Olivia Mitchell (Dublin South, Fine Gael) | Oireachtas source

I welcome the opportunity to raise the issue of disability services, residential and respite care services in particular. I thank the Minister of State, Deputy Alex White, for attending in person to respond.

All the talk is about medical cards but qualification for residential respite care has never depended on a medical card. It has never been the constraint. There have been constraints, but they have been funding constraints rather than constraints associated with an income threshold. I believe the Minister made this point recently. One reason I raise this issue is that a constituent of mine who was recently seeking residential care for her son was informed by the HSE that a policy decision had been made to no longer offer residential care to children with an intellectual disability. Is this an actual policy decision? Most accept that it is preferable to care for disabled children at home, but sometimes this is not feasible. Sometimes there are family breakdowns that preclude it. There are children whose intellectual disabilities are so complex and whose behaviour is so challenging that it is almost impossible for their parents to manage. Caring for them can be much more challenging in some cases than caring for a child with a physical disability. Financial constraints aside, I would like to be sure there has been no policy decision to preclude children whose behaviour or family circumstances are such that their parents cannot cope, irrespective of the budgetary position. That is one problem I would like the Minister of State to address.

Another aspect concerns the fact that there have been cutbacks during the years, obviously since the recession. Circumstances have become more acute. In recent years one has been able to say virtually no new residential places have been made available. This, in turn, has put pressure on respite care places. Emergency beds that were kept for respite care use are now being taken by those in need of long-term care, perhaps owing to a death in the family, marriage breakdown or a variety of other reasons. As all of the respite care places have been taken, there is virtually no respite care service available. It is almost non-existent and certainly does not meet the demand. This is coupled with the absence of other supports in the community. The Minister has spoken about the need for more support in the community, but the very concept of respite care is to help parents to cope. This can work only if parents see that their children are making some progress as a result of other interventions available to them to ensure they can meet their potential. I refer to physiotherapy, speech therapy to enhance communication skills and occupational therapy to help individuals function socially in the family and the community. Nothing I am saying is a mystery to the Minister of State because I am sure he is aware that there is a chronic shortage of therapists and services in this area. This is putting considerable pressure on families and, ultimately, driving up the demand for residential care.

For years we have been talking about providing care in the community. The HSE is talking about introducing new implementation networks to try to provide a more seamless service and easier access to services for parents. It is a nightmare trying to gain access to services or even to learn what services are available. Eighty new therapy places have been sanctioned, but I do not know how many therapists have been recruited. To be honest, there are thousands of children awaiting a needs assessment in addition to thousands who have been assessed but who are not receiving a service. It is clear that this must be a priority in the upcoming budget. It is early in the year to be raising this issue, but the problem is acute. Bearing in mind that funding is not available for respite care and residential services, we must try to prioritise in the upcoming budget the provision of services in the community for children with intellectual disabilities.

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