MARCH 5 2008

Dáil Debates

• Waiting Lists for Assessments
• A Vision for Change
• HSE Budget 2008

Parliamentary Questions

• Office for Disability and Mental Health
• Waiting Lists for Assessments
• Speech and Language Therapists
• Criminal Offences
• Autism and Research

PARLIAMENTARY QUESTIONS

• Office for Disability and Mental Health

Deputy David Stanton (FG): asked the Minister for Health and Children the budget that has been made available to the Office for Disability and Mental Health in 2008; the number of staff employed in the office;

Minister of State at the Department of Health and Children (Deputy Jimmy Devins): The Office for Disability and Mental Health was established by the Taoiseach at the end of January 2008. The Office supports me as the Minister for Disability and Mental Health in exercising my responsibilities in four Government Departments, namely the Departments of Health & Children; Justice, Equality & Law Reform; Education & Science and Enterprise, Trade & Employment. The new Office brings together responsibility for a range of different policy areas and State services which directly impact on the lives of people with a disability and people with mental health issues. The Office will bring about improvements in the manner in which services respond to the needs of people with disabilities and mental health issues, by continuing the work to develop person-centred services, focusing on the holistic needs of people with a disability and actively involving them in their own care. The budget for the Office is encompassed in the Vote of the Department of Health and Children. A Director has been appointed to the Office from within the Department’s staff complement and 34 wholetime equivalent staff, drawn mainly from the Disability and Mental Health Units of the Department, now form the core of the new Office. Senior managers from each of the three other Departments concerned also have a reporting relationship with the Director of the Office.

• Waiting lists for Assessments

Deputy Damien English (FG): asked the Minister for Health and Children the measures she will take to address the queue for assessment and diagnosis of children suspected of having autism which stands at up to two years, noting that this loss of time for early intervention in such cases where a positive diagnosis for autism is critical as the first three years of a child’s life presents the best chance of a positive outcome of such children;

Minister of State at the Department of Health and Children (Deputy Jimmy Devins): I refer the Deputy to the response which I gave this afternoon to Priority Parliamentary Question No. 1. In addition, waiting lists for health services are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have these matters investigated and to have a reply issued directly to the Deputy.

• Speech and Language Therapists

Deputy Willie Penrose asked the Minister for Health and Children if she has had discussions with the Department of Education and Science to address problems in the allocation of staff including speech and language therapists, occupational therapists and psychologists for children with special needs in primary schools which, in one case, has caused the board of management to postpone the opening of a school;

Minister of State at the Department of Health and Children (Deputy Jimmy Devins): The staffing of primary schools is a matter for the Minister for Education and Science and the provision of health-related services to pupils in such schools is a matter, in the first instance, for the Health Service Executive. Since the establishment of the Health Service Executive, the number of speech and language therapists has increased by 215 to 712 — an increase of 43%, the number of occupational therapists has increased by 320 to 1,025 — an increase of 45% and the number of psychologists has increased by 184 to 692.5 — an increase of 36%. As the Deputy is aware, intervention early in life can have a significant impact on the disabling effects of a condition or impairment. In recognition of this, Part 2 of the Disability Act 2005 was commenced for children aged under 5 years with effect from 1 June, 2007. This provides parents of young children with disabilities with an entitlement to an independent assessment of their child’s health and education needs and a statement of the services which it is proposed to provide for them. To date over 1,300 applications for assessment of need have been received and are being processed by the HSE. Representatives of the Department of Health and Children, Department of Education and Science, the Health Service Executive and the National Council for Special Education meet on a monthly basis to address a range of issues including matters arising in relation to the ongoing implementation of the Disability Act 2005. This work includes planning for the roll out of Part 2 of the Disability Act 2005 and the Education for Persons with Special Needs Act 2004 to children between 5 and 18 years and to adults. Issues in relation to the timely and appropriate provision of health and education supports to children with a range of disabilities including autism are being considered in the context of these discussions. Health related support services for children aged 5 to 18 and for adults will continue to be enhanced to enable the Health Service Executive to meet needs identified for this group. The recently-established Office for Disability and Mental Health will focus in particular on facilitating the delivery of integrated health and education support services for children with special needs, by further developing these existing mechanisms for co-operation and co-ordination between the health and education sectors.

• Criminal Offences

Deputy Pat Rabbitte asked the Minister for Health and Children the number of people with learning disabilities who have committed criminal offences and are being accommodated outside Ireland for specialised forensic services; the estimated cost of same;

Minister of State at the Department of Health and Children (Deputy Jimmy Devins): As part of the Multi-Annual Investment Programme 2006-2009 under the Disability Strategy, the Government provided the Health Service Executive with an additional €75m in both 2006 and 2007. This funding included monies to provide new and enhanced services for people with disabilities, to implement Part 2 of the Disability Act 2005, which came into effect on June 1st 2007 for the under 5s and also for the continuation of the implementation of the transfer of persons with intellectual disability from psychiatric hospitals and other inappropriate placements. The Government is also honouring its promise in relation to the Multi-Annual Investment Programme for people with disabilities, with a further €50m investment which was announced in the 2008 Budget. The Deputy’s specific question relates to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have these matters investigated and to have a reply issued directly to the Deputy.

• Autism and Research

Deputy Bernard J. Durkan asked the Minister for Health and Children the number of children born with autism or Asperger’s spectrum in each of the past 10 years to date in 2008 in each of the EU countries; the extent of research undertaken in each country arising therefrom; the full extent of research undertaken to determine the cause or contributory causes of the high incident of autism here; her proposals in this regard in the future;

Minister of State at the Department of Health and Children (Deputy Jimmy Devins): The Department of Health and Children does not collect data on the number of children born with autism or Asperger’s syndrome in this country. It does not know whether such information is available from each EU member state, or the extent of the research undertaken in each country. There has been an increase in recent years in the number of children being diagnosed with autism in Ireland. Similar increases have been experienced in other European countries and the USA. It is not clear whether the increase is due to greater awareness or whether there is a true increase in the prevalence of autism. It is recognised that the epidemiology of Autistic Spectrum Disorder is undergoing rapid change due in whole or part to better ascertainment and re-clarification. The diagnosis is a clinical one — it is based on a variety of observations rather than a defined laboratory investigation. Hence the evolving concept of an “autistic spectrum” which stretches from those severely affected to those with only a mild disability. In December 2004, the Department of Health and Children, through the Health Research Board, approved expenditure of \5 million on autism research to help improve international understanding of the genetic causes of autism. This \5 million is the Irish contribution to a major international research initiative called the Autism Genome Project which will receive a total investment of \12 million from a variety of international organisations over the next three years. The other co-funders in the international consortium include Autism Speaks (US), the British Medical Research Council (MRC), Genome Canada and Partners, Canadian Institutes for Health Research (CIHR), Southwest Autism Research and Resource Center (SARRC), and the Hilibrand Foundation. This unique combination of international, public and private partners funding a consortium of clinicians and scientists is a new and welcome departure in the field of autism research. The Health Research Board has informed my Department that this funding was awarded as follows: \2.8 million to Professor Michael Gill, Department of Psychiatry, Trinity College, Dublin; and \2.2 million to Professor Andrew Green, Director National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children, Crumlin, which is affiliated to UCD. This figure represents the largest tranche of funding to be awarded by any of the four funders within the international consortium. The Irish researchers are at the forefront in unravelling the genetic determinants of autism and related disorders. They are using novel state-of-the-art genetic sequencing technology to analyse DNA samples taken from autistic patients to identify candidate genetic markers for autism. They will collaborate with their international colleagues to then link these genetic markers with clinical outcomes. This unique international research effort will greatly improve not only our understanding of the causes of autism, but its diagnosis and treatment.

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