in the assessment of need of persons with a mental handicap. I assure the House it will remain a top priority.
I have not appeared before the House to suggest that all is clear and that everything is rosy in the garden, it is far from it. However, at least now we have the mechanism by which we can evaluate our performance and the ability to seek more funds. There was just as much money available to our immediate predecessors but they did not deliver. I intend to do far better than they did.
Flattery is all right as long as one does not inhale it.
It is not flattery, it is fact.
I wish to share my time with Deputies Timmins, Clune and Kenny.
Is that agreed? Agreed.
This very important motion seeks specific funds in this year's budget and specific services for those with mental handicap. I wish to put on the record the crisis that exists in mental handicap services in the south-east Dublin and east Wicklow regions.
There is now an unacceptably long waiting list — the waiting period can be as long as ten years. There are 97 people on the waiting list for residential places in that area, there are 180 people waiting for respite care, there are 25 crisis places required and 22 people waiting for day services. In addition to the waiting lists, there is insufficient co-ordination and co-operation between the Department of Health and Children and the Department of Education and Science in regard to the provision of education and other essential services, such as speech therapy, physiotherapy and psychological assessment. As a result, children are being deprived of either education or health related services.
How can we solve the problems in this region? The capital cost of covering the current waiting list for residential accommodation would amount to approximately £6 million and staff and running costs would amount to an estimated £2 million. The capital cost of covering the current waiting list for respite care, crisis care and new day services would amount to £1 million; staff and running costs would amount to £500,000. Therefore, the total amount of money required for a very large section of the population is £7 million in capital costs and £2.5 million in current costs. That region needs that money now. We also require resources for adults with learning difficulties, for special schools and classes and to integrate children into mainstream schools.
On 20 October my party colleague, Deputy Barnes, and I, who represent the Dún Laoghaire constituency which forms part of this region, together with our colleagues Deputies Hanafin, Gilmore and Eoin Ryan attended a meeting in Dunmore House on the crisis which exists in the mental handicap services in the south-east Dublin and east Wicklow regions. I can honestly say that in almost 25 years of public life I was never before so struck as I was by the parents at that meeting who felt so let down by the way they and their children have been treated over many years. I am not blaming the Government for the current crisis. We all share the blame, but the Government can do something about it. There is no point in the Minister harping on about what his predecessors did or did not do. There is a crisis not only in the south-east Dublin and east Wicklow region, but throughout the country and, as Members of the Dáil, it is our responsibility to ensure it is addressed. We should also note that mentally handicapped children cannot speak for themselves. They have to speak through a parent, a parent's friend or a relation and, ultimately, through their public representatives. That is why this motion is so important.
Many parents spoke at the meeting to which I referred and I took notes of their contributions. One parent told us he has a ten year old mentally handicapped son and other children. All that man is seeking is residential care five days a week for his mentally handicapped child so that he and his wife can have a break and devote time to their other children during the week. They are prepared to look after their mentally handicapped son at the weekend. Another lady told us she has a 30 year old son with Down's syndrome who is confined to a wheelchair. She is getting older and her main concern is what will happen to her son when she dies. She is not terribly concerned about the quality of her life, she is concerned about her son's future when she will not be here to look after him. Another lady told us she has a daughter with spina bifida and, among other items, her daughter is waiting for a pair of special boots. She has been waiting five months for them in this era of the Celtic tiger. Another 82 year old lady has a 38 year old son who has lived with her all his life and her main concern is what will happen to him when she passes on.
The story of another lady who attended that meeting and who has two sons is reported in this evening's newspaper. She poured out her heart at the meeting and explained the trauma she was going through with her mentally handicapped son who has severe behavioural problems. She openly admitted that at one point she had to put him outside the door because she had a knife in her hand. She said that at that moment the easiest thing for her to do was to get rid of him. I can understand her frustration day after day trying to share her time between her husband and her other child. All she wants is residential care for her son so that she can have a break, ensure her marriage will last and she can be a mother to her other son and to her mentally handicapped son. Another husband and wife, who have a 30 year old mentally handicapped son, told us they have not had a holiday or a break for many years. All they want is residential care for their son. If they could get residential care for him for five days a week, it would give them a break and some quality of life.
I came away from that meeting with an understanding of the sheer sense of frustration and fear felt by those parents, and, above all, the great love they have for their children. I honestly vowed that as long as I remain in public life this issue will remain at the top of my agenda. That is the issue we are discussing this evening. It is not a question of which Minister did what, it is a question of whether we, as a group of elected representatives, are prepared to stand up for people who cannot speak for themselves and who depend on us and their parents to make their case, give them a fair chance in life and guarantee their rights under the Constitution.
Those people have waited many years for things to happen. Now that more income than ever is going into the State's coffers, to quote the words of a newspaper headline carried in the run up to the last general election, it is payback time for these parents and their children. All Deputies, whether Independents or members of a political party, will have a chance to do something about this issue tomorrow night. At their parliamentary party meeting tomorrow, Government Deputies should forget about amendments to this motion and consider the specific sums mentioned in it. As a group of elected representatives, we should show these children we care and put £30 million aside this year to provide residential places and £30 million to provide services and back-up facilities. Now is the time for Independents to show their independence. They should not be bought off by promises. Now is the time for Fine Gael, Labour, Democratic Left, the Greens and Government Deputies to walk through the same lobby to ensure these people get what they deserve, having waited a long time for it.
I pay tribute to the many people who voluntarily or otherwise work with people with physical or mental handicap. In my constituency there are numerous individuals and organisations who make an enormous contribution without seeking monitory gain. Through a family connection I have regular contact with the Cheshire Home in Tullow where much good work is done by the staff. The new administrator started a building programme to house some of the patients independently. While some funding has been received much more is necessary to make up the shortfall from local fundraising. Local effort has also contributed greatly to the comfort of the residents in the Cheshire Home in Shillelagh. A visit to either of those locations would make one realise how lucky one is and when questioned on the availability of funding it is very difficult to justify some of the projects that have been grant aided when the homes merely wants to replace old wooden windows.
During the summer I had a visit from the parents of a young severely mentally and physically handicapped boy who they can no longer manage. I am currently assisting them to find a place in care for him, but should this not be achieved as a matter of course? The parents of such children should at least have the comfort of knowing that if things get difficult they can automatically obtain a place for their child where he or she could be well cared for.
We all remember the terrible accident involving a school bus and truck on the N11 during the summer when five people, among them two young children who attended the special needs school at St. Catherine's, Newcastle, were tragically killed. Without the fundraising undertaken by the school chairman, Mr. Harry Cullen, his staff and several volunteers, this school could not remain open. While I realise this is a matter more appropriate to the Department of Education and Science, I was embarrassed to hear that one of the handicapped children attending that school is strapped into his seat on a minibus at 7.20 a.m. until he reaches the school just after 9 a.m. How can we continue to let that situation prevail?
In the run-up to last year's budget I requested the Minister for Finance to target any additional available resources at the old, the sick and the disabled and to make the educational system more equitable. One year later I make the same request. Many sections of our society are seeking additional funds. However, health care, particularly for the old and the disabled, and education should be at the top of the list.
I welcome this motion tabled by the Opposition parties, but I regret the Government has failed to accept it. I look forward to the introduction of the measures proposed by the Minister. No political party has a monopoly on concern over this issue and anyone who purports to have is manipulating the most vulnerable section of our society.
I support the motion. The neglect of those members of our society who cannot speak for themselves is shameful. It is neglect at a time when we are recognised as one of the strongest economies in Europe. Those members of our society whose minds work in a different way are considered to have a mental ability inferior to others. Nobody with a learning disability should be considered inferior. People are different and are born with a different mental ability or, perhaps, with a mental ability that has been altered in some way through accident or illness. None of us are put on this world to judge, but we are here to help and support those weaker members of our society and not put them in a position where they must beg for handouts or charity, as has been the case historically here.
I hope the Government will support the motion and see its way to providing people with a learning disability and their families with the necessary support to ensure they can reach their maximum potential and live their lives to the full. Think of the value a personal assistant would bring to a young child with Down's syndrome, giving them the opportunity to attend his or her local national school. Such children deserve and have a right to be fully integrated into society. All members of his or her class in school would also benefit.
The toll that a person with mental disability makes on family members cannot be underestimated. It is a full-time job, 24 hours a day, seven days per week. There is no freedom to even go as far as the local shop without providing care. These families need respite care, the type of care that will give them the opportunity to recharge their batteries away from the constant demands and worry of their home environment.
Some 1,400 people are on a waiting list for residential places. Many of them are elderly parents struggling at home with their diminishing mental and physical strength, worried about their charge and who will care for him or her. Where will they go when they can no longer cope? Why will the State not help them? This is the torment and worry that many of these parents go through daily. The day their child was born with a disability was a sad day for them because they knew of the hard road ahead of them. These devoted parents do not deserve to be ignored. Instead the State should thank them for the support they have provided and the assistance they have given to their child.
Day resource centres play another vital role in the development and stimulation of the child or adult with learning disability. It is estimated there are 2,667 people who could use these facilities. Of that number, 1,248 rarely, if ever, get out of their homes for any reason. Such a simple thing as a few hours in a day care centre can calm the frustrations, provide vital stimulation and develop a routine, all increasing beyond measure the quality of life of a very important sector of our society.
Children with autism need and will also benefit enormously from special schooling and the opportunity to communicate with the assistance of a speech therapist. Spouses and family members of those who suffer from Alzheimer's disease need the support of society. They need help, respite care and the support of day care centres.
I agree with the Government's programme where it states that it recognises that disability is one of the most important social issues facing Ireland today. All the reports made since the middle 1990s spell out the gaps in the services. What is needed is a commitment by all Members to these members of our society and to give them the necessary financial support to enable these children and adults live their lives to their full potential.
This motion is not just concerned with money, it is also concerned with people. It could have a great effect on the personal lives of a large number of adults and children. I recently attended a funeral of a young woman in County Mayo. There was a large crowd at the removal. As she lay in her coffin at peace with herself, probably for the first time in her short life, it was hard to imagine that she had been a handicapped person. The expressions of sympathy were usual and genuine. Her mother told me that despite all the difficulties and that while her child had a short life and a confined happiness, she was also happy her child had gone before her because during her short life there was nothing but a litany of difficulties, barriers and constant effort to get all Governments to provide facilities.
I listened with interest to the Minister's speech, although members of the public could be confused with the litany of figures provided. I accept the Minister appreciates and understands how this issue impacts on the lives and on the minds of people. We are at a threshold because for the first time the Minister has the resources and is in a position to address the issue.
Does the Minister appreciate the unconfined joy in the central remedial clinic a couple of years ago when the first student ever passed her junior certificate examination? Last week I raised the issue of children travelling to special schools in County Mayo who were not and are not being provided with the facility of trained escorts on school buses. They are strapped into special harnesses, nobody is available to wipe their noses and those with special needs who may be agitated sometimes jump off the bus or at the driver. Despite this, an extension of the special pilot scheme was refused.
The Constitution states that all children of the nation should be cherished equally. We do not do this. The Minister has provided an extra £100,000 to western care. I ask him to issue a directive to ensure that the children are given the opportunity to travel to St. Anthony's and St. Bríd's. A mother called to my office and told me I had no conception of what it is to be a mother of one of the most beautiful children in the world and to appreciate the child's smile when it knows it will have the opportunity to swim in the local swimming pool in Castlebar, which is the highlight of its week. Yet, because it is agitated and because the driver has no trained escort on his bus the child is being left at home. That is not good enough in 1998.
Every Minister aspires to make his or her mark in politics. It is a long time since the late Donogh O'Malley introduced free secondary education. Other Ministers have made their own mark, but many good ideas have been lost in the confusion of politics. The Minister has the opportunity to strike a blow for the handicapped by dealing with this motion. The Independent Members, who are not present, have told their constituents, as we all do, that if they are given the opportunity to assist they will. They now have that opportunity.
When one speaks to psychiatric nurses, including those who, because of limitations, must confine their travels to the far reaches of the Barony of Erris or other remote parts of County Mayo to give injections to psychiatric patients once a fortnight in the hope they will be reasonably quiet, etc. , one begins to understand that this issue is not just about money. It is about people. Politics is essentially about people. A good, caring, determined Minister for Health and Children can set aside other matters and deal with something that every Member of the House can justify and willingly support. I received 47 telephone calls yesterday about this motion. The word is out. These people want something done. I ask the Government to accept this motion, and the Independent Deputies to listen to our words and do so as well.
Debate adjourned.