^^ Respite Care Services ^^

   Deputy Fergus O’Dowd: I thank the Ceann Comhairle and other Members of the House for facilitating this debate.  It is hugely important that carers are recognised and supported.  It is a fact that there has been a crisis in respite services in County Louth.  I welcome the interest shown by all my colleagues in Leinster House both in the Dáil and Seanad in resolving this issue.  I acknowledge the intent and commitment of the Minister of State, Deputy Finian McGrath, in respect of dealing with this issue not just in County Louth, but around the country.

It is shameful that families have been left in this appalling situation for too long.  When one sees how people like Jacinta and May in Dundalk and others – I am just using first names – look after their families and care for them and their total commitment, one sees how all their lives are devoted to their family members.  They look after them at home but when they need urgent care and respite, it is not available in County Louth.  I know a recent edition of “Prime Time” identified what we need to do.  I welcome the Minister of State’s commitment to solving this problem and that he came to Drumcar to see an issue there in a school for children with disabilities.

It is very important that, as our economy improves, the funding, services and support are put in behind those who care most and who have the least amount of help.  I know that in CHO8, in which the HSE operates in our area, over 100 people are waiting for respite care, which is a huge number.  It is unacceptable.  We have gone through a very difficult period economically.  Now that our economy is restored, the funding must be found and I hope the Minister of State has good news for us today.  I will hand over to my good friend and colleague, Deputy Breathnach.

 

   Deputy Declan Breathnach: Yet again, we are here highlighting the plight of the families in Louth looking for respite care for their loved ones.  When I came into this House, I gave a commitment that I would champion the cause of people with disabilities collaboratively with my colleagues in the Dáil and Seanad.  We have continued to highlight that issue to the Minister of State.  Like Deputy O’Dowd, I thank the Minister of State for his interest in trying to solve the problem not just in Louth, but across the country.  In respect of Louth, it took the “Prime Time” programme entitled “Carers in Crisis” for many of us to realise the difficulty faced by these families due to the lack of respite care, which is clearly not just a crisis in Louth, but across the country.  These families have been left alone to cope.

Despite all the parliamentary questions we have put and all the opportunities to raise the matter under the Order of Business or Questions on Promised Legislation, this is the second, if not the third, Topical Issue on this matter.  A resolution can be found.  We have put a series of proposals to the Minister of State over a period of time and I am sure Department officials have looked at them.  Praxis Care has recently purchased a property in Dundalk and the Talbot Group has an ideal property in Balbriggan.  I am sure that with the Minister of State’s help and encouragement, a resolution can, hopefully, be found in my constituency.  The figures in County Louth have always been skewed because of the St. John of God operation in Drumcar and the funding it receives, which covers a lot of people across the country.  I would welcome a statement from the Minister of State that these facilities, which are badly needed in Louth, will be provided urgently.

 

   Minister of State at the Department of Health (Deputy Finian McGrath): I thank Deputies Breathnach and O’Dowd for lobbying me for many months on this important issue.  I also thank the Deputies for giving me the opportunity to outline the position regarding the provision of respite services in County Louth.  Let me make it clear at the outset that the Government’s ongoing priority is the safeguarding of vulnerable people in the care of the health service.

We are committed to providing services and supports for people with disabilities that will empower them to live independent lives.  In recent months, I have spoken to many people with disabilities and their families and carers.  The same point has been raised again and again on the absolutely urgent need for increased respite care throughout the country.  I accept it as a valid argument and that is why I appeared on “Prime Time” last week to face the music and deal with the issue.  I have made it very clear to my colleagues in government and after much discussion, my colleague, the Minister, Deputy Simon Harris, and I have secured an additional €10 million for the HSE, specifically to enhance respite care in the disability sector.  We agreed that extra €10 million at Cabinet.

Many people with disabilities are being cared for by very elderly parents who are finding it very hard to cope.  Other carers simply do not have the hours in the day to look after other members of their families and, just as importantly, their own health and well-being.  The full details of the services to be provided with the additional €10 million will be contained in the HSE’s detailed operational plan.  I have made it clear that this money must be ring-fenced for respite services within the disability sector and that it must be targeted at those who are most in need.  I am pleased to inform the House that €8 million will be provided for nine new dedicated houses for respite in each community health area, plus an additional three houses in the greater Dublin area to respond to the very high demand for respite in this area.  These additional 12 respite houses will provide approximately 19,000 respite nights yearly to the people living in those areas.  In addition, a further €2 million extra funding will be used for innovative respite solutions, such as home sharing and extended day services, to provide assistance where people need it most.  I will be keeping a very close eye on how this additional funding is put to work and I will be requiring the HSE to give the utmost priority to putting these new facilities and services in place without delay.

I accept that the provision of respite services has come under additional pressure in the past number of years.  More children and adults are now seeking access to respite and the changing needs of people with a disability are also having an impact, as they, along with the rest of the population, live longer lives.  A Programme for a Partnership Government recognises the need for respite services to be developed further and I am fully committed to ensuring this happens.

In the context of respite services in County Louth, discussions are ongoing at CHO area 8 level regarding the emerging need for additional respite services and the options to be developed to meet these needs.  The HSE continues to work with agencies to explore various ways of responding to this need in line with the budget available.  The additional funding I have announced today will include the development of respite services in CHO area 8, including County Louth.  The officials in CHO area 8 are familiar with the TaIbot Bower House proposal for respite services.  Scoping out the most efficient way of commissioning respite services with this new money will be an immediate priority for the HSE to ensure services are brought on stream without delay.  The Deputies will appreciate that any proposals can only be considered within the funding available to the HSE and must adhere to a rigorous procurement process.

I warmly welcome the extra €10 million for respite services because it is urgently required.

 

   Deputy Declan Breathnach: I welcome the Minister of State’s announcement.  It will be music to the ears of the many families and disability groups who have encouraged us to harass and harry the Minister of State over the past number of months.  I had no doubt of the Minister of State’s concern to have this matter resolved.  I welcome his commitment to the allocation of €10 million and his commitment to make sure one of these facilities will be based in Louth.  Further to that, it is most important that with the age profile of families and the growing numbers who will need these services that we continue to enhance them in the years to come.  With that in mind, the issue of the funding of the St. John of God in Drumcar, which came to almost €32 million, needs to be examined in terms of whether we are getting value for money in delivering those services.  I will speak on that matter later.  I thank and commend the Minister of State for bringing some respite to a very difficult situation in Louth.

 

   Deputy Fergus O’Dowd: I agree absolutely with the Minister of State and my colleague opposite that this is really good news for everybody who needs respite care.  It is a start but it is not the final answer.  It is a way of finding a reasonable solution.  There is nothing reasonable about people who are on their own who cannot cope.  There is nothing reasonable about a person bringing a family member to a house in the middle of the night, only to be refused entry and having to go to an acute hospital instead to take up an acute bed with a security person outside the door and all sorts of other issues.  It is an unacceptable situation.  This will definitely help to resolve it.  There is no doubt about that and I welcome it.  I welcome the commitment to ongoing discussions and the Talbot Bower House proposal, which I visited.  It is a very fine place.

This is an issue on which all political parties stood together.  Fianna Fáil, Fine Gael, Sinn Féin and the Labour Party stood together to push for something and we got it.  It is a positive result for a community that needs 100% support.

 

   Deputy Finian McGrath: I thank Deputies Declan Breathnach and Fergus O’Dowd for repeatedly raising this issue.  I am very much aware of the importance of access to planned respite which ensures that people with disabilities receive opportunities to socialise separately.  It facilitates families having a break from caring because it is very difficult.  Respite services may vary according to the excess needs of the individuals and their carer.  The model of respite is changing and although some require overnight respite, others prefer to benefit from day respite.  The number of overnight respite places has been reducing as persons with disabilities seek alternative models such as day respite or extended day care.  We will also look at those areas.  For example, 42,552 day respite services were provided in 2017.  Personally, and throughout my political career, I have always advocated for the rights of people with disabilities.  I understand and acknowledge the value and importance of respite care for people with disabilities and their families.  I hope this funding will enable people to get a well-deserved break and to maintain their own health and well-being.

As I said earlier, I will keep a very close eye on how the additional funding is put to work.  I will require the HSE to give the utmost priority to putting these new facilities and services in place without delay because it is a very important part of our disability services.  We put €1.763 billion into the social care plan in 2017 and we have to ensure it goes to people with disabilities and their families and carers.  That is where our priority should be.  The 2017 plan deals with 5,720 people with a disability who avail of day-based respite services.  We have another 2,500 who avail of respite services, such as holiday respite or occasional respite and we also have other respite services.  We have 128 new emergency residential places, which is a priority issue for me.

I thank my colleagues for their support.  We will fight on and develop the services but above all the services will operate in the interests of the person with the disability.