Tuesday, 2 February 2016

Ceisteanna (60)

Colm Keaveney


60. Deputy Colm Keaveney asked the Minister for Health the funding the Health Service Executive will provide in 2016 for moving persons out of congregated settings; the number of persons this will benefit; the proportion of persons currently in congregated settings that will benefit; how long it will take to move all those in congregated settings out of them at this rate of support; and if he will make a statement on the matter. [4094/16]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte) (Ceist ar Health)

The purpose of the question is to afford the Minister an opportunity to explain the rationale for the funding provided to the HSE to move vulnerable people from congregated settings. The question also affords the Minister an opportunity to explain the benefits of that strategy, the number of persons in congregated settings who would be positively affected, how long it will take for those in congregated settings to see the type of supports in the community required for the scaling down of congregated settings and the plans to resource that kind of care and love in the community to ensure the human rights of citizens in the community are provided for.

The HSE’s 2011 report, Time to Move on from Congregated Settings – A Strategy for Community Inclusion, proposes a new model of support in the community by moving people from institutional settings to the community over a seven year timeframe. The plan will be rolled out at a regional and a local level and will involve full consultation.

The HSE has established a subgroup under Transforming Lives, the programme to implement the recommendations of the value for money and policy review of disability services, which is developing an implementation plan for moving people from institutions. I welcome the fact that the needs of people moving from congregated settings will be fully taken into account during this process as the model of care for individuals will be based on a person centred plan.

In terms of housing, the Department of Health and the Department of the Environment, Community and Local Government are working in collaboration to support the transition of people with a disability from institutions to social housing in the community under the Government's National Housing Strategy for People with Disability 2011-2016.

The HSE's 2016 national service plan has set a target of 165 people to move from institutions in 2016 into suitable accommodation. This is being supported by €20 million in capital funding from the Department of Health in respect of acquiring and renovating properties in priority institutions identified by the HSE. In addition, I am pleased to note that the Department of the Environment, Community and Local Government will provide €10 million under the capital assistance scheme to provide suitable accommodation for people transitioning from institutions in 2016. The HSE estimates that a further 100 people could benefit from this initiative. Additionally, €1 million in ring-fenced leasing funding is also being made available by the Department of the Environment, Community and Local Government in 2016 to support people moving from institutions into suitable social housing in the community. This demonstrates the joined-up commitment of both Departments to support decongregation.

I am sure the Minister of State will agree that progress on moving people from congregated settings has been abysmally poor, and there are over 3,000 people living in congregated settings. The 2015 HSE outturn with respect to the congregated settings indicate that only 150 citizens were moved from the setting. At the time of the publication of the HSE annual service plan, the projected outturn was only 112.

The 2016 service plan promises to enable the transition to the community of at least an additional 160 service users. Will the Minister of State confirm in her response the financial resources being provided by the HSE to maximise on the decanting of the setting? What is her vision with respect to the care supports that will be required in the community to ensure that citizens who have traditionally lived in the setting would have an active citizenship in society?

I will try to give the Deputy as much information as possible. We have managed to secure €20 million from the Department of Health and €10 million from the Department of the Environment, Community and Local Government. As I have already stated, there is an additional €1 million for transitioning. That €10 million will be for each of the next four years. That is an agreement we came to with the Department of the Environment, Community and Local Government, and we are insisting that when it comes to housing strategy, one cannot possibly allow people with disabilities to be outside that loop.

There has been a difficulty in certain areas and the Deputy knows about the shortage of housing and blockage in the capital assistance funding. It was always going to affect us because of the downturn in the economy. The Deputy knows there was also a difficulty relating to people who were presumed to lack capacity in signing leases. The capacity legislation deals with that now, which is very important. There were delays in securing HIQA registration and we are talking about small community homes, as opposed to what we were used to with big institutions. There has also been insufficient funding from service providers to allow the transition to occur. I will try to answer the other points in my next contribution.

Some parents have expressed concern with respect to residents moving from the congregated environment to an unfamiliar new experience when compared with their traditional home or setting. Is the Minister of State satisfied the Department has the resources to provide for that adjustment in the community? Unsupported relocation causes great distress. Is the Minister of State satisfied the recruitment strategy is in place to have the resources available in the community, such as those provided in A Vision for Change, with synchronised closure of long-term institutions? There would be a care facility, the virtual ward in the community. Is the Minister of State satisfied she has the resources to provide for that?

When one comes into government at first there is always an insatiable urge to do things as quickly as possible. When it comes to people with significantly greater needs in terms of disability, however, one must be absolutely certain that one is doing it, first, with their consent. Second, we must ensure that the type of wrap-around service or supports they will need - be it moving back to their own communities and families, or to another area - are there. That is why we have to be extraordinarily careful. As regards the available funding, which is within the existing service provision, and additional capital funding, I am convinced that we do have the necessary resources. It will be a different type of resource, but sometimes that is about attitudes and culture. We have had some experience of that with A Vision for Change, but I think it will translate over into this area also.