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Dáil Debates & Questions
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June 22 2010 Dáil Debates
Parliamentary Questions
DÁIL DEBATES Deputy Jan O’Sullivan (L): asked the Minister for Health and Children if she will address the funding shortfall of the Brothers of Charity Services in Limerick which has led to the loss of respite services for 63 families and to the reduction in residential services for other clients; if her attention has been drawn to the fact that every possible saving has been made in order to avoid this loss of service but that it has been unavoidable due to a cut in funding of more than €1 million for 2010; Minister of State at the Department of Health and Children (Deputy Barry Andrews): The Government’s commitment in the area of disability is consistent. Significant additional resources have been provided for services and supports in this area under the multi-annual investment programme 2006-2009, as part of the national disability strategy. Overall, approximately €1.6 billion is spent annually by the health services on disability programmes, including residential, day care, respite, assessments and rehabilitation services. I am aware of the valuable contribution the Brothers of Charity services make to the provision of services to people with intellectual disabilities in Limerick. During the period 2005- 08, the Brothers of Charity services nationally received more than €631 million in funding from the HSE. In 2009, approximately €177 million was provided to fund these services. This sustained level of investment reflects the significant growth and development in the services provided by the Brothers of Charity during the past five years. Arising from the introduction of cost containment and efficiency measures in the 2010 budget, the HSE advised all agencies providing services on its behalf of their financial allocations for 2010 and the required adjustments. The HSE is aware of the challenges which this reduction in allocations will present to organisations to ensure they meet the needs of service users and in planning for emergencies that arise throughout the year. In this context, it is vital that all providers work creatively and co-operatively to ensure the maximum level of services are maintained within the funding resources available. The HSE plans to maintain access to appropriate treatments and services for clients during 2010 despite current resource pressures. The HSE is very much aware of the importance of respite service provision for the families of both children and adults with disabilities, including the impact the absence of respite service provision can have on other services, for example, residential and day care services. Respite services throughout the country are being reviewed on an ongoing basis and the majority of local health offices have reported that services are being maintained, albeit with some difficulty. In all areas, disability managers are working closely with agencies to ensure those with the most urgent needs are prioritised. There has been a continued expansion in the availability of residential support services, especially planned or emergency centre-based respite services, which have grown substantially. A total of 4,599 people availed of this type of service in 2008, allowing them to continue living with their families and in their communities. The HSE is working in partnership with the voluntary service providers to deal with issues that arise from funding allocations, to ensure the needs of service users are prioritised and addressed and that frontline delivery is given priority. Disability service providers, including those in the Limerick area, have been asked to submit their plans for the maintenance of service levels within available resources and to discuss with HSE management how current challenges can be addressed. As part of this process, the Brothers of Charity services have prepared a detailed document for discussion with HSE personnel at local level. In response to the Brothers of Charity proposal to close one respite service on 14 June, which is affecting 19 service users, local discussions are taking place regarding the implications of this for users of its respite service and the HSE is endeavouring to ensure an alternative service will be made available. The HSE is aware of the pressures the Brothers of Charity services are experiencing in maintaining existing service levels and responding to the respite needs of service users. While significant changes have been applied to frontline services, in many cases these changes have not necessarily resulted in service reduction but in a different model of service delivery being applied. The HSE will continue to work in partnership with the Brothers of Charity in dealing with issues that arise from service cuts, to ensure the needs of service users are prioritised and addressed. However, any planned reductions must be risk assessed and risk managed by the Brothers of Charity. There are also plans to develop a local forum in Limerick of all service providers, both physical and sensory and intellectual disability, with a focus on the needs of service users now and in the future. Deputy Jan O’Sullivan: The Minister of State has given a very general answer to a very specific question. I raise this question on behalf of the 63 families in the mid west who look after their intellectually disabled loved ones at home and who now have nowhere to put them. For example, I speak on behalf of a woman who is looking after her brother. Her parents are dead and she has no other brothers or sisters. She has nowhere to go. Another woman is concerned about going into hospital and reckons she will have to bring her adult son, who is over 40 years of age, with her to hospital. I will not be satisfied until I get a direct answer to the question of when the respite centre in Clonisle, Limerick, will be re-opened. I seek a very simple answer to a very simple question. The amount of money involved is €157,000. It is not a large sum of money but it must be found for this purpose this week. Deputy Barry Andrews: I did not get to the end of the answer. More specifics are available.Disability service providers, including those in the Limerick area, have been asked to submit their plans for the maintenance of service levels within available resources. As part of this process, the Brothers of Charity services have prepared a detailed document for discussion with HSE personnel at local level. In response to the proposal to close one respite service on 14 June, which affects 19 service users, local discussions are taking place regarding the implications of this for users of its respite service and the HSE is endeavouring to ensure an alternative service will be made available.Deputy Jan O’Sullivan: I am not satisfied with discussions and talks. We need action. It is not possible to leave families who look after their loves ones at home and who save the State a fortune by not putting them into residential care with no respite whatsoever. Talks are no good. They may solve other problems. There is a shortfall of €1 million in terms of what the Brothers of Charity received this year and other services are threatened. However, my question refers specifically to the opening of the respite house. I demand that the Government finds the €157,000 necessary to keep the house open. Otherwise, they are leaving dependent families, who have nowhere else to go, with an adult intellectually disabled person who may have to attend hospital with them. That is not good enough. Normally, I do not get as angry as I am today when I put questions in the Chamber. However, I am very angry on behalf of those families and parents. I do not care whether the HSE is in talks with the Brothers of Charity or with the Department of Health and Children. I call for someone to represent the interests of the families affected. It is not enough to simply hold ongoing talks. We need a direct answer. When will the institution open such that the families concerned may sleep in their beds at night? Deputy Barry Andrews: The position is that discussions are ongoing. No one disputes the value of respite services to families under extreme pressure and who have children or older adults with intellectual disabilities. No one disputes the value of the service the Brothers of Charity provides in this area. Solutions must be found. I agree with the Deputy and there is no dispute in this regard. This is the purpose of the discussions. While I understand the level of anger expressed by the Deputy and that the issue has a particular significance in her area, unfortunately, in this area, the HSE is seeking ways to solve the issue. Reference has been made to a demography fund. An additional €19.5 million is being provided nationally for service throughout the country. Part of the ongoing discussions refer to that fund. It is a national fund but it refers to an additional 24 respite places in the HSE west area. I assure the Deputy that she will be updated with the outcome of those discussions. Deputy Jan O’Sullivan: I express my disappointment that the Minister of State directly responsible, Deputy Moloney, is not here. The Minister of State, Deputy Barry Andrews, is not responsible. I would have thought that since the Minister of State, Deputy Moloney, is not here, the Minister for Health and Children would have answered the question because these families cannot be left in the lurch with no answer from either the senior Minister or the Minister of State responsible. An Leas-Cheann Comhairle: As the Deputy knows, the Government is collectively responsible and any Minister can speak on behalf of the Government. Deputy Jan O’Sullivan: Since the Minister of State is not here for whatever reason, I would have expected the senior Minister to have answered the question. I will ask the senior Minister to address this issue as a matter of urgency today. Deputy David Stanton (FG): asked the Minister for Health and Children if she has calculated the estimated cost of implementing National Quality Standards — Residential Services for People with Disabilities which were published by the Health Information and Quality Authority in May 2009 on a statutory basis; the number of institutions which will be covered by the standards and the number of residents in each of these institutions respectively; Deputy Barry Andrews: The HSE estimates 9,000 persons with disabilities are resident in approximately 1,200 centres across the country, which includes approximately 150 centres that provide residential or respite care to some 300 children with disabilities. National Quality Standards: Residential Services for People with Disabilities, published by the Health Information and Quality Authority in May 2009, relate to adult services. These standards will provide a national framework for quality, safe services for adults with disabilities in residential settings. Given the current economic position, to move to full statutory implementation of the standards, including regulation and inspection, presents significant challenges at this time. Notwithstanding the difficulties of immediate statutory implementation, my Department, the HSE and HIQA have agreed that progressive non-statutory implementation of the standards should commence and become the benchmark against which the HSE assesses both its own directly operated facilities and other facilities that the HSE funds. The Department of Health and Children is liaising with the HSE in terms of implementing the HIQA standards on a progressive non-statutory basis within existing resources. Currently every service provider is required, as part of its service level agreement with the HSE, to have appropriate mechanisms in place to assess quality and standards for the delivery of all services. This agreement requires all service providers to comply with relevant legislation, statutory regulations, codes of practice and agreed guidance documents relating to the standards associated with the service in question. Providers of care are required to set out in detail the specific actions or plans to maintain and monitor quality and service standards. Examples of such actions include audit tools appropriate to the service, service and service user evaluations and satisfaction surveys. The Department is also engaged in ongoing discussions with HIQA regarding the resources that would be required to implement a mandatory scheme of registration and inspection of residential services for persons with disabilities. In tandem with this work, and arising from the Ryan Commission report, the Department of Health and Children is preparing detailed proposals regarding the protection of vulnerable adults with disabilities who are currently in institutional care. I will bring these proposals to government in the near future. Deputy David Stanton: The first part of my question related to the estimated cost but the Minister of State did not respond to that. He might respond later. Is it true that the non-statutory guidelines are not legally binding? What weight have they? Will the lack of statutory guidelines and inspection services have an impact on our ability to ratify the UN Convention on the Rights of Persons with Disabilities, given the Irish Human Rights Commission has said that the standards relating to the right to health, education and so on are not being met adequately in the State today? Deputy Barry Andrews: It is not possible at this stage to outline the cost requested by the Deputy. We are awaiting detailed proposals regarding adults and until they are provided and the children’s standards are finalised, we will not be in a position to provide details of the cost. With regard to the rights of people with disabilities under the UN convention, clearly the ambition of the Government to provide a statutory basis for the guidelines is directed towards complying with the convention. I refer to the weight of the non-statutory guidelines, a service level agreement with any nonstatutory organisation provides for detailed compliance with not only the statutory framework, but also regulations and other requirements specific to the service provided. This is the way in which the HSE is able to require the service providers to make sure the service is of at least a minimum standard to ensure safety but also a high quality service. We await final discussions with HIQA and the details of the services provided. Until that is done, we cannot provide the cost. Deputy David Stanton: What is the timeframe for this? Does he agree it is a disgrace in this day and age that there are not independent inspections of services for people with disabilities, the most vulnerable in our society? How many centres run by voluntary organisations and funded by the HSE are not included in the inspection regime under the Child Care Act 1991? Is it true that hundreds of children have no protection whatsoever at this time? If so, what is the Minister of State doing about it? Deputy Barry Andrews: According to the figures I have, there are 150 centres caring for 300 children with disabilities. Clearly, the Government recognises that this area requires reform and improvement. Deputy David Stanton: When? Deputy Barry Andrews: That is why we enacted the health Bill, set up HIQA, set down standards and are waiting for the standards to be set down for children. They are a measure of the Government’s commitment in this area. The Deputy asked when that will happen. We are awaiting final discussions with HIQA regarding the standards we expect. Deputy David Stanton: This year or next year? The standards for adults were published only last year. I expect we will be in a better position to give an indication to the Deputy in the new term. At this point, I cannot give a concrete date on which we will move to an inspection and registration regime. Deputy David Stanton: It is not good enough. An Leas-Cheann Comhairle: That concludes Priority Questions. Deputy David Stanton (FG): I have three questions for the Taoiseach. First, is the mental capacity Bill still going to be published before we rise for the summer recess? Second, on the promise to sign the UN Convention on the Rights of Persons with Disabilities, must we deal with other serious human rights before doing so? Third, regarding No. 82 on today’s Order Paper, where stands Dáil reform from the Government’s point of view? Will there be proposals from the Government side this year, next year or any year? The Taoiseach: On the first question, it is hoped that Bill would be published this session. Deputy David Stanton: Will it be before the summer recess? The Taoiseach: That is the hope of the Department. On the Convention on the Rights of Persons with Disabilities, Ireland was in the first group of countries to sign, subject to ratification. It is the Government’s intention to ratify the Convention on the Rights of Persons with Disabilities as quickly as possible, taking into account the need to ensure that all necessary requirements under that convention are being met. There will be no undue delay in the State’s ratification of it, I understand. Regarding the third matter, the Whip must deal with it in due course.
PARLIAMENTARY QUESTIONS
Deputy Kieran O’Donnell (FG): asked the Minister for Health and Children the number of adults and children currently residing in residential centres for people with disabilities; if she will provide a list of these centres; when she will introduce legislation to regulate and inspect residential centres for people with disabilities; the cost of same; Minister of State at the Department of Health and Children (Deputy John Moloney): The Health Service Executive estimates that there are 9,000 persons with disabilities resident in approximately 1,200 centres across the country, which includes approximately 150 centres that provide residential or respite care to some 300 children with disabilities. I have asked the HSE to furnish the Deputy with the most up to date list of these centres. As the Deputy will be aware, the National Quality Standards: Residential Services for People with Disabilities, published by the Health Information and Quality Authority in May 2009, relate to adult services. These standards will provide a national framework for quality, safe services for adults with disabilities in residential settings. Given the current economic situation, to move to full statutory implementation of the standards, including regulation and inspection, presents significant challenges at this time. Notwithstanding the difficulties of immediate statutory implementation, my Department, the HSE and HIQA have agreed that progressive non-statutory implementation of the standards should commence and become the benchmark against which the HSE assesses both its own directly operated facilities and other facilities that the HSE funds. The Department of Health and Children is liaising with the HSE in terms of implementing the HIQA standards on a progressive non-statutory basis within existing resources. Currently every service provider is required, as part of its service level agreement with the HSE, to have appropriate mechanisms in place to assess quality and standards for the delivery of all services. This agreement requires all service providers to comply with relevant legislation, statutory regulations, codes of practice and agreed guidance documents in relation to the standards associated with the service in question. Providers of care are required to set out in detail the specific actions or plans to maintain and monitor quality and service standards. Examples of such actions would include audit tools appropriate to the service, service and service user evaluations and satisfaction surveys. The Department is also engaged in ongoing discussions with HIQA regarding the resources which would be required to implement a mandatory scheme of registration and inspection of residential services for persons with disabilities. In tandem with this work, and arising from the Ryan Commission report, the Department of Health and Children is preparing detailed proposals in relation to the protection of vulnerable adults with disabilities who are currently in institutional care. I will be bringing these proposals to Government in the near future. Children with disabilities in generic residential centres under the Child Care Act 1991 are covered by the standards and inspection regimes already applying to those centres. There are a number of other centres providing residential or respite care to children with disabilities. Children who reside in these centres are not in the care of the State, although they are cared for by the State. The majority of these centres are run by voluntary organisations funded by the HSE and are not included in the inspection regime under the Child Care Act 1991. In relation to the children with disabilities in these other residential centres, the Ryan Commission report recommends that “all services for children should be subject to regular inspections in respect of all aspects of their care”. The implementation plan for the recommendations of the Ryan Commission report contains a commitment that the Health Act 2007 will be commenced to allow the independent registration and inspection of all residential centres and respite services for children with a disability by December 2010. Deputy David Stanton (FG): asked the Minister for Health and Children the progress that has been made regarding the value for money and policy review of disability services; if a steering committee has been established within her Department to oversee the review; the way service users and service providers have been and will be consulted to help inform the review; when she expects the review to be concluded; Minister of State at the Department of Health and Children (Deputy John Moloney): A Review of the Efficiency and Effectiveness of Disability Services in Ireland is being undertaken as part of the Government’s Value for Money Reviews for 2009-2011. This in-depth review of disability services will assess how well current services for people with disabilities meet their objectives and support the future planning and development of services. The evaluation will focus on the current provision of disability services and explore the way forward for the development of services within a value for money and policy framework. The objectives of the review are to:
A Steering Group has been established to oversee the VFMPR and is meeting today for the sixth time. The Steering Group is chaired by an independent chairperson, Mr. Laurence Crowley, and has two other independent members, as well as members drawn from the Disability Sector, Department of Health and Children, the Department of Finance and the HSE. A Project Team and a Policy Expert Reference Group reporting to the Steering Group meet on a regular basis to progress the work of the review. Steady progress is being made with the review, however some slippage in terms of the expected end date has occurred because of the breadth and complexities of the services under review. Difficulties have also been experienced in accessing data essential to the progress of the review due to industrial action affecting the Health Service Executive. A public consultation process was undertaken in late 2009 and attracted almost 200 responses from a wide variety of respondents including service users, family members and service providers. The Project Team has provided a report to the Steering Group on a statistical analysis of the responses. A thematic analysis of the responses is nearing completion and a final report on the consultation is being drafted. The National Disability Authority (NDA) also conducted 15 focus group consultations with people with disabilities, their families, advocates and frontline service providers in March 2010 to inform its advice to the review. I understand that the NDA is currently formulating an Advice Paper incorporating the results of the consultation, together with other relevant research. The Policy Expert Reference Group is nearing completion of a report to the Steering Group on a new policy framework for the provision of disability services and has taken cognisance of the findings of the public consultation process in developing this policy framework. Further consultation on aspects of the draft policy may be considered before it is ratified by the Steering Group. I expect that substantial progress on completing the overall Review will have been made by the end of this year. Deputy Maureen O’Sullivan (I): asked the Minister for Health and Children the reasoning behind the reduction by the Health Service Executive of €4 million from the budget of an organisation (details supplied) in Dublin 7, one of the immediate effects of which will be the closure of a respite house; if the budget for disabilities and special needs is being allowed a separate entity within the HSE when money is being allocated by the Department of Health and Children. Minister of State at the Department of Health and Children (Deputy John Moloney): The Government’s commitment in the area of disability is consistent. Significant additional resources have been provided for services and supports in this area under the Multi-Annual Investment Programme (MAIP) 2006-2009, as part of the National Disability Strategy. Overall approximately €1.6 billion is allocated by the HSE and is spent annually on disability programmes (residential, day care, respite, assessments and rehabilitation services). With the exception of service development funding allocated under the M.A.I.P., under the Health Act 2004, it is a matter for the HSE to decide on the most effective allocation of resources to meet the health and personal and social support needs of the population, including the needs of people with disabilities. The National Service Plan which is laid before both Houses of the Oireachtas sets out the quantum of services, including disability services, to be provided in any financial year by the HSE out of resources allocated to it. I am very much aware of the valuable contribution the Daughters of Charity services makes to the provision of services to people with intellectual disabilities in Dublin. During the period of the Multi Annual Investment programme, the Daughters of Charity Services received funding from the HSE in the region of: Year € million 2005 85.126 2006 94.748 2007 101.301 2008 106.790 2009 110.542 This sustained level of additional investment reflected the significant growth and development in the Daughters of Charity Services throughout this period. Arising from the introduction of cost containment and efficiency measures in the 2010 budget, the HSE advised all agencies providing services on its behalf of their financial allocations for 2010 and the required adjustments. The HSE is aware of the challenges service providers, including the Daughters of Charity, are experiencing and the particular difficulties facing all health services in 2010. In this context, it is vital that all providers work creatively and co-operatively to ensure that the maximum level of services are maintained for service users within the funding resources available. The HSE plans to maintain access to appropriate treatments and services for clients during 2010 despite the current resource pressures. The HSE is aware of the challenges which this reduction in allocations will present to organisations in ensuring they meet the needs of service users and in planning for emergencies that arise throughout the year. It is recognised that the maintaining of service levels within available resources will require significant levels of cooperation, change, flexibility and creativity. The HSE will continue to work in partnership with the Voluntary service providers in dealing with issues that arise from funding allocations, to ensure the needs of service users are prioritised and addressed. Disability Service Providers have been requested to submit their plans for the maintenance of service levels within available resources taking the following into consideration:
The HSE will continue to work with the voluntary service providers to streamline costs, further identify and improve areas where efficiencies can be achieved that do not impact on frontline service delivery. Deputy Dan Neville (FG): asked the Minister for Health and Children the reassurances that she can give to the people in County Limerick whose family members are attending an organisation (details supplied) in view of the fact that they are concerned that the proposed cuts to the service will have a major impact on its ability to continue providing the necessary services; Minister of State at the Department of Health and Children (Deputy John Moloney): The Government’s commitment in the area of disability is consistent. Significant additional resources have been provided for services and supports in this area under the Multi-Annual Investment Programme 2006-2009, as part of the National Disability Strategy. Overall approximately €1.6 billion is spent annually by the health services on disability programmes (residential, day care, respite, assessments and rehabilitation services). I am very much aware of the valuable contribution the Brothers of Charity Services make to the provision of services to people with intellectual disabilities in Limerick. During the period 2005 — 2008, the Brothers of Charity Services nationally received over €631 million in funding from the HSE. In 2009, approximately €177 million was provided to fund these services. This sustained level of investment reflects the significant growth and development in the services provided by the Brothers of Charity over the past five years. Arising from the introduction of cost containment and efficiency measures in the 2010 budget, the HSE advised all agencies providing services on its behalf of their financial allocations for 2010 and the required adjustments. The HSE is aware of the challenges which this reduction in allocations will present to organisations in ensuring they meet the needs of service users and in planning for emergencies that arise throughout the year. In this context, it is vital that all providers work creatively and co-operatively to ensure that the maximum level of services are maintained within the funding resources available. The HSE plans to maintain access to appropriate treatments and services for clients during 2010 despite current resource pressures. The HSE is very much aware of the importance of respite service provision for the families of both children and adults with disabilities including the impact the absence of respite service provision can have on other services, for example residential and day-care. Respite services throughout the country are being reviewed on an ongoing basis, and the majority of Local Health Offices have reported that services are being maintained, albeit with some difficulty. In all areas, Disability Managers are working closely with agencies to ensure that those with the most urgent needs are prioritised. There has been a continued expansion in the availability of residential support services, particularly planned or emergency centre-based respite services, which have grown substantially. A total of 4,599 people availed of this type of service in 2008, allowing them to continue living with their families and in their communities. The HSE is working in partnership with the Voluntary Service Providers in dealing with issues that arise from funding allocations, to ensure the needs of service users are prioritized and addressed and that frontline delivery is given priority. Disability Service Providers, including those in the Limerick area, have been asked to submit their plans for the maintenance of service levels within available resources, and to discuss with HSE management how current challenges can be addressed. As part of this process, the Brothers of Charity Services have prepared a detailed document for discussion with HSE personnel at local level. In response to the Brothers of Charity proposal to close one respite service on the 14th June, affecting 19 service-users, local discussions are taking place regarding the implications of this for users of its respite service, and the HSE is endeavouring to ensure that an alternative service will be made available. The HSE are aware of the pressures the Brothers of Charity Services are experiencing in maintaining existing service levels and responding to the respite needs of service users. While significant changes have been applied to frontline services, in many cases these changes have not necessarily resulted in service reduction, but in a different model of service delivery being applied. The HSE will continue to work in partnership with the Brothers of Charity in dealing with issues that arise from service cuts, to ensure the needs of service users are prioritised and addressed. However, any planned reductions, must be risk assessed and risk managed by the Brothers of Charity. There are also plans to develop a local forum in Limerick of all service providers (both Physical & Sensory & Intellectual Disability), with a focus on the needs of service users now and in the future. Deputy Aengus Ó Snodaigh (SF): asked the Minister for Transport his plans to publish the document on designated parking badges and bays. Minister for Transport (Deputy Noel Dempsey): I understand that the Deputy is referring to the review of the Disabled Parking Scheme which has been carried out by my Department. I have received the report of this review and considered and approved its recommendations. Work on implementing these recommendations is under way in my Department. The report will be published in the near future. Deputy Ciarán Lynch (L): asked the Minister for Health and Children if caring organisations that are funded through the Health Service Executive to deliver services are being compensated in situations when they are forced to replace front-line staff that are not exempted under the public service moratorium; if her attention has been drawn to the fact that many such organisations have, in effect, suffered major funding cuts because of the moratorium; Minister for Health and Children (Deputy Mary Harney): The Government has made it clear that a critical part of its strategy to restore the public finances is to achieve sustainability in the cost of delivering public services relative to State revenues. To help achieve this goal, it will be necessary to restructure and reorganise the public service and to reduce public service numbers over the coming years. The Employment Control Framework for the health sector provides for a net reduction in employment of 6,000 in wholetime equivalent (WTE) terms from March 2009 to the end 2012 and consequential pay roll savings. Based on numbers reductions already achieved in 2009, the net target reduction to end 2012 is 4,560 WTE. Therefore, the net target reduction in numbers in 2010, and in each of the following two years, is 1,520 wholetime equivalents. The Government decision has been modulated to ensure that key services are maintained insofar as possible in the health services, particularly in respect of children at risk, older people, persons with a disability, mental health services, and cancer services. The Framework, accordingly, provides for a number of grades and posts that are exempt from the moratorium on recruitment and promotion. In addition, the HSE also has some degree of flexibility under the Framework to sanction the filling of certain other posts (both within its own organisation and in voluntary service providers funded it by it) on an exceptional basis provided it achieves the overall target reductions in both staffing levels and pay costs. The requirement is that a post or posts of equivalent value must be suppressed in order to meet the cost of the post being filled. Against the background of reduced budgets and staffing levels in the health sector, a reorganization and restructuring of work is required not only to maintain the level, quality and safety of services but also to expand the range and accessibility of community services in order to avoid the necessity for hospital attendances. The new Public Service Agreement, which was ratified last week by the Public Services Committee of ICTU, clears the way for the implementation of a major transformation programme for the health sector to commence on a collaborative basis involving unions and employers. The programme is designed to achieve significant cost efficiencies while protecting the quality and effectiveness of services to the public. The foregoing arrangements apply across the publicly funded health services and there can be no question of exempting voluntary service providers or providing them with additional funding. This would undermine the strategic objectives of Government policy which are to reduce staffing levels and achieve payroll savings in order to bring the public voluntary finances into sustainable balance. Voluntary providers, in common with the HSE, need to identify, and implement under the Public Service Agreement, whatever changes in staffing levels, skill mix and work practices are necessary to protect services within the reduced level of funding now available. Deputy Mary O’Rourke (FF): asked the Tánaiste and Minister for Education and Skills if she will review the whole spectrum of autism provision now available throughout the entire range of educational services; if she will respond to a request (details supplied). Tánaiste and Minister for Education and Skills (Deputy Mary Coughlan): The Deputy will be aware of the Government’s commitment to ensuring that all children with special educational needs, including those with autism, can have access to an education appropriate to their needs preferably in school settings through the primary and post primary school network. Such placements facilitate access to individualised education programmes which may draw from a range of appropriate educational interventions, fully qualified professional teachers, special needs assistants and the appropriate school curriculum. My Department has put in place a training programme for teachers in autism-specific interventions including Treatment and Education of Autistic Communication Handicapped Children (TEACCH), Picture Exchange Communications System (PECS) and Applied Behaviour Analysis (ABA) through the Special Education Support Service (SESS). The SESS facilitates a partnership approach involving support teams of practising teachers, Education Centres, the Inspectorate, the National Educational Psychological Service, the National Council for Curriculum and Assessment, the National Council for Special Education, Third Level Colleges, Health Board Personnel, Teacher Unions and other relevant bodies and services. The Deputy will also be aware that the National Council for Special Education (NCSE) is responsible, through its network of local Special Educational Needs Organisers (SENO) for allocating resource teachers and special needs assistants to schools to support students with autism. The SENO will also consider applications from schools to establish special classes for students with autism. All schools have the names and contact details of their local SENO. Parents may also contact their local SENO directly to discuss their child’s special educational needs, using the contact details available on www.ncse.ie. The establishment of a network of autism-specific special classes in schools across the country to cater for children with autism has been a key educational priority in recent years. In excess of 390 classes have now been approved around the country, including over 40 at post-primary level. The NCSE will continue to sanction further classes where the need is identified.
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Inclusion
Ireland, Unit C2, The Steelworks, Foley Street, Dublin 1, Ireland.
Tel: 01 8559891 Fax: 01 8559904 Email: info@inclusionireland.ie |