Seanad Éireann - Volume 157 - 12 November, 1998

Adjournment Matter. - Respite Care Facilities.

Dr. Henry: The research department of the National Rehabilitation Board recently produced a comprehensive booklet on respite care facilities for people with disabilities. Respite care has been defined as “the temporary care of people with disabilities of all kinds to relieve their social, physical and emotional stress and to provide relief to their primary care givers”.

The booklet lists, on a health board by health board basis, those homes which can offer respite [145] care. Looking at the lists one would believe there was plenty of help available but this is not the case in practice. The booklet is also divided into sections of establishments which will cater for people with learning disabilities, physical disabilities and a combination of both.

My research assistant, Ms Erin Dunn, telephoned a cross section of these homes, on my behalf, to ask about the availability of places and I discussed her findings with the National Rehabilitation Board. The response from the agencies was, in the main, depressing. The vast majority could not tell when respite care would be available nor for how long. Some said they had admissions committees which decided on the individual circumstances. Certainly there was no one who said “Yes, of course, help is available”.

This was very much in line with the comments the Minister may have heard made by parents on television and in the press recently. Mr. Joe Little did an excellent interview on RTE's “Six-One” news a couple of weeks ago, showing the severe difficulties of a woman with an adult daughter with learning and physical disabilities and her problems in finding respite care.

The programme “Would you Believe” last week interviewed four mothers with younger children with similar disabilities and their plights would move a heart of stone. All wanted to care for their children but all longed for just a little life of their own. Parents are now starting to get angry and this issue will be raised more and more. We profess to be a kind, loving and caring population. Now we have money at last and I am glad to see the increase for the Department of Health and Children in the recently published Estimates for the Public Service. Surely people like these are the first we should help.

About 40,000 people are involved in caring for others in the home and about 9,000 are caring for children. Some of these people are dealing with relatives who are doubly incontinent as well as having severe medical problems and they are being ground down. Sometimes when I meet carers I do not know which person is more in need of care — the carer or the one to whom the loving care is being given.

No matter how parents try dealing with a disabled child it affects the other children in a family and, indeed, it may lead to the breakdown of the family because the stress may be too great. Some people simply want breaks for things like family weddings or to be sure they can go on holidays with the other children. Frequently, however, even these small requests have to be refused.

We are desperately short of residential accommodation and any that is available is immediately taken up by emergency cases so that planning respite care is impossible. About 1,500 places are needed at the moment. Agencies can only cater for their own clients so that those cases which may fall outside district groups are in a very difficult situation. There are lay people who are good and kind and take children who are not too difficult to deal with on a charitable basis. They are [146] to be much applauded. Such people have made some sort of normal life possible for the parents of such children. The most severe cases, however, need professional help.

The agencies are there and if they had the money they could respond. At present, they have to ration help. Surely it is time, with the increase in money that has been given to the Department of Health and Children, to expand the facilities to a level which will cater for all those who need residential care.

About 1,500 places are needed. Recently I was contacted by a man in his eighties about his 47 year old son to see if I could get a place for him. His wife is dead and he has cared for his child without help for nearly 50 years. If beds were available they would free up facilities for respite care.

A society should be judged on how it treats its most vulnerable citizens. The Federation of Voluntary Bodies has run an advertisement in recent days in the newspapers asking for money to be taken from the budget surplus to support the needs I have mentioned. It is dreadful to see the added stress of raising awareness and money to run organisations being put on carers. If the Government does not respond to requests for help now, it will end up paying for care for the carers as well. Does it have to come to this before we will support their reasonable requests?

Minister of State at the Department of Health and Children (Mr. Fahey): I am glad of the opportunity to clarify the Government's policy on this important issue. The report referred to by the Senator is a directory of available respite care facilities throughout the country and makes no recommendations or comment about the adequacy of such facilities. However, I am conscious of the fact that respite care is a service in need of on-going development.

The Govemment's policy, as set out in An Action Programme for the Millennium, is a commitment to ensuring that the needs and aspirations of people with disabilities and those of their families, carers and advocates are comprehensively addressed through a wide range of measures in the health, social, leisure and sporting areas.

With regard to the provision of health services, the overall objective in relation to the development of services for people with disabilities — that is, people with physical and sensory disabilities and those with mental handicap — is to enable each individual to achieve his or her full potential and to live within the community with the maximum degree of independence possible. This involves the provision of a broad range of support services, including respite care.

The report of the review group on health and personal social services for people with physical and sensory disabilities, “Towards an Independent Future”, published in December 1996, and “An Assessment of Need for Services to Persons with a Mental Handicap, 1997-2001”, published [147] in April 1997, set out in detail the requirements for the development of these services.

On foot of the review group report, the previous Government made available an additional £3.695 million in the early part of 1997 for the maintenance and development of services in this sector. Since coming into office, the Government has invested an additional £19 million in these services, £10 million in the latter part of 1997 and a total of £9 million this year. The £10 million in 1997 included a capital grant of £600,000 to the Irish Wheelchair Association for the development of its national residential respite care centre, Cuisle, in Roscommon, which provided an additional 60 places for people with physical and sensory disabilities. Of the £3 million made available for development of these services this year £500,000 is being allocated by health boards to the development of respite care facilities.

The Government is committed to the development of services for people with mental handicap in line with “An Assessment of Need” and to this end the Minister for Health and Children has provided an additional £25 million for the development of these services in the last 12 months. He has also put in place a £30 million capital programme which began this year and will run over the next four years. At the end of this year more than 200 new residential places and more than 300 day care places will have been provided for the mental handicap sector and services will continue to be expanded and enhanced as a result of the allocation of these resources. While the additional residential places include some respite [148] facilities, further development of specific respite care services has been identified as a priority development.

I assure Senator Henry that the Minister for Health and Children who is in Brussels today and cannot be here is very conscious of the need to expand respite care services. Indeed, such services are regarded as one of the priority areas for development in services for people with disabilities. Respite care services have been highlighted in the reports “Towards an Independent Future” for people with physical and sensory disabilities and “An Assessment of Need for Services to Persons with Mental Handicap 1997-2001” and the Government is committed to implementing the recommendations of these reports.

This question was discussed last night in Dáil Éireann and I met some of the parents later. I have no doubt that the needs of mental and physically handicapped people must be at the top of our priority list. Even within the Department various needs are competing for resources but when one hears the parents of handicapped people speaking about their children — and a good friend of mine is the parent of a severely mentally and physically handicapped 14 year old — one is left in no doubt that they must be our top priority. I hope the Government will devote the necessary resources to this area in this year's Estimates and in the budget.

Dr. Henry: I am absolutely assured of the Minister's commitment to this cause. I thank him very much.

The Seanad adjourned at 4.15 p.m. until 2.30 p.m. on Tuesday, 17 November 1998.