Dáil Éireann - Volume 346 - 30 November, 1983

Ceisteanna—Questions. Oral Answers. - Residential Care for Physically Disabled.

9. Dr. O'Hanlon asked the Minister for Health the number of physically disabled persons in residential care.

Mr. B. Desmond: A survey has shown that there are 802 physically disabled people in residential care.

Dr. McCarthy: Are all of those 802 patients in specialised residential care homes or are some in hospitals as such?

Mr. B. Desmond: For the most part in special residential care but, as the Deputy [695] knows quite well, a number are in psychiatric hospitals, for example, a particular matter which should be a source of shame to everybody.

Mrs. Geoghegan-Quinn: When the Minister talks of residential care does he include in that the Cheshire Homes?

Mr. B. Desmond: Yes, as far as I am aware.

Mrs. Geoghegan-Quinn: Has the Minister figures for the number of patients in Cheshire Homes?

Mr. B. Desmond: I do not have that information before me but I can send it to the Deputy.

Dr. McCarthy: Why is it, in the present day and age, that we still must have people who are physcially disabled in psychiatric hospitals?

Mr. B. Desmond: I suppose the short answer to that is they do not have the same political influence as the Deputy and I have.

10. Dr. O'Hanlon asked the Minister for Health if he is satisfied with the residential care accommodation available to the physically handicapped; and if he has any plans to cater for their specific needs.

Mr. B. Desmond: I am satisfied that there is a need to develop additional residential care facilities for physically handicapped people.

I will be asking the health boards to pay special attention to the residential care needs of physically disabled people when drawing up their priorities for capital development.

Dr. McCarthy: Does the Minister intend in any way to effect alterations in the type of residential care available because he must be aware of the fact that most of these buildings are quite old fashioned, were designed more for the poor law type of health care which obtained many years ago than for the present day? [696] Is he further aware that many of these patients have no privacy, that they are literally institutionalised in the residential care homes in which they are accommodated at present? Has he any immediate plans to alter this situation?

Mr. B. Desmond: I have menticned a particular number. I might advise the Deputy that a review of residential care for the physically disabled began in July 1980. A survey found that there were 1,482 people with a handicap which substantially affected their mobility in no less than 137 institutions throughout the country. Excluding those whose primary condition was mental illness or mental handicap, who were better cared for in mental hospitals or mental handicap centres, this left 802 people whose primary handicap was physical. Many of these appeared to be inappropriately placed. For example, 28 per cent of them were in geriatric institutions, even though the survey was confined to people under 65 years of age, and a further 20 per cent were in mental handicap centres. Therefore, there is a great deal of work to be done. Perhaps we could do it were we to close down a couple of mental hospitals and spend the money in that other direction.

Mrs. Geoghegan-Quinn: What is the attitude of the Minister and his Department to the Cheshire Homes already in existence for the care of physically handicapped people? Furthermore, what would be their attitude in relation to those at present in the planning process?

Mr. B. Desmond: The Cheshire Homes have done quite exceptional work. I opened a substantial home in Bohola in County Mayo. They are a voluntary organisation, with an enormous capacity to accumulate substantial sums of money to spend on their services, and my Department certainly look with considerable favour on their capital works and particularly on the extent to which they are able to administer their affairs, availing of the enormous goodwill there is in the country for voluntary work within such homes. As the Deputy well knows, [697] the cost of employing fulltime health board nursing staff in such institutions is of great dimension. Therefore I assure the Deputy that I look with great favour on the work being done by the Cheshire Homes.

Mr. Hugh Byrne: Arising out of the Minister's reply——

An Ceann Comhairle: Deputies, Question Time was never meant for comfortable little tête a têtes across the floor.

Mr. H. Byrne: I think you will agree, Sir, that this is a vitally important issue. Is the Minister aware that all statutory and some voluntary agencies in Ireland do not draw a distinction between people being ill and in need of medical treatment and those who are physically disabled and, therefore, in need of a home with home supports? Is he further aware that, consequently, many disabled people who are in need of a home are hospitalised for life? Since the Minister himself has just admitted that it is a source of shame that so many of our disabled people are in mental institutions, what measures does he intend taking in the immediate future to resolve that situation?

Mr. B. Desmond: The first method I propose is a draft Green Paper on Services for the Disabled. Inherently in that Green Paper there are proposals for additional capital allocations into this area. I would make the point that if the Opposition and indeed members of the Government for that matter, insist that I should spend about £40 million a year capital on acute hospitals and not permit me to divert resources into the area of greatest need, namely the area raised by Deputies, that of the disabled, both mentally and physically handicapped, it will not be done.

The incessant pressure is for £50 million hospitals all over the place. As a consequence, in recent years I estimate that we have spent £300 million to £400 million on acute hospital capital works when at least £30 million of that would have transformed the situation I [698] have referred to. Psychiatric patients, disabled people, mentally handicapped people, do not have much voting power, not as much as consultants, doctors and nurses in hospitals. Politicians, regrettably, have responded in the wrong direction.

Dr. McCarthy: I wish to make a few points——

An Ceann Comhairle: This is becoming an Estimates debate.

Dr. McCarthy: The Minister would like to blame the Opposition for the Department's ineptitude. We cannot be responsible for that.

Mr. B. Desmond: My Department are not inept.

Dr. McCarthy: The Minister has conceded the deficiencies that exist. Therefore, as a pro tem procedure, would he allow increased vocational training in these institutions so that the people in them can be treated in a more humane manner, so that they will have a better insight into the possibilities around them, so that they will not be treated as sick people who are just physically disabled but not sick.

Mr. B. Desmond: I must point out that a number of Ministers, notably two former Ministers of the Deputy's party, committed capital funds in some cases in irreversable directions, because the contracts were signed. As a consequence, we now have examples, like Beaumont, where we have a £55 million hospital unopened. It is arguable that we could have a much better facility if a substantial proportion of that money had been diverted. We had a major expenditure of £40 million in the Mater and as the Deputy, as a member of a health board, should know it is not the Department who are at fault but Ministers for Health promising hospitals all over the country and major extensions with more beds, when that money should have been spent on the provision of the facilities the Deputy is talking about.

[699] Mr. H. Byrne: That is dodging the issue.

Mr. B. Desmond: Deputy Haughey became Taoiseach on foot of many such promises when he was looking for votes in 1979.