Thursday, 8 November 2012

Ceisteanna (1)

Billy Kelleher


1. Deputy Billy Kelleher asked the Minister for Health the action he is taking to ensure that school leavers with disabilities who are due to finish school in 2013 will have appropriate placements and services available to them on finishing school; and if he will make a statement on the matter. [49290/12]

Amharc ar fhreagra

Freagraí ó Béal (5 píosaí cainte) (Ceist ar Health)

The HSE, through its occupational guidance service, works with schools, service providers, service users and families to identify the needs of young people with disabilities who are due to complete their second level education. The aim is to address the needs of individuals through health-funded rehabilitative - life skills - training; health-funded day services; FÁS-funded vocational training; and approval to extend education placements for a specified time.

The demand for services for school-leavers continues to grow. A total of 695 school-leavers were identified as requiring supports or services in 2012 and a similar number is expected in 2013. Budgetary constraints and the moratorium on staff recruitment mean that service provision continues to be a challenge in the current environment. While the HSE makes every effort to provide day services or rehabilitative training places to school-leavers with special needs, this has always been dependent on the availability and location of appropriate places coupled with the needs of the individual school-leaver.

There is evidence that an accelerated move towards a new model of individualised, person-centred service provision in the community can help to achieve efficiencies. The HSE has established an implementation project team to oversee the implementation of the recommendations in the report of the national working group for the review of HSE-funded adult day services. The report, published in February 2012 and entitled New Directions, proposes that day services take the form of a menu of 12 individualised, outcome-focused supports that will provide adults with disabilities with the support necessary to live a life of their choosing in accordance with their wishes, aspirations and needs. The guiding principle is that supports will be tailored to individual need and will be flexible, responsive and person centred.

The difficulty is that there is great concern. The Minister of State met many organisations, groups and advocates who are advocating continually to have proper services available to people with disabilities. Approximately 700 people emerged from second level education this year and were afforded places. The difficulty is that the service providers are telling me time and again that they are under significant pressure trying to deliver services for 2013 and that if there are further cutbacks or a diminution of services, they will simply not be able to provide the services we expect and demand. More important, New Directions, to which the Minister referred, challenges people with disabilities to have high expectations for themselves and their communities. This is a central theme in the report. If we expect and demand that people with disabilities challenge themselves, we surely expect the Government and State to provide the resources necessary for people to fulfil their potential. The latter does not seem to be the case and there is considerable concern. People's minds must be put at ease at this stage. The service providers, clients and families are at their wits' end owing to the fear that there will be no places available next year.

I fully recognise that there has always been and will continue to be fear in the community in respect of those who require the types of interventions required by people with special needs. There is a spectrum to be considered. There are those who will require very little intervention and clearly those who have very challenging needs.

For the first time this year, school-leavers were dealt with by way of the services. I reiterate the gratitude not just of the Government but also of parents and those who support those with intellectual disabilities over the addressing of this issue without additional funding being made available. It was always the case that demographic funding was made available but, unfortunately, we now find ourselves in different circumstances.

Groups such as Genio have sought service providers in the marketplace to offer a different type of day service for people with intellectual disabilities. It had been successful in that 184 places were made available. That is the direction we are going to go. I fully understand that service providers are very worried about the challenges faced. On the one hand, they are being hit with cuts from the Government and, on the other, they are being hit in respect of increments that are legal under the Croke Park agreement. While I understand that, I contend that even if we were not experiencing the current financial crisis, we would still be examining the provision of services in a different way and giving people the right to have a choice in how they live their lives. People will have to accept that.

I accept what the Minister of State said about New Directions proposing a menu of 12 individualised, outcome-focused supports that will provide adults with disabilities with the support necessary to live a life of their choosing.

This is the critical issue - that the supports provided will be of the recipients' choosing and will be individualised and outcome-focused. The difficulty for individuals and service providers is that, in their experience, adequate resources are not being made available to tailor customised programmes based on the menu of 12 supports.

Will the Minister of State give a commitment that the necessary funding will be put in place and where there are difficulties arising from the moratorium on staff recruitment, that those issues will be addressed in some way? We are looking potentially at an additional 700 people requiring support next year. The current level of provision to service providers is insufficient to deliver the menu of individual courses and training places. People are concerned that by this time next year, they will still be without placements.

We are spending €1.4 billion per year on disability services. Given that level of expenditure, there are areas where changes simply have to be made. I am very conscious that service providers are worried. However, even though we could not do the job without them, my main concern is not for the providers. Rather, my concern is for the people who require support and to whom, in the majority of cases, those providers deliver an excellent service. I acknowledge that families are very concerned about the future of those members with whose care they are charged. We are obliged to do things differently, but I am confident that this will, in fact, ensure a better outcome for the individuals who avail of these services.