By J. P. Anderson

Hundreds of children with intellectual disabilities have been told that vital respite care services are no longer available due to deepening HSE cutbacks.

Inclusion Ireland and the Special Needs Parents Association revealed the situation affecting 300 families across south Dublin on the same day as the HSE warned of yet more drastic cuts to the overall health service.

In meetings with affected parents over the past two days, Carmona Services — which provides outsourced services for children with "severe" intellectual disabilities on behalf of the State — said it could no longer afford respite care support.

The issue is being repeated in other parts of the country, with 63 Limerick parents told last month they will need to pay out of their own pockets to keep accessing respite care from the Brothers of Charity, which has suffered €1m in funding cuts this year.
In Dublin, the Glenageary-based private firm’s Angels Quest section told parents the service changes were due to HSE funding cuts of €2.5m this year as a result of the health service’s wider financial problems.

Outsourced firms providing this type of service have seen HSE funding reduced by almost 2% this year.
The Angels Quest section said all other options, such as administrative cutbacks, have already been implemented and that if respite care was left untouched some therapeutic services would have to be axed.

While day services will continue on a limited basis, any affected family in the south Dublin area will be unable to access weeknight, emergency or holiday support — with any emergency referrals also blocked.
Carmona Services did not return phone calls from the Irish Examiner yesterday.

Special Needs Parents Association chairwoman Lorraine Dempsey said removing the support would have a devastating impact.
"We don’t want to be held captive by what is going on between the HSE and the company, we don’t want to be outside their doors with our children’s names on placards. These children are profoundly disabled and families don’t have many options available when it comes to having a day or night off every few weeks.

"It’s not a simple matter of arranging a babysitter or sleepover as it might be for other children. These children have severe intellectual disabilities, some arising from complex syndromes and some children suffer from seizures and require medications to be administered."
National intellectual disability advocacy group Inclusion Ireland said families facing the cutbacks were likely to be unable to transfer to another service in the wider south Dublin area as few exist.

The group’s spokeswoman, Siobhan Kane, said the situation was the hidden result of health service cutbacks and meant children in need of help were "being caught in the middle" of the HSE and outsourced firms funding disputes.
"Respite is a very important service for families. Research shows that 64% of people with intellectual disabilities across all age groups, 16,000 people, live at home and not in residential care, so there is a significant level of need."

A HSE spokesperson said 80% of disability services were delivered by outsourced firms, with the overall disability service facing 3.7% in cuts this year.
She added that "2% of this should not impact on services and needs to be generated from other savings and increased efficiencies".

HEALTH SERVICE Executive cuts to home help and services for high-dependency patients have provoked a furious reaction from groups working with older people and the disabled and disagreement between the Government parties.

The strength of the reaction appeared to take Government by surprise and caused dismay among Labour politicians.
Labour Party chairman and Galway East TD Colm Keaveney said last night he was “very uncomfortable” with the cuts affecting older people and the disabled.

While accepting the need to deal with the HSE’s €260 million deficit, cutbacks should be targeted on “trophy areas that appear to be protected” instead of vulnerable groups. “In the context of political stability, this can’t happen again.

If I were minister instead of James Reilly, I’d be tackling consultant salaries and drug costs instead of the areas of greatest dependency.”
Another senior Labour source warned that the Government risked a re-run of the 2008 revolt by older people over changes to medical card eligibility.

He claimed the cutbacks wouldn’t have been necessary if Minister for Health James Reilly had achieved savings in drug costs and secured a deal to charge more for the use of public hospital beds by private patients.

Siptu said its members working as home helps “will not stand idly by and allow this attack on the sick and vulnerable to proceed”.
Of the eight cost-cutting proposals in the HSE plan outlined yesterday, at least three will affect older people or the disabled exclusively.

Services for both groups are likely to be seriously affected by a 600,000-hour cut in home help hours, as well as a reduction of 200 home care packages and a €10 million reduction in hours for personal assistants for people who need high levels of support trying to live independently.

Dr Reilly has consistently championed the care of patients in the community in preference to long-term stays in hospital, but advocacy groups predicted the effect of the cuts would be to increase hospital admissions.

“If this culture of homecare cuts continues, children with life-limiting conditions will end up back in hospital unnecessarily, which nobody wants and which costs nine times more than homecare,” said Jonathan Irwin, chief executive of the Jack and Jill Foundation.

The HSE said “the impact of these reductions will be minimised by ensuring that services are provided for direct patient care”.
HSE performance director Laverne McGuinness said “home helps in some rural areas are now providing assistance to older people over the phone” rather than visiting in person.

Groups working with older people sharply criticised the cuts. The Irish Senior Citizens’ Parliament said they could prove “the straw that broke the camel’s back” for many families coping with caring in the home.

Older and Bolder described them as “tantamount to turning off the life support machine on services which were already thinly spread”. Home help services have already been cut by 500,000 hours earlier this year.
But the HSE, which is currently running a €259 million deficit, insisted it had a legal obligation to remain within the budget targets set by the Government and the troika.

Agency staff is being cut by 50 per cent and overtime by 10 per cent, while the removal of products such as glucosamine, a dietary supplement, from the medical card will save €6 million.

Dr Reilly, who was accused by Fianna Fáil of going into hiding, said in a statement he had directed that all areas of expenditure in the health system be closely examined to ensure that suspension of services was a last resort.

He acknowledged that reductions in service were inevitable but said these would be monitored constantly. The Minister said he would announce other savings to deal with the deficit next week.

These are expected to include a €28 million cut in capital funding, a €125 million advance payment due from health insurers and €45 million from the Medical Defence Union.
The impact of cuts in each region won’t be known until next week but is likely to include bed and theatre closures, particularly at weekends.
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