June 30 2010

Dáil Debates

• Leaders’ Questions: Funding to services for people with a disability
• Adjournment Debate: Funding to services for people with  disability

Parliamentary Questions

• Number of persons waiting to receive a service or therapy
• Reason Dept. Education and does not have a sectoral plan under Disability Act
• No. of SNAs employed by Dept. in 2010-2011

DÁIL DEBATES

• Leaders’ Questions: Funding to services for people with a disability

Deputy Enda Kenny (FG): Governments must make choices every day, and sometimes they are difficult choices. I have disagreed with many of the choices made by this Government in recent years, particularly on spending. The Taoiseach is well aware that in recent days, 60 organisations providing services to the intellectually disabled are now being forced to either reduce services or to cut them out entirely. This is having an enormous impact on those involved and on their parents, friends and families. It is quite stressful to see the anxiety and distress this has caused. The Taoiseach is aware the unit in Caherdavin in Limerick run by the Brothers of Charity that provides services for 377 people is to close and that two weeks’ notice was given to the Daughters of Charity about the closure of the respite centre on the Old Cabra Road. The Taoiseach is also aware that the best value for money in the health service is given by voluntary organisations, none of which is represented by SIPTU or IMPACT. These people have an enormous output for relatively little money. In the context of priorities and choices that must be made, how is it in a country where there is so much obscene wasting of public money, that this sort of choice is forced on voluntary organisations providing services to the intellectually disabled? The Taoiseach is also aware of the consequences. How can the Taoiseach justify the reduction of services that are so important to the well-being of thousands of people with intellectual disabilities at a time when there is obscene waste?

The Taoiseach: The whole purpose of the money that is allocated is to protect frontline services to the greatest extent possible. As the Deputy has said, when I was Minister for Health and Children and Minister for Finance, I was anxious to support the area of disability services and brought forward a five year plan by Government to improve and greatly extend the range of services for people with disabilities, be they sensory, physical or intellectual. More than €1 billion is being spent on intellectual disabilities alone. There are 178 service providers under sections 38 and 39 of the Health Act. Up to 90% of services are provided by 25 of them. The important point, given that there are limited resources generally and against a background of increased resources being given to this sector, is that the provision of services in the non-frontline areas ensures there is enough money at the frontline. The Minister of State with responsibility in this area, Deputy Moloney, and the Minister for Health and Children are working to see how we can ensure that for the future. Changes must take place in the support services behind the frontline services. We cannot have 178, or even 25, service providers, even if they provide an excellent service. There must be room for change so we can release resources to the frontline against the background of strict budgetary parameters. That being said, we must do everything we can to assist the most vulnerable. That is being worked on as a priority by the Minister and the Department. In the context of sustaining services for the future, there must be changes in how organisations cooperate. Why should there be 25 different payroll systems, why should there be a series of different approaches by various organisations? Those all must be pulled together so there are sufficient services at the frontline.

Deputy Enda Kenny: I do not doubt the Taoiseach’s personal commitment to this area and I do not disagree that changes must be made. I disagree fundamentally, however, with the fact that no analysis was done of the impact of across the board cutbacks before those changes were implemented. About whom are we talking? These are children and young people with great difficulties in their personal lives because of the intellectual challenges they face, which leave them needing 24 hour care and attention, ranging from someone trying to understand their gestures to those with metabolic disorders and intellectual disabilities that cause serious behavioural problems. The consequences of the administration minding itself and cuts in frontline voluntary services impact directly on these children and young people and, as a consequence, on their families. I met some of them yesterday. That respite has been taken away, even for four hours once a month, impacts seriously on their lives. That is the consequence of such cutbacks. When the Taoiseach says he wants to do all he can to help this area, I take the sentiment at face value but what has happened in the Department of Health and Children? What other choices are being made? In the Vote for the Department’s budget, the administration budget has gone up by 11% to €42 million this year. That €4 million increase would keep the Daughters of Charity facilities open. The increase includes rises of 67% for office supplies, 104% for consultancy services and almost 600% for value for money reviews. The entertainment budget has been doubled from €100,000 to €200,000, which would keep one of the facilities open for this year.

An Ceann Comhairle: Deputy Kenny has a tendency to over-run time on Leaders’ Questions. Could he ask a question please?

Deputy Enda Kenny: I do not doubt the Taoiseach’s personal commitment but this is what has happened under his nose, these are the choices the Government has made, these are the priorities the Government has decided upon and these are the consequences for those children and their families. If the Taoiseach wants to make changes he should at least have looked at what the structure has done; it has protected itself and is demolishing services throughout the country to the detriment of people’s quality of life, particularly that of young people affected by intellectual disability. In what circumstances can the Taoiseach justify making choices such as this without examining areas where we could have had serious cutbacks in administration that would keep these levels of services open for those who so need them?

Deputies: Hear, hear.

The Taoiseach: I would like to give the full picture because sometimes I am afraid that statistics can be used for particular purposes. If one looks at the situation with regard to the increase——

Deputy Paul Kehoe: About how many parties——

The Taoiseach: I have listened to the Deputy’s leader with respect and I ask him to step back for a minute——

An Ceann Comhairle: The Taoiseach without interruption.

The Taoiseach: ——and hear some context and understanding of what is going on.

The Taoiseach: With regard to the administrative situation, bodies have been subsumed back into the Department. I want to explain this because there is no point in putting out information and then everyone assuming——

The Taoiseach: ——it is just random spending on areas that are not essential. The issue is that there are bodies which needed to be brought back within departmental responsibility and they are being subsumed back into the Department. The administrative costs of subsuming them back into the Department are less than the cost of the previous entities when they were separated. With regard to the question on value for money, if one is spending, as we are, more than €15,000 million of taxpayer money on health services of course one will increase value for money initiatives to see, in a sustainable way against the background in which any Government now has to operate, what savings initiatives can be identified. That work has to be done and it is precisely what is being done in the area of disability services. There are more than 176 providers of disability services throughout the country; there are probably more than 200 such providers. Section 38 organisations include the Brothers of Charity which obtained approximately €125 million and the Sisters of Charity which obtained approximately €100 million. Section 39 organisations are smaller organisations which receive a grant-in-aid from the Department. There have to be savings in respect of how those services are organised. It is clear we have to do this against the background of less money being available from the taxpayer to deal with these services. We want to make sure that we protect to the greatest extent possible the front line…If it is the contention that the solution to the problem is simply to increase the allocations against a background where we know more money is not coming into the Exchequer, that will not solve that problem…I would put my record in this area against Deputy Stanton any day of the week. I would put my record on this issue against anybody in the House and my record will prove it and has proven it…It was the Cinderella part of the services for a long time and there were significant moneys involved. In fairness to those involved in the area, this has often been fully acknowledged and recognised. The point is that we have a problem now and the problem we need to address is how we re-organise the provision of those services to try to maintain sufficient moneys at the frontline and a value for money audit is required for that. It is ongoing and will be available to the Minister by August or September. A question was asked on whether international conferences on health issues will come to this country, which is part of the subhead mentioned with regard to expenses. No Member of the House would stand over non-essential spending in some of these areas but there are aspects of the work of the Department that are ongoing. I want to come back to the central point. Some of the issues raised by Deputy Kenny can and should be answered in full. They will be answered in full but I am explaining the context in which all of this is happening. The real point to make is that every effort will be made to work with people providing disability services. How do we reduce non-frontline expenditure so we have sufficient funding for the frontline? We all know some element of support expenditure has to be provided, no more than one cannot have a consultant in a hospital providing proper services without secretarial support. We all understand it is not a black and white issue but it is an issue that needs to be addressed and will only be addressed if we re-organise how the services are provided. That is what we intend to do; that is how we intend to work with the services. In the meantime, we have to try to address the difficulties that arise in the context of the budget. Against the background of last year’s budget, an extra €20 million over the 2009 spend was provided for disability services. In total it is in the order of €1.6 billion. I recall when I announced in this House a five year programme for the development of disability services what the initial baseline figure was. That aside, it does not take away from the fact that issues arise today that we want to try to resolve but they can only be resolved if we approach it in the way I suggest…To suggest it would be resolved otherwise, simply by providing for more expenditure regardless of the budget situation, is not being honest or straightforward with the people with whom we want to engage on this issue.

Deputy Enda Kenny: The best value is in the voluntary sector and the Taoiseach knows that. 

• Adjournment Debate: Funding to services for people with  disability

Deputy Denis Naughten (FG): Outside the gates of Leinster House yesterday, the parents and families of children with intellectual disabilities protested about cutbacks in the services provided to such people. At the same time, certain Government Deputies had a crisis of conscience in this Chamber with regard to stag hunting. We have not heard a dickie bird from them about the decision to give €22,000 million to a septic bank. The most vulnerable people in society, many of whom cannot speak for themselves, will have to carry on their shoulders the debt resulting from that decision. The crisis I am raising has resulted from the decision of the HSE to take €15 million more than was agreed from the intellectual disability budget. People with intellectual disabilities, along with their families and carers, are terrified that services which are vital to people with disabilities will be withdrawn. I wish to refer to a letter I have received from the Ballinasloe Advocates group, which highlights the massive cuts that are proposed to vital services in the east Galway and south Roscommon area. The group in question comprises parents who are trying to manage as best they can, sometimes in intolerable situations, as they care for people who pose various challenges and require care 24 hours a day, seven days a week, 365 days a year. The letter states “we strove and begged during the “Celtic Tiger” years and received what could be described as minuscule improvements”. They were given the scraps from the table, year in year out, and now they are facing severe cuts in the services they need. The HSE has left the Brothers of Charity in Roscommon and Ballinasloe with no option other than to introduce significant restrictions. This significant impact of this measure on valuable day, respite and residential services will cause untold hardship for parents of people with intellectual disabilities. It is likely that some services will have to close completely from January 2011. These cuts will lead to the amalgamation of a number of homes, with consequent effects on residents. I have already written to the Minister of State, Deputy Moloney, to express my health and safety concerns about one of these facility in County Roscommon. The unexpected moratorium cut that was proposed and introduced by the HSE has caused us enormous problems. The Brothers of Charity are unable to fill vacancies that arise, even in front line positions, despite the Government’s contention that the moratorium would not affect vital services. This matter has been brought to the attention of local HSE staff and the Minister of State, Deputy Moloney. It is galling for service providers to be told by the HSE and the Government to cut their non-existent administration budget, at a time when the Department of Health and Children has increased its budget for office supplies by 67%, its budget for consultancy services by 600% and its entertainment budget from €100,000 to €200,000. These appalling facts demonstrate the lack of priority of this Government, which is turning its back on the most vulnerable people in our community.

Deputy Ulick Burke (FG): I thank Deputy Naughten for sharing his time with me. I also wish to highlight the plight of many elderly parents and siblings in the Ballinasloe and south Roscommon area who care for young adults and children with learning disabilities. The Brothers of Charity have indicated that a cutback of €2.75 million will have to be imposed this year. Such a restriction would make it impossible to deliver the services to which people are accustomed. Over the years, these parents have begged and cajoled various Ministers to provide funding for the services needed by such people. As Deputy Naughten said, care is required in many cases 24 hours a day, seven days a week, 365 days a year. What are elderly parents supposed to do if these services are closed? Will the Government take responsibility for making provision for the most vulnerable people in our society, who need help now? Many elderly parents are worried about what will happen to their children when they have moved on. The Acting Chairman, Deputy Michael Kitt, is familiar with the issues in the Ballinasloe area. The same cutbacks have been suffered by each of this country’s 60 voluntary organisations that assists children with learning disabilities. How can any Minister or Government stand over such cuts? I hope the Minister of State, Deputy Barry Andrews, will clearly outline in his reply that emergency funding is to be provided to allow these parents to get some relief.

Minister of State at the Department of Health and Children (Deputy Barry Andrews): I am responding on behalf of my colleague, the Minister for Health and Children. I thank Deputies Naughten and Burke for raising this matter. I appreciate that the Acting Chairman, Deputy Michael Kitt, is also interested in it. I am pleased to have an opportunity to outline the position with regard to respite services for people with disabilities. I wish to reaffirm the Government’s commitment to the national disability strategy. We will continue to pursue the long-term goals and objectives of the strategy in the coming years, in partnership with all the stakeholders. Our commitment in the areas of disability and mental health is consistent. Approximately €1.6 billion is spent by the health services on disability programmes, including residential, day care, respite, assessment and rehabilitation services, each year. Despite the current economic climate, the HSE’s national service plan for 2010 makes provision for additional funding of €19.5 million to meet the anticipated growth in demand for disability services in 2010. The Government appreciates the valuable contribution the voluntary sector makes to the provision of services, including respite care, to people with intellectual disabilities. Respite services are being reviewed by the HSE on an ongoing basis, and the majority of Local Health Offices have reported that services are being maintained. Over 4,500 people with intellectual disability avail of respite services nationwide and only a small number of service providers have taken the decision to cut these services. In all areas, HSE disability managers are working closely with agencies to maintain respite service provision at 2009 levels as far as possible, thereby ensuring that those with the most urgent need for respite services are prioritised. The HSE has informed the Department of Health and Children that it will continue to work in partnership with all service provider agencies in an effort to maintain core service delivery and respond to emergencies, as outlined in the service plan. The HSE acknowledges the challenges service providers are experiencing and the particular challenges facing all health services in 2010. In this context, it is vital that all service providers including the voluntary sector, 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 will work with the voluntary service providers to deal with issues that arise from funding allocations, to ensure the needs of service users are prioritized and addressed. Disability service providers were asked to submit their plans for the maintenance of service levels within available resources taking the following into consideration: items of expenditure which do not immediately and directly impact on frontline services; opportunities for rationalisation; the manner in which services are delivered; opportunities to reduce costs by sharing services and-or activities with other agencies; and the cost of back office administration, all other unnecessary costs, and rationalisation of general management structures. The HSE will continue to work with the voluntary service providers to streamline costs and identify areas where efficiencies can be achieved without impacting on frontline services. There has been a continued expansion in the availability of respite support services. These services have grown significantly in recent years with 307 new places and 61 enhanced places provided since 2005. More than 4,500 people avail of respite services funded by the HSE. This service has supported people to continue living with their families and in their communities. The Government is very much aware of the importance of respite service provision for the families of both children and adults with disabilities, and will seek to ensure that frontline services are protected as far as possible.

PARLIAMENTARY QUESTIONS

• Number of persons waiting to receive a service or therapy

Deputy Joe McHugh (FG): asked the Minister for Health and Children the number of persons waiting to receive a service or therapy under each category of service in the community care section of Donegal Health Service Executive; the average waiting time in each category in tabular form;

Minister of State at the Department of Health and Children (Deputy John Moloney): As the Deputy’s question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply.

• Reason Dept. Education and does not have a sectoral plan under Disability Act

Deputy Joe McHugh (FG): asked the Tánaiste and Minister for Education and Skills the reason her Department does not have a sectoral plan under the terms of the Disability Act; if she will introduce such a plan;

Tánaiste and Minister for Education and Skills (Deputy Mary Coughlan): My Department was not required to develop a sectoral plan under the Disability Act 2005. For the Deputy’s information the six Departments required to develop sectoral plans under this Act were the Departments of Health and Children; Social and Family Affairs; Transport; Communications, Energy and Natural Resources; Environment, Heritage and Local Government; and Enterprise, Trade and Employment. Following recent transfers of functions involving a number of Government Departments, including my own, the issue of which Departments carry responsibility for sectoral plans under the Disability Act 2005 is currently being examined in the context of a review of the operation of that Act. This review is underway and is being co-ordinated by the Department of Community, Equality and Gaeltacht Affairs.

• No. of SNAs employed by Dept. in 2010-2011

Deputy Joe McHugh (FG): asked the Tánaiste and Minister for Education and Skills the number of special needs assistants that will be employed by her Department for the 2010-2011 academic year;

Tánaiste and Minister for Education and Skills (Deputy Mary Coughlan): As the Deputy will be aware, the National Council for Special Education (NCSE) is responsible, through its network of local Special Educational Needs Organisers (SENOs), for allocating resource teachers and special needs assistants to schools to support children with special needs. The NCSE operates within my Department’s criteria in allocating such support. 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. SENOs then carry out assessments of a child’s special educational needs, on request by parent or schools subsequent to which they recommend appropriate resources, including special needs assistant provision. While mainstream teaching posts are allocated at the start of a school year and remain for the full school year, the allocation of SNA posts has never been tied to the start of the school year. This flexibility is designed to assist schools who may not have been able to access relevant  professional reports in advance of the start of the school year, or who may have new pupils with special educational needs enrolled during the year. Similarly, while new SNA posts may be allocated throughout the school year, some SNA’s may also leave during the school year where a child may leave or move school, or may achieve a greater level of independence. As this process is continuous throughout the life of a school year, it is therefore not possible to say how many special needs assistants will be employed by my Department for the 2010/2011 academic year. There are currently over 10,000 SNA’s employed throughout the school system. I wish to confirm for the Deputy that my Department is very supportive of the SNA scheme. It has been a key factor in both ensuring the successful integration of children with special educational needs into mainstream education and providing support to pupils enrolled in special schools and special classes. The SNA scheme will continue to be supported and the NCSE will continue to support schools, parents, children and teachers and resources will continue to be allocated to schools to meet children’s needs in line with my Department’s policy.

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