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Dáil Éireann díospóireacht -
Wednesday, 25 Jun 2003

Vol. 569 No. 4

Autism Services.

I thank the Leas-Cheann Comhairle for giving me the opportunity to raise this matter on the Adjournment although I am disappointed that the Minister for Health and Children is not here to deal with this himself. This saga has been going on for a number of months and no progress has been made.

The parents of two autistic young adults are in the Visitors Gallery this evening because they are angry and frustrated that their requests for places for their children with the Irish Autism Society have been refused over a long period. The reasons put forward by the Eastern Regional Health Authority for refusal to transfer the young adults to the facility reputedly relate to a review of the Irish Society for Autism. In the first instance, I found it annoying to deal with the ERHA on this matter and to be either ignored or kept waiting for an extensive period of time for any substantial reply to a number of questions put by me. When a substantial reply did finally arrive, it referred to the review being completed and some recommendations being made to the society. The answer is so vague as to be useless. It includes terms such as, "some suggestions about advancing the implementation of those recommendations", and so on. There is no timeframe for the implementation plan. It offers no insight into the reasons for the review or of the gravity or otherwise of the need for the recommendations to be implemented. In the meantime, the parents are becoming more frustrated with the system and the two young people awaiting placement are in limbo and uncertain about what the future holds for them.

These parents are only concerned about getting the best quality service for their children. They want them to be secure and comfortable in their environment. They want to be assured that the service that is being provided is the most suitable for their children. I suggest that nobody knows better the psychological needs of the children than their parents.

Can the Minister give me some indication of the reasons for the delay in implementing the recommendations, in auditing them and in reaching an agreement between the autism society and, specifically, the South-Western Area Health Board? Does the delay relate only to the fact that there is a cost involved to the health board? Is this a cutback by another name? The intransigence of the health board on this issue is beyond belief.

Autism is described as one of the most distressing forms of mental disorder of which the most outstanding characteristics are extreme aloneness, difficulty in relating to other people and severely impaired or no speech. Sadly, it is not a passing ailment that will be cured with medication in a few weeks or months. The Irish Society for Autism met and agreed a way forward with the health board in April of this year, or so it thought. Any outstanding issues were not considered to be substantial by either side. Why is it then that two months later there is no progress? The autism society thought it had answered all the queries that arose in that review process.

I am asking the Minister of State to examine this case and to ensure that the two boys in question are given the opportunity to have a reasonable quality of life through being able to access the appropriate adult service. Their names are John and Mark. They are real people. They are not statistics, and it is not good enough to make scapegoats of John and Mark or their parents because of what seems like another cutback by stealth. This week we have been lauded in this country for our response to the athletes taking part in the Special Olympics, and rightly so. However, John and Mark are also special and they too would like to be given an opportunity to attain their potential.

I am replying on behalf of the Minister for Health and Children, Deputy Martin. Certain matters of a general character are set out rather extensively in the reply. I thank the Deputy for raising the case. I appreciate it relates to two individuals named Mark and John.

Since 1997 the Department of Health and Children has allocated significant levels of funding across the disability sector. This has resulted in very significant and unprecedented developments in the quality and quantity of health-related services.

Additional funding of €27 million has been allocated to services for persons with disabilities and those with autism in 2003 to meet the full year costs of 2002 developments and to further enhance the services in the sector. This funding is in addition to the very significant revenue investment, amounting to €288 million which has been made in these services in recent years and which is built into the ongoing budget base.

Approximately €100 million in additional ongoing revenue has been provided with regard to the maintenance and development of services for people with physical and sensory disabilities. Such services include, residential, respite, home support services, which includes personal assistance services, therapy services and day care services. A significant proportion of this funding, more than €20 million, has been provided specifically for home support services. A further €81 million has been provided in once-off grants for capital projects and issues such as the provision of technical aids and appliances.

Between 1997 and 2002, an extra €188 million in revenue and €139 million in capital funding has been provided, making a total additional investment of €327 million for the maintenance and development of services for persons with an intellectual disability and those with autism. Included in this funding is €27.2 million, which was allocated to meet identified needs in existing services.

The additional funding provided by this and the previous Government between 2000 and 2002 was used to put in place, in addition to a range of other services, more than 900 new residential, 380 new respite and around 2,000 new day places for people with an intellectual disability and those with autism.

In the current year, further additional funding of €13.3 million has been allocated to services for persons with an intellectual disability or autism to meet the full year cost of the 2002 developments and to further enhance the health related support services for children with an intellectual disability or autism. This funding brings the total extra investment in these services to €340 million over seven years. Of this total amount, over €200 million has been built into the ongoing budget base.

In particular €14.6 million has been invested in health-related support services for children with autism or an intellectual disability nationally between 1998 and 2002. A further €4 million has been allocated to these services in 2003. This includes diagnostic and assessment services, early intervention, home support and outreach support for children of schoolgoing age.

Despite this very significant investment, demographic factors are contributing to growing waiting lists for residential services in particular, even though the numbers of people in receipt of services, including full-time residential services, continues to increase. The increased birth rate in the 1960s and 1970s has resulted in large numbers of adults in their late 20s and early 30s requiring full-time residential services. In addition, people with an intellectual disability are living longer than previously adding to the need for services compared to previous generations. This has also been the international experience in service provision for this population.

The overall economic position in 2003 has had implications for all aspects of public investment, and this is reflected in the Estimates and budget adopted by the Government for 2003. Within this overall framework, however, some two thirds of the additional funding available for non-capital investment in services has been allocated to the health services.

This funding is being applied largely to maintain existing levels of services across all service programmes, including services for people with disabilities. While it is regrettable that the level of investment in these services achieved in recent years could not be maintained in 2003, my Department will work closely with the health board and other service providers regarding service provision this year.

With regard to the details supplied by Deputy Upton, responsibility for the provision of services is a matter for the relevant health board. From inquiries made by my Department, I understand that discussions are ongoing between the South-Western Area Health Board and the Irish Society for Autism regarding matters of mutual interest. The South-Western Area Health Board is currently awaiting a response from the Irish Society for Autism regarding the audit of the service and other related matters. When this process is complete the board is prepared to open the service for admissions pending funding. I trust that all matters will be resolved shortly to the satisfaction of all concerned.

The health board is failing miserably to respond to my queries over a period of months. We are not talking about a cut and paste answer but about two individuals.

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