Thursday, 8 November 2012

Ceisteanna (3)

Finian McGrath


3. Deputy Finian McGrath asked the Minister for Health his plans to address and take action to alleviate serious issues in our disability services as a matter of urgency. [49092/12]

Amharc ar fhreagra

Freagraí ó Béal (8 píosaí cainte) (Ceist ar Health)

Expenditure on health services for people with a disability in 2012 will be in the region of €1.4 billion. The HSE National Service Plan 2012 provides for a 3.7% reduction in budgets but makes it clear that there is scope for achieving efficiencies of 2%, thereby limiting as much as possible the impact on front line services. Despite this reduction, which is similar to that applied across all care areas in the health sector, the HSE has undertaken to maximise the provision of services within available resources by providing for the following in 2012: some 9,100 people in residential places; 18,600 day service places; 6,300 people receiving respite residential support; and 1.64 million hours of personal assistant-home support hours.

I recently published the value for money and policy review of disability services which identifies fundamental issues that need to be addressed in the way in which HSE-funded disability services are managed and operated. It lays the groundwork for the introduction of a significant restructuring of the disability services programme through first, migration from an approach which is predominantly organised around group-based service delivery towards a model of person-centred, individually chosen, supports and second, the implementation of a more effective method of assessing need, allocating resources and monitoring resource use.

I must also stress that the nature of the core underlying deficit within the HSE, taken together with the requirements nationally to bring our public spending deficit down by 2015, will make the years 2013 and 2014 very challenging for all sectors, not just health. I will be doing everything possible to ensure that as much protection as possible is afforded to the disability sector and the social care area as a whole.

Is the Minister of State aware of the urgent need for, and the crisis going on in, disability services? I will refer to two such services. First, there are major concerns at Prosper Fingal in Swords that if more cuts are implemented they will have to reduce transport and respite facilities. Second, St. Michael's House has 1,663 service users and 454 residential service users. These are very concerned because since 2008 they have taken cuts in the region of €11.2 million. In the context of the forthcoming budget, is the Minister of State aware that St. Michael's House will have to consider intermittent closure of day, residential and respite services? In addition, there will be a reduction in transport, support and clinical services, as well as closures.

There is a huge problem there at the moment. Hundreds of families across the northside of Dublin have lobbied me about these services in recent days. They are very frightened about potential cuts. There are major issues facing elderly parents of adults with an intellectual disability who are in their mid-40s or 50s. These families are very worried. Such parents in their 80s and 90s are scared of what lies ahead.

While I do not wish to pick out one service in particular, St. Michael's House is one of the exceptionally good ones.

Those involved are innovative, imaginative and have done all the things we would like other services to do as well, such as reducing absenteeism and having a better skills mix. I am very conscious of the waiting list they have whereby older parents are awaiting residential spaces for their adult children. I do not want to dismiss or minimise any of the arguments that have been made concerning pressures on services. Deputy Kelleher made the same point earlier. I am not saying that arguments about anxiety over the prospect of what might happen in the budget are misjudged. Neither am I saying that there is no need to be concerned, because nothing is so protected that it cannot be cut. That sort of "worried well" argument may be just that but, nevertheless, we will do our very best.

I welcome the Minister of State's comments on St. Michael's House which has done an excellent job in getting absenteeism down from 6.5% to 3.5%. It has also had a reduction in administration costs of approximately 34%. St. Michael's therefore has delivered in terms of fairness and efficiency. However, the Minister of State will have to fight her corner in this budget because this is a very serious issue. If one is to protect the vulnerable, one must target those with an intellectual disability. All people with disabilities have to be top of the list. If it means bringing in extra taxation and tapping the rich people in this State to pay for such services, the Minister of State should do it. She will have my support. We must focus our priorities on those with an intellectual disability.

I call on the Minister of State for a final reply.

I agree with the Deputy. Unfortunately, however, every other group approaching us feels that it should be top of the priority list. That is the balancing act that one is constantly trying to achieve in order to ensure a degree of fairness. That is the difficulty. St. Michael's House has done all the things we would expect other service providers to do and, in fairness, a lot of them have done so. Last year, there was speculation - and the Deputy was one of those speculating in public - that we were going to have cuts of between 5% and 7% in disability services, yet we managed to bring it in at 3.7%. I will fight my corner and have always done so. I am charged with looking after people with disabilities. That is my specific responsibility and I will do my very best on their behalf.