Alex White (Dublin South, Labour) | Oireachtas source

I am thankful for the opportunity to outline to the Deputy the position on the matters raised by her.

Specialist disability services are provided in a variety of community and residential settings to enable children and adults to achieve their full potential, including living as independently as possible. Traditionally, the provision of a residential placement would follow a detailed assessment to establish other means of addressing needs rather than admission to residential care. There would be considerable communication between the HSE, the family or guardian of a service user, the service provider and the service user.

The number of children and adults benefiting from residential services in 2013 was 8,880. The target for 2014 is 8,884. Respite care occurs in a variety of settings, depending on the family's needs and available resources. It can be provided as out-of-home care, in-home care, home-to-home care, home support or family support. Respite care helps to prevent out-of-home placements, preserves the family unit and supports family stability.

There has been continued expansion of the availability of residential support, particularly planned or emergency centre-based respite services. A total of 5,798 persons availed of a total of 243,260 bed nights from residential centre-based respite services in 2013. In 2014, 5,890 people are expected to benefit. In addition, between 2,000 and 2,500 persons availed of non-centre-based respite care services, including holiday placement, host family respite care, overnight respite care in the home and summer camps.

In 2010 a working group carried out an overview of models of respite and residential care with host families in community settings to determine the viability of these models of service delivery for future development. The HSE is aware of the challenge in maintaining existing service levels. By working together, we can identity innovative ways to maximise resources to protect front-line services appropriately.

In 2013 we commenced a major reform programme implementing the recommendations made in the value for money and policy review and the move to a person-centred support model. Key steps this year include an additional investment of €14 million and 130 additional staff. Some €7 million of the moneys allocated are to provide places for approximately 1,200 young people leaving school or rehabilitative training. Some €3 million is to provide emergency placements, while a €4 million investment and 80 additional therapy staff will facilitate the rolling out of a new model of assessment and intervention to provide one clear referral pathway for all children, irrespective of their disability, where they live or the school they attend. There is a reconfiguration of existing resources and efficiencies valued at €5 million are being achieved.

Disability service provision is moving towards a community-based and inclusive model, rather than being institutional and segregated. The conclusions and recommendations made in the report on adult day services entitled, New Directions, and the report, Time to Move on from Congregated Settings - A Strategy for Community Inclusion, alongside the value for money and policy review, are helping us to achieve a more effective, person-centred disability service in line with international best practice. The radical change involves collaborative responsibility shared between the affected persons, their families and carers, a multiplicity of agencies, the Government and society as a whole.

I have listened carefully to what the Deputy has said and agree entirely with the points she raised. As to whether there is a specific catch-all policy in place against providing a residential place, I would be very surprised if that were so. I will certainly raise the matter with my colleague, the Minister of State, Deputy Kathleen Lynch, just to be absolutely clear on the specific point the Deputy fairly raises. The Deputy has correctly pointed out that there are gaps, particularly in the community. I am very conscious of the position on primary care services also because the topic raised is related to it. The gaps in services in the community comprise a priority we have to address. The Deputy is correct to say it should be addressed in the context of the budget to be introduced later in the year.

See this speech in context