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Dáil Debates & Questions
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July 08 2008 Parliamentary Questions
PARLIAMENTARY QUESTIONS Deputy Michael D. Higgins (L): asked the Minister for Justice, Equality and Law Reform if the Government proposes to ratify the United Nations Convention on Disability. Minister for Justice, Equality and Law Reform (Deputy Dermot Ahern): Ireland was in the first group of countries to sign, subject to ratification, the UN Convention on the Rights of Persons with Disabilities when it opened for signature on 30 March 2007. A high-level, cross-departmental implementation group was established in 2007 to advise on any changes to the Government’s National Disability Strategy that may be required to enable the State ratify the Convention. This group has developed a work programme setting out the matters that need to be aligned with the UN Convention in order that ratification may take place and the work programme is being actively addressed by Government Departments. It is the Government’s intention that the Convention will be ratified by Ireland as quickly as possible, taking into account the need to ensure that all necessary requirements under the Convention are being met. In so far as my own Department is concerned, there is a need to reform the law on legal capacity of vulnerable adults. The Government’s Legislative Programme contains a commitment to bring forward a Mental Capacity Bill. That Bill is an important element of the programme of work on the Convention. The Scheme of the Bill is at an advanced stage of development in my Department. Deputy David Stanton (FG): asked the Minister for Justice, Equality and Law Reform the responsibilities he has for disability issues and the National Disability Strategy; Minister for Justice, Equality and Law Reform (Deputy Dermot Ahern): The National Disability Strategy was launched by Government in September, 2004 and underpins the participation of people with disabilities in Irish society by building on existing policy and legislation. The implementation of the Strategy is the agreed focus of disability policy under the Partnership Agreement, Towards 2016. My Department is responsible for the provision of the framework for the implementation of the Strategy including cross-Departmental co-ordination and reports to the Cabinet Committee on Social Inclusion on progress of the Strategy. Under the terms of Towards 2016, the National Disability Strategy Stakeholder Monitoring Group was established in November, 2006 to monitor progress on the overall implementation of the Strategy. The Group comprises representatives of stakeholder groups, trade unions, senior officials and the National Disability Authority (NDA) while my Department also serves as Secretariat to the Group. Key elements of the National Disability Strategy include the Disability Act 2005 and Sectoral Plans for service provision for people with disabilities. The Disability Act is the cornerstone of the National Disability Strategy and my Department played a lead role in its development and enactment. The accessibility provisions of the Disability Act are supported by the Code of Practice on Accessibility of Public Services and Information provided by public bodies which was published in July 2006. The Code of Practice was developed by the NDA in consultation with my Department. The Act also gives statutory effect to the 3% employment target for people with disabilities in the public sector. My Department has a key role in relation to the implementation of these provisions while progress achieved by public bodies in this regard is being monitored by the NDA. Again, under the Act, a Centre for Excellence in Universal Design has been established within the NDA with the support of my Department. The Centre has an important role in contributing to the development and promotion of standards in universal design. The NDA is concerned with the implementation of important aspects of the Strategy and works closely with my Department to meet relevant objectives. My Department had a central role in relation to the negotiation of the UN Convention on the Rights of Persons with Disabilities which was adopted by a UN General Assembly in December 2006. Ireland was in the first group of countries to sign the Convention. My Department continues to have a central role in relation to the Convention’s ratification process. My Department also had a central role in the development of the Council of Europe Disability Action Plan, 2006 — 2015. My Department also funds certain accessible transport initiatives for people with disabilities, provided €6 million for an independent living support programme and provides financial support to People with Disabilities in Ireland (PwDI). My Department also continues to fund the Enhancing Disabilities Services Programme which was launched in 2005. The Programme comprises a funding package of €15 million over the five-year period 2005 — 2009 to support once-off projects which can demonstrate an innovative, efficient, collaborative and cost effective approach to service provision for people with disabilities. The budgetary allocation for this project is €3 million per year. In 2007, my Department undertook a number of awareness raising initiatives, including funding two TV programmes and a National Information Day. The cost for these projects was €341,000 in 2007. My Department is continuing these projects in 2008 and the budgetary allocation for the year is in the region of €423,000. Deputy Seán Barrett (FG): asked the Minister for Health and Children the way she proposes to accommodate those 18 year old mentally and intellectually challenged young people who are leaving a school (details supplied) in County Dublin, and who have been informed that there is no place available for them in a designated school due to lack of funding; Minister of State at the Department of Health and Children (Deputy John Moloney): The Multi Annual Investment Programme for Disability Services makes provision for the development of additional residential, respite places and day care places each year between 2006 and 2009 for people with Intellectual Disability and Autism and additional residential care and home support services for people with physical and sensory disabilities. €50m was provided to the Health Service Executive (HSE) in 2008 to fund a range of additional services under the Multi Annual Investment Programme for Disability. As the Deputy will be aware, the commencement of the planned developments in disability services this year had been delayed due to a financial review in the HSE. However, I am pleased to be able to inform the Deputy that the HSE has assured me that it is now in a position to roll out the planned developments as outlined in its 2008 Service Plan. Planned services include additional residential, day care — including training places — and respite care places for people with intellectual disability and autism; additional residential care and home support services for people with physical and sensory disabilities; and additional multi-disciplinary therapy posts to provide assessment and ongoing intervention services to children with a disability. I understand that the HSE hopes to be able to finalise the position in relation to the commencement of such developments over the next week. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the specific matter raised by the Deputy investigated and to have a reply issued directly to the Deputy.
Deputy James Reilly (FG): asked the Minister for Health and Children the progress made on the programme for Government commitment to ensure that any child under five years of age waiting more than three months for occupational speech and language therapy can access these services automatically through the National Treatment Purchase Fund; Minister of State at the Department of Health and Children (Deputy John Moloney): The Department of Health and Children is currently considering a range of measures aimed at improving access to therapy services for children with disabilities. The main concern is to ensure that quality services can be provided to those most in need in the most effective manner possible. The commitment in the Programme for Government is being considered in that context. Deputy James Reilly (FG): asked the Minister for Health and Children the progress made in relation to the Programme for Government commitment to invest in and fully implement the Vision for Change Strategy and provide further additional funding to support the recovery model of mental health service provision; Deputy Dan Neville (FG): asked the Minister for Health and Children if further to her statement of 8 May 2008, in which she expressed her concern that the resources allocated to the Health Service Executive to implement the recommendations contained in A Vision For Change were not spent for the purposes voted by Dáil Éireann; if she will inform the Houses of the Oireachtas of the outcome of her discussions with the Health Service Executive regarding same and explain the reason the HSE did not consult with her of its decision to re-direct the funding from the purpose for which it was allocated. Minister of State at the Department of Health and Children (Deputy John Moloney): I propose to take Questions Nos. 266 and 418 together. The estimated additional cost of the implementation of ‘A Vision for Change’ the Report of the Expert Group on Mental Health Policy is €150m over 7 to 10 years. A total of €51.2 million has been allocated since 2006 which represents over a third of the overall requirement. In addition to the extra funding required to finance ‘A Vision for Change’, existing resources need to be remodelled and reallocated. It is clear that the implementation of the report is dependent to a much greater extent on the remodelling of existing resources, than on new additional funding. It is also clear that additional investment must be phased in parallel with the reorganisation of mental health services and resources. In view of the significant additional investment in 2006 and 2007, it is necessary to pause and review the situation in 2008, to ensure consolidation of the investment to date. Substantial resources have been invested in mental health services. Estimated expenditure in 2006 and 2007 was €984 million and €1 billion respectively. It is also important to bear in mind that some 90% of mental health services are provided at primary care level. Expenditure on these services is not captured in the above figures. The Department of Health and Children has been advised by the HSE that €24 million of the €51.2 million development funding was not used as planned, because of competing expenditure pressures and the overriding obligation on the HSE to live within its overall Vote. As a result, some of the planned developments in mental health services have been delayed; however, some of the mental health services funded in 2006 and 2007 will be put in place in 2008. These include the provision of 8 additional child and adolescent mental health team, and the provision of 18 additional beds for children and adolescents at St. Anne’s, Galway, St. Vincent’s, Fairview and St. Stephen’s Hospital, Cork, to increase the bed complement from the current provision of 12 to 30 during 2008. Implementation of ‘A Vision for Change’ is a key priority for the recently established Office for Disability and Mental Health. The Office is working in partnership with the HSE and other stakeholders to achieve implementation of agreed targets. Deputy James Reilly (FG): asked the Minister for Health and Children the progress made in relation to the Programme for Government commitment to provide community alternatives to psychiatric in-patient care for young people with special education needs; Minister of State at the Department of Health and Children (Deputy John Moloney): A Vision for Change — the Report of the Expert Group on Mental Health Policy proposes a holistic view of mental illness and recommends an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. It recognises that responding to children’s mental health needs can be conceptualized at different levels, ranging from early intervention and health promotion programmes, to primary and community care services and specialist mental heath services for the treatment of complex disorders. Recommendations in the Report are consistent with commitments in the Programme for Government. Implementation of A Vision for Change is the responsibility of the Health Service Executive (HSE). In this regard the HSE has prioritised the development of child and adolescent services in 2008 and has recently advertised 12 Consultant Child and Adolescent Psychiatrists posts; teams to support the consultants are also being advanced. In addition the HSE propose to increase the in-patient child and adolescent bed capacity from the current number of 12, to 30 by the end of the year.??Construction will also begin on two purpose-built 20 bed children’s in-patient units in Galway and Cork. It is noted that considerable work in planning the reconfiguration of mental health services for people with an intellectual disability was undertaken in 2007 following the Report of the Forum on Mental Health and Intellectual Disability. In 2008, each area will be required to agree the reconfiguration necessary to meet the recommendations in relation to the provision of services for people with Intellectual Disability.??As the majority of services for people with intellectual disability is provided by voluntary partners, these arrangements will be agreed and developed jointly with the voluntary partners. Deputy Tom Hayes (FG): asked the Minister for Health and Children when the review of the Health Service Executive will take place, including structural reform; if there will be a possibility of redundancies highlighted in this review; Minister for Health and Children (Deputy Mary Harney): The HSE is making progress in the integration of a large number of health sector agencies, in setting and implementing consistent performance standards, and in improving patient care across many different service areas. The HSE endeavours to make constant and continuous improvement. To this end, I meet with the Chairman and CEO of the Executive regularly. In this context, I wrote to the Chairman of the HSE last March, on foot of the report into the handling of events at Portlaoise. I asked him to consider whether the governance and management issues which had been identified in relation to the events at Portlaoise had wider application across the HSE. I acknowledged that the Board had already been considering these issues and I asked for this work to be expedited. The Chairman wrote to me about these wider governance and management issues on 27 May and outlined for me the key elements of a proposed new management structure. In summary, this will involve:
The Chairman explained that these changes are designed to:
The implementation of these new management structures will necessitate a clarification of associated staffing implications below National Director. In line with the Government’s decision today, this will include developing a voluntary redundancy scheme to streamline the number of management layers and positions. This scheme will be subject to consultation, will require the prior approval of the Minister for Finance and will operate on a voluntary basis. It is to meet the test of delivering value for money. The purpose of the new structure is to make operational decision-making clearer and more efficient. It will allow those charged with service delivery to take a far more active role in delivering services within budget and staffing limits. National strategies will remain at national level. I am committed to the review of the Health Service Executive as set out in the Programme for Government and to ensuring that staff will have an opportunity to propose ways in which the HSE can work more effectively. To this end, I expect the Executive will:
Deputy James Reilly (FG): asked the Minister for Health and Children the progress made in relation to the Programme for Government commitment to continue to provide more frontline staff in health as needed on a case by case basis; Minister for Health and Children (Deputy Mary Harney): I wish to advise the Deputy that employment in the public health service between 1997 and March 2008, in the Medical/Dental, Nursing, and Health & Social Care Professionals categories, has increased as follows:
(1) All figures in wholetime equivalentsAn overall employment ceiling of 111,650 whole time equivalents has been set for the public health service for 2008. This level of employment provides for 1,050 additional new posts arising from development funding provided by the Government in the Budget Day package for 2008. A breakdown of these development posts is provided in the table.
The filling of the above development posts is to be managed by the HSE within the employment control framework for the health services and its own circular issued in January 2008. Deputy James Reilly (FG): asked the Minister for Health and Children the progress made in relation to the Programme for Government commitment to increase the supply of professionals needed to develop new services for persons with disabilities; Minister of State at the Department of Health and Children (Deputy John Moloney): The Programme for Government proposes increasing the supply of professionals to meet its ambitious plans to develop new services for persons with disabilities. There has been significant investment in therapy services over the last number of years. A particular priority for the Department of Health and Children and the Department of Education and Science in recent years has been the expansion of the supply of therapy graduates. Training places for Therapists have increased since 2002. The percentage increase in the number of training places for therapy professions since 2002 are highlighted in the table:
The Department of Health and Children has worked closely with the Health Service Executive (HSE) in the provision of clinical placements for these students; an essential component of the therapy degree programmes. The growth in the numbers of physiotherapists, occupational therapists, speech and language therapists and dietetics since 1997 is outlined in the table:
A national therapy project office has been set up by the HSE to oversee the recruitment of competent staff in line with the HSE Transformation Programme and HSE Corporate policy. A national recruitment process has been organised in 2008 for staff grade therapists in Occupational Therapy, Physiotherapy and Speech and Language Therapy. The aim of this national recruitment process is to ensure that panels of therapists are available to take up positions as they become available. Panels of Occupational Therapists, Physiotherapy and Speech and Language Therapists are now in place. As the Deputy will be aware, the commencement of the planned developments in disability services this year had been delayed due to a financial review in the HSE. However, I am pleased to be able to inform the Deputy that the HSE has assured me that it is now in a position to roll out the planned developments as outlined in its 2008 Service Plan. Planned services include additional residential, day care — including training places — and respite care places for people with intellectual disability and autism; additional residential care and home support services for people with physical and sensory disabilities; and additional multi-disciplinary therapy posts to provide assessment and ongoing intervention services to children with a disability. Deputy Alan Shatter (FG): asked the Minister for Health and Children if her attention has been drawn to the fact that the parents of children with an intellectual disability whose children until the end of the 2007/2008 school year attended a school (details supplied) have been informed that the rehabilitative training programme in which the children were to participate from September 2008 in a day care centre will not be available due to lack of funding; the reason persons suffering from intellectual disabilities are being targeted by Government cutbacks; and if she will take steps to restore this essential service. Minister for Health and Children (Deputy Mary Harney): The Multi Annual Investment Programme for Disability Services makes provision for the development of additional residential, respite places and day care places each year between 2006 and 2009 for people with Intellectual Disability and Autism and additional residential care and home support services for people with physical and sensory disabilities. Some €50m was provided to the Health Service Executive (HSE) in 2008 to fund a range of additional services under the Multi Annual Investment Programme for Disability. As the Deputy will be aware, the commencement of the planned developments in disability services this year had been delayed due to a financial review in the HSE. However, I am pleased to be able to inform the Deputy that the HSE has assured me that it is now in a position to roll out the planned developments as outlined in its 2008 Service Plan.Planned services include additional residential, day care — including training places — and respite care places for people with intellectual disability and autism; additional residential care and home support services for people with physical and sensory disabilities; and additional multi-disciplinary therapy posts to provide assessment and ongoing intervention services to children with a disability. I understand that the HSE hopes to be able to finalise the position in relation to the commencement of such developments over the next week. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the specific matter raised by the Deputy investigated and to have a reply issued directly to the Deputy. Deputy Denis Naughten (FG): asked the Minister for Health and Children the results of the investigation by the Health Service Executive into allegations of exploitation in sheltered workshops for people with intellectual disabilities; the steps which are being taken as a result of this investigation; Minister for Health and Children (Deputy Mary Harney): I am not aware of any specific investigation of the kind mentioned by the Deputy. The Health Service Executive (HSE) is currently undertaking a National Review of HSE funded adult day services. This review includes sheltered workshops. The Review’s terms of reference are to advise on the reconfiguration and modernisation of existing Adult Day Services to reflect the core principles of theHealth Strategy — Access, Quality, Accountability and Person Centredness — to incorporate the following approach: Best Practice; Good value for money; Better outcomes for services users in line with relevant legislation and national standards. This process aims to produce a recommended service model/s that is reflective of these principles. The work of the Review is well underway and a report is due by the Autumn. In tandem with the HSE Review, the Office for Disability and Mental Health is also actively working with the Department of Enterprise, Trade and Employment towards improving and developing employment opportunities for people with disabilities.
Deputy Tom Hayes (FG): asked the Minister for Health and Children the income limit for the parents of a child with an intellectual disability under 18 years of age; and the way this compares to the limit for children under 18 but over the age of six without intellectual disability. Minister for Health and Children (Deputy Mary Harney): The table below shows details of the income thresholds used by the Health Service Executive to assist it in determining if a person qualifies for a medical card.
In recent years there have been significant improvements to the way in which people’s eligibility for medical cards and GP visit cards is assessed. Since the beginning of 2005, the qualification guidelines have increased by a cumulative 29% (7.5% and 20% in January and October 2005 respectively). Assessment is now based on a person’s and, where relevant, his/her spouse’s income after tax and PRSI, and takes account of reasonable expenses incurred in respect of rent or mortgage payments, childcare and travel to work. In June 2006, there was a further increase in the qualification threshold for the GP visit card to 50% above that for a medical card (previously 25%). Deputy Olwyn Enright (FG): asked the Minister for Health and Children the reason for a ten day delay before the Health Service Executive sanctions the release of funding under the multiannual programme for residential, day services and respite for people with disabilities; Minister of State at the Department of Health and Children (Deputy John Moloney): The multi-annual investment programme for disability services makes provision for the development of additional residential, respite places and day care places each year between 2006 and 2009 for people with Intellectual Disability and Autism and additional residential care and home support services for people with physical and sensory disabilities. €50 million was provided to the Health Service Executive (HSE) in 2008 to fund a range of additional services under the multi-annual investment programme for disability. As the Deputy will be aware, the commencement of the planned developments in disability services this year had been delayed due to a financial review in the HSE. However, I am pleased to be able to inform the Deputy that the HSE has assured me that it is now in a position to roll out the planned developments as outlined in its 2008 Service Plan.Planned services include additional residential, day care — including training places — and respite care places for people with intellectual disability and autism; additional residential care and home support services for people with physical and sensory disabilities; and additional multi-disciplinary therapy posts to provide assessment and ongoing intervention services to children with a disability. I understand that the HSE hopes to be able to finalise the position in relation to the commencement of such developments over the next week. My Department has requested the parliamentary affairs division of the executive to arrange to have the specific matter raised by the Deputy investigated and to have a reply issued directly to the Deputy. Deputy Tom Hayes (FG): asked the Minister for Health and Children if there are facilities for people reaching the age of eighteen with intellectual disabilities in south Tipperary to further their development in order to live an independent life in so far as possible; the number of places that will be available for persons wishing to apply in 2008 for these places; Minister of State at the Department of Health and Children (Deputy John Moloney): The Deputy’s question relates to the management and delivery of health and personal 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 this matter investigated and to have a reply issued directly to the Deputy. Deputy Tom Hayes asked the Minister for Health and Children if funding for disability services in south Tipperary will be cut; if respite care will remain at its current level within disability services; if she will make a statement on disability facilities in south Tipperary generally, outlining the different day and residential facilities available; the amount of funding they received in 2005, 2006 and 2007; the amount they will receive in 2008; and if she will confirmif these facilities have received funding for 2008. Minister of State at the Department of Health and Children (Deputy John Moloney): The Multi Annual Investment Programme for Disability Services makes provision for the development of additional residential, respite places and day care places each year between 2006 and 2009 for people with Intellectual Disability and Autism and additional residential care and home support services for people with physical and sensory disabilities. €50m was provided to the Health Service Executive (HSE) in 2008 to fund a range of additional services under the Multi Annual Investment Programme for Disability. As the Deputy will be aware, the commencement of the planned developments in disability services this year had been delayed due to a financial review in the HSE. However, I am pleased to be able to inform the Deputy that the HSE has assured me that it is now in a position to roll out the planned developments as outlined in its 2008 Service Plan. Planned services include additional residential, day care — including training places — and respite care places for people with intellectual disability and autism; additional residential care and home support services for people with physical and sensory disabilities; and additional multi-disciplinary therapy posts to provide assessment and ongoing intervention services to children with a disability. I understand that the HSE hopes to be able to finalise the position in relation to the commencement of such developments over the next week. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the specific matter raised by the Deputy investigated and to have a reply issued directly to the Deputy.
Deputy Denis Naughten (FG): asked the Tánaiste and Minister for Enterprise, Trade and Employment the plans to increase the rate of training bonus paid by FÁS to trainees who are regarded as socially disadvantaged or people with disabilities in vocational training; when this rate was last increased; if she will review the policy of not increasing the training bonus; Tánaiste and Minister for Enterprise, Trade and Employment (Deputy Mary Coughlan): The training bonus was introduced as a special initiative to introduce an additional allowance for the following categories of people who were on, or commenced, a FÁS training course on or after 19 April 1999:
At the time of its introduction, no inflation proofing element was built into the bonus and none was envisaged. I understand that all FÁS trainees receive the FÁS training allowance (currently €197.80 for trainees over 18 years of age) and this increases annually in line with increases in social welfare entitlements. The training bonus of €31.80 is payable to eligible trainees on FÁS mainline training courses and also to people with disabilities in training with Specialist Training Providers monitored by FÁS. Deputy Denis Naughten (FG): asked the Minister for Education and Science, further to Parliamentary Question No. 465 of 20 November 2007, his plans to fulfil the Programme for Government, which commits to ensuring early intervention for pre-school children with special educational needs; Minister for Education and Science (Deputy Batt O’Keeffe): As the Deputy is aware, the Programme for Government commits to ensuring early intervention for pre-school children with special educational needs. This commitment is being addressed in the context of the implementation of the Education for Persons with Special Educational Needs Act, 2004 (EPSEN Act) and the Disability Act 2005. My Department is now at an advanced stage in finalising proposals to facilitate implementation of the remaining sections of the Education for Persons with Special Educational Needs (EPSEN) Act 2004. The time taken to finalise proposals reflects the complexities involved, the need for consultation across the wide range of people and sectors involved, the need to align with the requirements of the Disability Act, 2005 and define how the Health Service Executive (HSE) and NCSE will work together under both acts. This approach will allow for the co-ordinated delivery of services across the education and health sectors. My Department’s proposals for the implementation of the EPSEN and Disability Acts are being considered in the context of the 2009 Estimates process.
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Inclusion
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