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 Header Item Home Help Service Provision (Continued)
 Header Item Special Educational Needs Services Provision

Thursday, 13 December 2012

Dáil Éireann Debate
Vol. 786 No. 3

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  6 o’clock

(Speaker Continuing)

[Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch] While ongoing developments have been designed to standardise and maximise the use of limited resources in the face of increasing demand, they are also intended to enhance quality, safety and other key aspects of planning and delivering services, for both providers and care recipients alike. The HSE service plan for 2012 originally envisaged some 50,000 recipients of mainstream home help and approximately 11,000 recipients of enhanced home care packages at any one time. Notwithstanding the recently announced reduction in HSE home care towards the end of this year, investment in these services remains significant, with expected outturn expenditure of approximately €320 million for home help and home care packages in the course of 2012.

The recent measures adopted by the executive were designed to secure a reduction of approximately €8 million in expenditure on home help hours to the end of December, equating to some 400,000 hours, and a reduction of approximately €1.2 million on home care packages. Every effort has been made to ensure the impact of these reductions will be minimised for individual recipients so that services are provided, in the first instance, for direct patient care. Decisions in regard to the provision of home help hours continue to be based on a review of individual need and no current recipient of the service who has an assessed need will be without a provision. The latest information available from the HSE indicates that in balancing overall projected financial savings for the home help budget nationally against maintaining adequate service in individual cases, it will probably not meet the savings target envisaged. The Department continues to work closely with the executive to monitor the position between now and year end.

I emphasise again that in addressing very difficult financial realities overall, protecting community-based services for vulnerable older people continues to be a priority for the Government. However, the challenge facing the HSE in drawing up its 2013 service plan should not be underestimated. I am pleased, therefore, to reiterate our commitment to restore to 2012 levels of service the core community services of home help, home care packages and personal assistant hours.

Deputy Seamus Kirk: Information on Seamus Kirk Zoom on Seamus Kirk I thank the Minister of State for her reply. I am somewhat disappointed, however, that the underlying message seems to be that the position is as it is and the prospect of enhanced provision for those who are down to three quarters of an hour of care under the home help scheme are poor. I ask the Minister of State again to examine those cases where the curtailment of hours is such that it is unrealistic to expect that the type of care and support required by individuals and families can be met within the assigned allocation.

I have no reason to question or doubt the provision contained in the Estimate for this scheme. Moreover, I accept the financial constraints with which the Minister of State is dealing. However, this is an absolutely invaluable scheme. If we get to a position where a person of 82 or 83 years of age can be maintained in a home setting for another 12 months rather than being taken into institutional care, there are benefits not only for the individual but also for the State. The arithmetic dictates that providing more resources in this area is in line with best public policy. I urge the Minister of State to endeavour to secure greater resources for the scheme.

Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch I do not doubt for one minute the Deputy's sincerity on this issue. I am not certain, however, that he heard the last part of my reply, which indicates that we have indeed revisited the matter. I stated:

I emphasise again that in addressing very difficult financial realities overall, protecting community-based services for vulnerable older people continues to be a priority for the Government. However, the challenge facing the HSE in drawing up its 2013 service plan should not be underestimated. I am pleased, therefore, to reiterate our commitment to restore to 2012 levels of service the core community services of home help, home care packages and personal assistant hours.

In other words, we have done exactly what the Deputy is asking.

Deputy Seamus Kirk: Information on Seamus Kirk Zoom on Seamus Kirk The challenge here is the inadequacy of the 2012 provision.

Deputy Kathleen Lynch: Information on Kathleen Lynch Zoom on Kathleen Lynch We are all agreed that the difficulties which arose midway through 2012 caused undue hardship. However, that budget has been restored.

Special Educational Needs Services Provision

Deputy Jonathan O'Brien: Information on Jonathan O'Brien Zoom on Jonathan O'Brien The Minister of State, Deputy Kathleen Lynch, is well aware of the challenges facing the parents of children with special needs in Cork and their concerns in regard to the process of reconfiguration of service delivery that is now under way. I attended the meeting at which she outlined in great detail what is proposed in this regard and attempted to allay some of the fears that were raised from the floor. The difficulty, however, is that the communication breakdown between the HSE and parents' groups remains a problem. Several of the parents who attended the public meeting and whose children are attending special needs schools had received virtually no information on the proposed reconfiguration before the Minister of State provided some of the details. From speaking to parents in recent days, it seems this communication deficit has not yet been addressed. There are parents who are still not aware of the plans that are being implemented. This is something that needs to be taken on board by the Department.

I am sure the Minister of State is aware of the meeting that took place last Monday in the HSE offices in Cork at which parents of children with special needs had an opportunity to voice their concerns about the changes that are taking place. I assume she received the minutes of the meeting, as did I, which clearly point to the concerns that remain outstanding and which must be addressed as soon as possible. One of the main concerns relates to the issue of parent representation on the implementation groups. The answer attendees received to queries as to whether there might be increased representation was that the proposed complement of four is larger than that in other geographical areas. In other words, the message was that four parent representatives is more than enough. That position must be clarified. At the same time, there is a genuine concern among parents that the requirements of the parent representative role go above and beyond what they should be asked to do. The Minister of State will recall from the public meeting she attended that many people are concerned that anybody who accepts the role of parent representative on the implementation group will be held responsible for all of the decisions made. I accept that the Minister of State sought to clarify this matter at the meeting, but that fear persists.

The other main concern among parents is how the changes can be implemented on a cost neutral basis. In fact, there is a genuine view among parents that it is simply not possible. Nobody has yet been able to provide them with details or a plan for how to improve the services and implement the proposed reconfiguration on a cost neutral basis without impacting on front-line services. If the Minister of State could outline how that is proposed to be achieved, it might ease parents' fears. There was a debate at the public meeting around the need for a mapping of services. An argument is being put forward that such mapping should be in place before the implementation groups are established. To do it the other way around would seem to be putting the cart before the horse. Will the Minister of State comment on that?

There is a danger that parents will be pitted against parents. The minutes of last Monday's meeting show there are already differences of opinion, with parents of children attending mainstream schools or units attached to mainstream schools indicating a wish to proceed with nominating representatives to the implementation group as quickly as possible.


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