Disabled bear brunt of HSE cuts while millions are squandered

Closure of St Louise's daycare centre shows the terrible impact of cuts on residents, says Maeve Sheehan

SHIREEN O'Brien doesn't have to rise at any particular hour. Usually she wakes at between 8am and 10am and the care staff at St Louise's, the Daughters of Charity-run residential facility, will help her out of bed. They will help her wash and dress, after which she will go for breakfast in the kitchen of her independent bungalow -- one of six in a secure compound.

Now aged 40, she has lived in Glenmaroon in Chapelizod since the state-of-the-art facility opened two years ago, along with 53 other women.

She has a severe intellectual disability and is unable to live alone. She returns to her parents' home each weekend.

There are six to a bungalow and each has their own room -- a first, according to Shireen's mother. In all the previous residences in which her severely disabled daughter has lived since the age of eight, Shireen had to share a room.

Breakfast over, the day now stretches ahead. Shireen and the other women used to go to the daycare centre each day, a purpose-built unit in the compound. It was part of their routine. Specialist teachers developed a tailored care plan for each of the women, and Shireen's included art classes and music, which she loved. There were also exercise classes, therapies such as massage and reflexology, a hair-dressing room, and a multi-sensory room.

The parents and families of these women chipped in, raising €68,000 through various fund-raising efforts, to buy four people carriers so they could be taken for walks in the nearby Phoenix Park.

Although open for two years, the official launch of St Louise's took place in May with Michael Finneran, the junior environment minister, doing the honours on the bright sunny day last May before he left in his chauffeur- driven car for his next appointment. Four weeks later, in early June, the daycare centre was closed by the Daughters of Charity because of staffing shortages.

The charity is struggling to care for 470 residents in Dublin alone, following a €4.5m budget cut this year on top of pay cuts for staff, according to Walter Freyne, chief executive.

Each day since, Shireen has passed hour after hour in a communal day room, watching cartoons on television. The highlight of her day, weather permitting, is a walk inside the compound.

Shireen probably doesn't grasp that the daycare centre has closed and that staff are no longer available to pile them into the cars -- now gathering dust -- to go on outings to the Phoenix Park or to the shops.

Shireen does not have the mental capacity to understand that budgetary cutbacks imposed by the Health Services Executive mean that the Daughters of Charity have had to let staff at the end of their contracts go, can't hire new staff and can't replace those who are off sick or on maternity leave.

Nor does she have the ability to vocalise her feelings, but the inactivity is taking its toll. When her parents, Anne and Kevin O'Brien, called to see her last Wednesday, Shireen burst out the door to greet them and said she wanted to go home. That was a first, according to Anne and Kevin.

"That gives you the impact of all these cuts," said Anne. "You have increased behavioural problems, increased sedation, because the ladies' needs cannot be met."

In the past few weeks, thousands of marchers -- many of them outraged families -- have taken to the streets in protest at the insidious budget cuts to voluntary organisations providing respite care to the severely disabled.

The HSE spends €1.5bn a year on 42 voluntary agencies that provide respite services to people with disabilities. Having already introduced cuts last year, the HSE recently imposed a second cut on the voluntary groups. The HSE claims it's two per cent. The voluntary groups claim the cuts are closer to 4.5 per cent.

"We have read all of the stories; the incredible, incredible waste of money in this country. Most of all, we feel, why should our daughter have to pay for the greed and the incompetence of others? Because that is exactly what's happening," said Anne.

"Everybody in the country has taken their cuts. We have all paid the price. But certainly it had never ever crossed my mind that the handicapped would be included in this. Never ever."

When it comes to waste, Mary Harney could start looking in her own Department.

There is the unaccounted- for €2.3m the Department of Health squandered on a Siptu slush fund set up in 2004. On top of that is €60m forked out over five years to train porters and caterers in its employ.

The HSE meanwhile has spent more than €11m in three years to allow its union bosses and managers to mingle, talk shop and attend conferences as part of the HSE Partnership Forum.

According to Fine Gael, entertainment allowances in 13 government departments were more than doubled this year. Ms Harney's own department has been allocated €200,000 to spend on launches, conferences and general spin doctoring.

Then there are the quangos. A year ago, economist Colm McCarthy's An Bord Snip Nua said the State could save €5.3bn by abolishing or merging these entirely dispensable State agencies. Brian Lenihan, the Finance Minister, promised to cut 30 by 2010. So far, according to a study published by the Institute of Pub-

lic Administration last month, only 18 have been abolished. A handful of others have been merged or subsumed back into departments. And no-one appears to be able to say how much money this half-hearted cull has saved, least of all the Department of Finance.

The process is not as simple as it looks, the Government has argued. There are people's employment contracts to consider, new laws to pass before overlapping agencies can be merged into one. The National Consumer Agency and the National Competition Authority are a case in point. Colm McCarthy recommended that they be merged, but the Government has yet to pass the necessary laws to facilitate the merger. While we wait, these two expensive agencies will have swallowed up €7.2m and €4.7m by the end of the year.

The Irish Council for Bioethics, a quango which ponders medical ethics,used to be an agency of Batt O'Keeffe's Department of Enterprise. But he got shot of it in April, kicking it back to the Department of Health along with three of its staff and a budget of €400,000. Mary Harney could shut it down and divert its €400,000-a-year budget to respite services.

As with most rows about our health service, there is more to this than money. The Government claims there are too many agencies and that they are stumbling over each other in providing duplicate services. Mary Harney suggested that some managers were overpaid, describing their salaries as "disturbing". Her junior minister, John Moloney, questioned why the Brothers of Charity needed six regional chief executives on salaries ranging from €90,000 to €113,000. He also hinted at an overreaction by the Brothers of Charity when he questioned why, with a €25m budget, the Brothers should need to close three respite centres because of a funding shortfall of €145,000?

To Anne, this is astonishing. "There has to be some way that money can be saved without affecting the lives of the most vulnerable people in our society. I think it's an absolute scandal that this has to happen."

As her husband pointed out, the rest of us can tighten our belts, but people like Shireen cannot do anything at all. "They have to take what they get," he said.

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