Seanad debates
Wednesday, 14 June 2023
Nithe i dtosach suíonna - Commencement Matters
Disability Services
10:30 am
Victor Boyhan (Independent)
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The next matter is in the name of Senator O'Loughlin.
Fiona O'Loughlin (Fianna Fail)
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Apologies; I thought we were waiting for another Minister to come in.
Victor Boyhan (Independent)
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We have the top man on the job.
Fiona O'Loughlin (Fianna Fail)
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I certainly appreciate that the Minister of State is here to take on board what I am going to say. I have no doubt that he will go back to the Minister of State with responsibility for disability, Deputy Rabbitte, and the Minister for Health with these sad and pertinent points and the situations I am going to describe. Many of us deal with this issue for the people we represent. I know the Minister of State appreciates the importance of supporting families and communities to grow, develop and prosper, be that through adequate education, adequate therapeutic supports or adequate social infrastructure. The decisions, laws and policies we make in these Houses have the potential to be transformative for the lives of the people we represent. However, lack of action also risks stagnation and communities and families being very negatively impacted.
I am going to talk about two families that have been very negatively impacted by the lack of supports for their children and for them. Obviously I am not going to mention their names. One family are doing absolutely everything in their power to access the services they so desperately need but they are not getting anywhere. Their son is now 20. He is practically non-verbal and he has a number of developmental disorders. He has been registered and put on the waiting list for full-time residential care with one of our section 39 organisations. While he has been registered, the family home situation has deteriorated to a crisis point. I will honestly say that the family, with all the love in the world, are unable to meet his needs. A number of medical professionals have strongly supported the application for residential care as his current situation does not meet any of his needs, either physical or social. He requires an adequately supported living environment and so do his family.
I have been liaising with the HSE on this, I have liaised with Ministers and I am raising it here on the floor. Here is a 20-year-old man living at home with his parents and his younger siblings. He becomes agitated and upset at all times, day and night, which leads to extreme aggressive episodes. One of the parents has already had a nervous breakdown. No family should have to deal with this on their own. It has a hugely negative impact, particularly on the younger siblings. They do not have a life. They cannot go on holidays. It is always tense. Once a month there is respite for two days - it is two hours away - when the family can try to learn to be a family once more.
I have been in politics a long time and I have come across a lot of different situations.To have a dad sitting across from the desk and explaining what life is like on a day-to-day basis makes me concerned for the dad and the family. This is an absolute crisis.
A school principal contacted me about another family situation where a nine-year-old boy is in a school without adequate support. Sadly, the boy's dad took his own life a few months ago. The mum has mental health problems and was taken into psychiatric care so there was no one to care for the child. There is still no one to care for the child. The mum had to leave psychiatric care to care for the child. The principal rang me to see if there was anything I could do. I feel so helpless. There are so many issues like this that come across our desks. We have to put supports in place cases like this. The Tánaiste has said there is enough money. What is the issue? We can put more money into the housing. A lot of our section 39 organisations are registered as housing co-operatives. We should be able to support those. Some of them have places. How do I go back and support these families?
Seán Fleming (Laois-Offaly, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister of State at the Department of Health, Deputy Anne Rabbitte. I thank the Senator for raising this important issue for discussion in the House. I have listened very carefully to the cases she has raised. These ultimately are the type of issues that must be raised in the national Parliament but if everything was working as plan, we would not need to have these discussions here. Clearly, from the evidence produced by the Senator, it is very necessary that these matters be raised here to highlight these issues so they can get a greater level of attention.
She will be aware that there is significant demand for respite and residential placements across all community health organisation, CHO, areas in the HSE. Challenges facing the provision of centre-based respite and residential care, for example include the necessary obligations that regulation places on providers; the difficulty in recruiting personnel and retaining them in the services and difficulties in procuring appropriate accommodation. The issue of recruitment and staffing is central to the difficulties we are having here. Funding is available but the recruitment process can be very difficult. To retain staff in those positions can also be very difficult. This is having an effect on the provision of residential services and overnight respite services.
Nevertheless, in budget 2023, the Minister of State, Deputy Rabbitte, secured €177 million in additional funding, increasing the overall funding for disability services to an unprecedented €2.5 billion. This level of funding for disability services reinforces the programme for Government commitment to improving the lives of people with disabilities. Significant additional resources have been provided. In the past three years in particular, sustained new development funding has been secured. In 2023, €6.7 million in new development funding is being made available to further expand respite services.
Residential services make up the largest part of the specialist community-based disability services funding currently distributed by the HSE. As of March 2023, the HSE is funding a total of 8,330 existing residential placements, delivered predominately by the section 38 and section 39 organisations funded under the Health Act 2004. The Senator also referred specifically to section 39 organisations.
The HSE National Service Plan 2023 provides for the support of additional residential placements across a range of services, including 43 new placements, 23 residential packages for young people aging out of Tusla placements, 18 delayed transfers of care, with additional transitions of young people under 65 inappropriately placed in nursing homes, and further moves from congregated settings.
I support the points made by the Senator. I will speak with the Minister of State, Deputy Rabbitte, in the course of the afternoon to emphasise the points made by her. It is very important that I do this. I am aware from speaking with the Minister of State on an ongoing basis that she is acutely aware of the issue and is, impatient about where funding is available having it translated into staffing to increase the number of places over and above the 8,330 places that are currently being funded.
I come back to the fact that not only is it a tragic situation for the 20-year-old son and the nine-year-old boy, but there is also the impact on the family. It is not one person we are talking about. There are four or five people in each case. The distress this is causing is, in another extent, equally as severe from a mental health point of view, as for the person with the particular mental disability the Senator referred to.
Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State. I know that the Minister of State, Deputy Rabbitte, is very compassionate and is trying to do her best. I am also aware that a lot of extra money is going into the system but it is about outcomes, it is not about finance. The Minister of State, Deputy Fleming, said that there will be 43 new placements. These 43 placements will go nowhere. They would be absolutely taken up in CHO 7. When I went into the recent CSO data, I saw that 299,000 people identify as unpaid carers. This is an increase of 53% on 2016. I was saddened but I was not surprised. Here we are now with 43 new placements for this year.
The cases I have raised today are very serious but they are not unique. The situation is unsustainable. Parents talk about their fear for the wellbeing of their children and for themselves. There is a lot of pain out there. We must be better. As Family Carers Ireland has said: "Over the years, the number of family carers has increased while the availability and quality of respite care has steadily declined, leaving many in a precarious situation." A precarious situation is exactly where so many people are. They want and deserve better.
Seán Fleming (Laois-Offaly, Fianna Fail)
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The Minister of State, Deputy Rabbitte, and her Department are aware of the challenges being faced around the delivery of additional capacity in the areas of respite and residential care services. The review of the disability social care demand and capacity requirements to 2032 was published in 2021. An action plan for disability services has been prepared to progress action on the findings developed by an interdepartmental working group. There have been some delays in publishing this draft plan and the Minister of State intends to progress this and have it accelerated so that people will see a clear pathway.
To the families involved, I understand and appreciate the difficulties. The two days of respite care are brilliant insofar as they go but when the 20-year-old son goes in for respite, do not let anyone think for a minute that the parents can relax because they know he will be back in 48 hours. It might be a temporary physical relief but it does not resolve the mental stress that this is causing on loving parents in those situations who do not see any way of dealing with it in the long term, until we get the additional residential places.
Victor Boyhan (Independent)
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I thank the Minister of State for coming to the House today to deal with these Commencement matters as selected by the Cathaoirleach. It is appreciated. I am aware that he is very busy and we appreciate that he took the time to take all of these matters. I thank Senator O'Loughlin also for raising that very important matter.