Carol Nolan warns of crisis in respite and disability services

I want to raise with you the ongoing crisis surrounding the allocation and provision of respite services, particularly for children and adults with a disability. As you will be aware, this is an area that has effectively been in deep crisis since the National Disability Strategy was launched in 2004. The Minister of State, Ann Rabbit, who I want to commend for her compassion and her strong commitment to improving this issue, has accepted that further progress on addressing the deficit in services is needed. The situation has not been helped in the last few years with the transfer of functions in this area from the Department of Health to the Department of Children, Equality and Disability, in addition to the chaos that COVID brought about with the closure of residential day care services. There is a lack of cohesion and an inability to precisely pin down where the responsibility for respite actually lies. This is compounded by the issue of transport services for adults and children with a disability. A family is allocated a respite place only to find out that there is no transport, or they have transport and then they find out that there is no respite bed. I am aware that Minister Rabbit recently announced funding for the upgrading and improvement of transport options for HSC-funded disability organisations, and that is certainly welcome. But what good is that if there are no residential or respite services for people to be transported to? Last week, Minister O'Gorman and Minister Rabbit issued a statement on the impact of the war in Ukraine on persons with disabilities, saying, Ireland will not leave people with disabilities behind as we respond to the crisis. Leaving no disabled person behind is exactly the type of ambition that we need. That being said, there are very many families out there who will have heard or read the statement and questioned not the will, but the actual capacity of the State to deliver on that promise. They will have looked at their own children or young adults who are falling between the cracks in terms of child and adult disability services. Where are the services going to come from, Taoiseach? How can we talk of leaving no disabled person behind when it is clear that we already have a system that is manifestly unable to provide even the most minimal levels of respite care for thousands of adults and children languishing on respite and disability lists? What assessments are currently taking place around the further strain going to be placed on our already creaking and highly dysfunctional respite services? I want to emphasise, Taoiseach, that this is not about refusing help, but it is more about asking difficult and important questions, because at present it is abundantly clear that we simply do not have the capacity to meet the existing respite needs. Do you agree that our rhetoric should be shaped by our capacity to deliver on those promises that we are making to disabled persons, irrespective of where they are coming from? First of all, I appreciate the Deputy raising this issue, and just to say at the outset, you referenced transfer of disability policy and functions and so on from the Department of Health to the Department of Children. That was a deliberate decision taken, and in fact before the last General Election there was much commentary on disability services, and there was a view that for the medium term it would be better if there was a more singular focus by a new department in relation to disability. Because there was a view that within the enormity of the health department, because there was a view that within the enormity of the health department and all of the issues in the health department, that disability wasn't getting the type of focus under that statutory framework and under that delivery system that it should. And that was the motivation behind it. And I think it is one that I support. And there has been challenges, as there always is, when it comes to transferring services from one department to another, particularly on the delivery mechanisms. Secondly, in respect, and I can go through, there has been additional funding, new funding of about 65 million allocated to disability services in the budget for 2022, of that about 9 million is in respite services. But that said, I'm not satisfied with where we are in relation to disability services, and I want to be candid about that, and particularly on respite, but also in relation to the provision of therapies, of therapies to children. Now, the HSE for quite a long number of years have developed a progressing disability program and approach. And I, and the government has allocated additional funding to the HSE in respect of therapists. And I'm still not satisfied that the translation, if you like, of that resource to parents on the ground is happening to the degree that it should. Because we, because we, you know, I was, I was involved myself in an early era in developing new schools for occupational therapy, physiotherapy and speech and language therapy in the colleges outside of Dublin. So we have a regional spread in terms of providing more graduates, but it's not translating to the degree that it should in terms of services for children. And that's, and I acknowledge what you said in relation to Minister Ann Rabbit and Minister Gorman and others, we have more work to do in relation to that. And I just simply acknowledge that, and in particular in terms of provision of therapies and of respite services. There has been a lot, you know, ongoing progress in terms of the after school services, community initiatives, personal assistant hours and the school leavers day services and so on. But again, we do believe that that shift from health over to children is the right decision. Ultimately, in terms of having a focused delivery mechanism, capacities do need to be built up and proper integration between those delivering services on the ground with the parent department. Thank you for your response. But even with the transfer of functions to another department, the whole issue of respite and disability is not getting enough focus. It's still lacking and severely lacking. And back to my core question, how are we going to cope with the pressures? How is the respite service in this country going to cope with additional pressures? I think we need to answer that question honestly, because there are many families who are very concerned, and I meet families struggling every week in my offices, who are really begging for help. They are begging for respite for adult children, being unable to cope with themselves and with health conditions themselves. So are we going to assure those people that there will be no erosion of current services, weak and all as they are, with the extra pressures coming into the system? I think we need to have that honest debate now, and I think we need to provide assurances to these families, very many families across this state, who are struggling and who are pleading for more help and for basic respite services. I think we owe it to those families to be very clear that their services will not be eroded in any way, and in fact that there will be more services put into the system to help those families. Thank you very much Taoiseach. I don't want to juxtapose the mainstream and the ongoing national provision of services for disabilities with the war on Ukraine. The war in Ukraine is devastating on the people of Ukraine. It has enormous implications for the continent of Europe and for the world at large. And across the border we are going to have to rise above what we do normally in respect of helping and doing everything we can to support the people of Ukraine, as part of a European Union, and I don't think we can resign from that. Now we are doing an analysis in terms of the refugees that are coming into the country, so that that can inform the type of responses that we need to make, apart from accommodation, responses in education, responses in early childcare, responses in health. And it's very, very serious. I could have been informed yesterday, but 6,000, for example, unaccompanied minors from Ukraine have entered into the European Union. That's across the European Union now. Now we'll have a share of those, and that's an appalling feast to comprehend. But we can't let those children behind. We have to do everything we can, and rise above what we normally do. And I appreciate the points you're making, and you're making them honestly, and I accept that. Hon. Hon. Hon.