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 Header Item Building Regulations (Continued)
 Header Item Neuro-Rehabilitation Services

Thursday, 1 October 2020

Dáil Éireann Debate
Vol. 998 No. 4

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(Speaker Continuing)

[Deputy Malcolm Noonan: Information on Malcolm Noonan Zoom on Malcolm Noonan] While the latest iteration of Part M of the building regulations initially coincided with the general downturn in economic and construction activity, its positive effects on access and use in the built environment can now be seen widely. The building regulations, including Part M requirements, are subject to ongoing review in the interests of safety and well-being of the persons in the built environment and to ensure that due regard is taken of changes in construction techniques, technological processes and innovation. Costs are examined in the context of proposed legislative changes, particularly in the building regulations, and a cost-benefit analysis and regulatory impact analysis are carried out on any proposed amendments.

The Minister and I will give full consideration to a review in respect of the provision for what is called changing places, commonly known as the changing places toilet, in certain buildings. This may involve an amendment to the requirements of Part M and the development of sufficiently detailed guidance for inclusion in the associated technical guidance document M to ensure proper practical implementation in certain new buildings and existing buildings undergoing works.

Separately, it is open to any person who feels discriminated against to refer a discrimination complaint to the equality tribunal under the Equal Status Acts 2000 to 2018 which prohibit discrimination on nine specific grounds, including that of disability. It should also be noted that requirements set out under the equality legislation are a matter for the Minister for Justice and Equality.

Deputy Steven Matthews: Information on Steven  Matthews Zoom on Steven  Matthews I thank the Minister of State for his response and welcome the fact that he has committed to giving consideration to a review of the provision of changing places. It will, of course, involve an amendment to Part M of the building regulations. I believe we should address the issue quickly and I will continue with the Minister of State and his Department to ensure that we can provide these facilities for people who urgently need them. As I said earlier, there are only 15 of these facilities in the country. Similar facilities are provided throughout Northern Ireland and Great Britain. People in those countries have the same needs as people here, and I believe we should make those provisions available so that people who have those needs can enjoy the freedom to go about their business with confidence and not be forced to restrict their journeys to the locations of those 15 facilities. This impacts on entire families and not only people who are in need of those services. I thank the Minister of State for his response and look forward to the Minister's appraisal of the need to review the regulations in this regard.

Deputy Malcolm Noonan: Information on Malcolm Noonan Zoom on Malcolm Noonan The Deputy has our commitment that we will look at setting up a departmental working group for this matter, which I think is the next logical step. I agree with the Deputy. There are 187 such facilities in Scotland, as far as I am aware, and 1,300 across the UK. As the Deputy mentioned, there are more mandatory guidelines in place in those jurisdictions.

The accompanying technical guidance document to Part M of the building regulations, dealing with its access and use, came into effect on 1 January 2012. It sets out the minimum statutory requirements that a building must achieve in respect of access. Under Part M, there is a requirement to ensure that "regardless of age, size or disability", these accessibility issues are resolved.

Part M of the building regulations aims to foster an inclusive approach to the design and construction of the built environment, and while Part M requirements may be regarded as a statutory minimum level of provision, the accompanying technical guidance encourages building owners and designers to have regard to the design philosophy of universal design and to consider making additional provisions where practical and appropriate.

Our Department will look at the possibility of setting up a departmental working group to examine this issue and the required changes under Part M. The Deputy is Chair of the Joint Committee on Housing, Local Government and Heritage, and that can give us a good way forward to progress this matter. We have an opportunity to progress the matter and make the necessary amendments to Part M. I commend the Deputy on bringing the issue to the Dáil, and we can make progress on it over the next number of months.

Neuro-Rehabilitation Services

Deputy Pádraig O'Sullivan: Information on Pádraig O'Sullivan Zoom on Pádraig O'Sullivan I thank the Minister of State for taking this Topical Issue matter. Since I was elected as a councillor in 2014, I have encountered strong, resilient people and families and have had the privilege of getting to know them. Many of those people have suffered acute brain injuries and spinal injuries resulting from farm and road accidents and so on. It is with admiration that I look upon both those people who have suffered those traumas and their families. It takes much work, not just medically but also mentally, to get people's lives back on track.

I have brought this Topical Issue matter to the floor of the House because a number of reviews and reports have been compiled since 2012 in relation to the South/South West Hospital Group. The group is responsible for approximately 1 million people in its catchment area across counties Cork, Kerry, Waterford and south Tipperary, more than 20% of our country's population, but, unfortunately, it has no access to the full range of rehabilitation services akin to what is provided in the National Rehabilitation Hospital in Dún Laoghaire. It is difficult to get a place in that rehabilitation centre, as the Minister of State knows. Many can be waiting for six to 12 months to get a place in that unit.

In 2017, Dr. Andrew Hanrahan undertook a review of rehabilitation services within the South/South West Hospital Group. A further review was taken in May 2019 and outlined the requirements for rehabilitation services in the area. In 2012, a regional specialist rehabilitation unit was first proposed for the South/South West Hospital Group to provide for patients with high to moderate intensity inpatient rehabilitation. This unit was to support patients with moderate to severe physical, cognitive or communicative disabilities, or a combination thereof. Services would be provided by trained rehabilitation staff and rehabilitation medicine consultants, supported by consultant neurologists. The review also recommended the development of a full range of rehabilitation services in the South/South West Hospital Group. That was in 2012.

We are now eight years on and I am asking that the Minister of State makes the aspiration a reality for the people of the south and the south west. I welcome, in response to a parliamentary question, a letter from Mr. Gerry O'Dwyer, chief executive officer of the South/South West Hospital Group. He stated that discussions are progressing about the development of a rehabilitation unit in Cork and an announcement will be made in the next few weeks. That is most welcome, especially for those families in Cork, Kerry, the Minister of State's native Waterford and south Tipperary who heretofore have been waiting up to 12 months for admission to the National Rehabilitation Hospital in Dún Laoghaire. People should be cared for in their own region, particularly in the context of Covid-19. It makes no sense that patients from the southern region would continue to travel to Dublin for specialist treatment that can be provided locally.

While I welcome the announcement that the rehabilitation unit is being progressed, I urge the Minister of State in the meantime to accede to requests made by consultants in Cork University Hospital for the provision of the required specialists who deal with trauma to be sanctioned. They are looking for additional rehabilitation consultants, speech and language therapists and physiotherapists, among other specialists. If this team could be put in place before the construction of a new rehabilitation unit, we could make a considerable difference to the lives of people who suffer from such debilitating diseases and serious traumas. There is currently an application with the HSE for the provision of that team, which is distinct from the application from the unit. I hope that the HSE would look favourably on that application.

I will share my remaining two minutes with Deputy O'Connor after the Minister of State has replied.

Minister of State at the Department of Health (Deputy Mary Butler): Information on Mary Butler Zoom on Mary Butler I thank the Deputy for raising this issue and giving me the opportunity to provide an update to the House on the development of regional rehabilitation services in the South/South West Hospital Group. This is an important issue for all of those who live in the area. Rehabilitation is a critical component of any modern healthcare system and is essential if patients are to regain or maintain their quality of life after serious illness or injury. Rehabilitation improves health outcomes and reduces disability. There is a growing body of evidence that rehabilitation in specialised environments is not only effective but also cost effective. This has been demonstrated in a variety of settings such as inpatient units and community teams, and in different diagnostic groups such as trauma brain injury, stroke, multiple sclerosis and acquired brain injury.

The demand for rehabilitation services is growing and is anticipated to continue to grow with changes of population and the advances in healthcare, new interventions and technology. The model of care under the national clinical programme for rehabilitation medicine was launched in 2018 and presents, in line with National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011-2015, an outline for future provision of specialist rehabilitation services in Ireland.

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