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 Header Item Estimates for Public Services 2020: Message from Select Committee
 Header Item Saincheisteanna Tráthúla - Topical Issue Debate
 Header Item Home Care Packages

Thursday, 12 November 2020

Dáil Éireann Debate
Vol. 1000 No. 6
Unrevised

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Estimates for Public Services 2020: Message from Select Committee

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl The Select Committee on Children, Disability, Equality and Integration has completed its consideration of the following further Revised Estimate for Public Services for the service of the year ending on 31 December 2020: Vote 40.

Saincheisteanna Tráthúla - Topical Issue Debate

Home Care Packages

Deputy Verona Murphy: Information on Verona Murphy Zoom on Verona Murphy I wish to raise a very sensitive and emotive issue relating to the delivery of home care support services. Changes to the disability home support packages are causing immense distress and anxiety to many families who avail of these services. A constituent of mine contacted me last week regarding her daughter, Fran. Fran is 31 years old and profoundly intellectually disabled. She has refractory epilepsy. When unwell, she can have a seizure every five to ten minutes. She also has epidermal nevus syndrome, a rare skin disorder. She experiences rapid mood changes and sensory overload when changes to her environment or routine occur. Fran is normally good-humoured and happy. She can verbalise with loud shouting sounds when stressed or anxious, but is otherwise unable to express herself or communicate. Covid has caused Fran's personal routine to go out the window. This has resulted in her lashing out and a major regression in her personality and mood which, in turn, makes life very difficult for the family.

Fran's parents are her full-time carers. Her mother, Paula, was awarded carer of the year last year. I was present at the award ceremony. In the same week Paula received the award, she was diagnosed with kidney cancer. She is currently undergoing treatment and has been further diagnosed with chronic obstructive pulmonary disease, COPD, cardiac issues and osteoarthritis. This family was in turmoil and already had its hands full when this cancer-suffering mother received a phone call from the HSE to inform her that Fran's carer of some ten years would be replaced within 48 hours by the HSE without any prior warning. The call to tell her that a new carer would take over on Friday came on Wednesday. It is unbelievably upsetting. I know the personal circumstances of the family. I might as well tell the Minister of State that similar calls came in rapidly from my constituents as the week evolved.

I was contacted by the family of a woman named Mary. She is 68 years old and has Parkinson's disease and intellectual disabilities. Mary likes and needs routine. Her world has been turned upside down already this year with the arrival of Covid, resulting in her not being able to attend her beloved centre every day. This has affected Mary deeply. She cannot understand this monumental change in her life. Mary lives in a predominantly male environment with her 88 year old father, so her carer has been a pivotal part of her life for the past 12 years. The family just cannot understand how the HSE can expect Mary and the rest of the family to accept such a massive upheaval and have a complete stranger come into their home and lives. Such a change would be difficult at any time, but it is particularly challenging in the midst of Covid.

I will not mention the other cases. This situation is too upsetting to bear. It is happening as a result of the HSE realigning home care support services to two sections, namely, disability services and older persons services. I do not believe that it is as simple as that in terms of the delivery of home support services. I ask the Minister of State to fully explain the current changes in the south east community healthcare home support packages within disability services. As I have outlined, the changes are having a grave impact.

Minister of State at the Department of Children, Equality, Disability, Integration and Youth (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte I thank Deputy Murphy for raising this issue. If she had not raised it, I would not have been aware of it. I thank her for bringing my attention to the issue, which means my focus and that of my office are on the matter. She referred to two families that have been directly impacted but it has had a significant impact on many families. For Fran and Mary and their families listening to these proceedings, I am taking on board what has been said about their situation. I acknowledge that it is not acceptable or good enough to ring a person on Wednesday to tell them that after ten years their carer will be changed on Friday.

I will read out my prepared response. We had to go out and find a little bit of information in order that I could answer the question. I know the Deputy has been a strong advocate for people with disabilities. This is not the first time she has raised such issues with me. It is not unusual for her to do so.

As the Deputy knows, responsibility for disabilities is moving from the Department of Health to the reconfigured Department of Children, Equality, Disability, Integration and Youth. My hope is that this will ensure a greater focus on disabilities, rather than it being swamped by other issues in the Department of Health. The move will allow for clearer pathways to be developed and ensure progress is made. The Oireachtas is well aware that reform of disability services is ultimately based on the value for money and policy review of disability services in Ireland, published in 2012. It created the strategies that my Department and the HSE are adhering to in the roll-out of these reforms. This has already ensured that more effective services can be delivered to more people and resources can be better targeted to give better quality of care to the people most in need. That does not mean we cannot deliver this in a constructive, empathetic, understanding and informative way. From the cases the Deputy has presented, that does not appear to have happened.

I have been informed by the HSE that following the review of the way in which it delivers home support services in south east community healthcare, a recommendation was made that all home support staff should be aligned to disability services or older persons services, as the Deputy mentioned. This decision is to ensure the services have clear governance, management and communication and are in line with best practice and national guidelines. I believe the HSE has already been in contact with the Deputy regarding a representation she raised in respect of a service user who is affected by the change.


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