THE HEALTH Service Executive (HSE) may be over-staffed and dysfunctional but it would be wrong to blame it solely for the savage cuts in services that are turning the lives of young people with intellectual disabilities and their families upside down. Ultimate responsibility for the withdrawal of care and respite services from these extremely vulnerable people lies with the Government and the Minister for Health.
It is difficult to appreciate the unselfish dedication and courage that parents of children with Down syndrome and intellectual disabilities exercise as they struggle with day-to-day problems. Other members of the household are also affected. Many families are helped through these extremely stressful times by the provision of home help and respite care by voluntary agencies.
Recent reports have itemised the withdrawal of respite services and the closure of care centres across the country as cuts in Government funding take effect. Respite facilities have closed in Galway, Limerick, Mayo and Dublin. And some 60 service-providers catering for 25,000 people with Down syndrome and intellectual disabilities have announced they will have to reduce their services because of financial constraints. What is particularly disturbing is an allegation by the chief executive of the National Frontline Voluntary Bodies Brian O’Donnell that the cuts made by the HSE were double those agreed with the voluntary agencies last year. An agreed 2 per cent “value for money” reduction eventually translated into a cut of 4.5 per cent. That was in addition to a moratorium on recruitment.
The State has traditionally evaded its duty of care to the families of people with Down syndrome, intellectual disabilities and serious physical illnesses. That is why 80 per cent of all services to this group are provided by hundreds of voluntary agencies, part-funded by the State. Inevitably, some duplication of effort and inefficiency have crept in. These matters should be addressed. It is clear, however, that the HSE’s priority is to save money rather than reform or realign existing structures. It is hard to avoid the conclusion that voluntary agencies are seen as a “soft touch”; lacking political clout and without the connections that could lead to industrial unrest within the health services. The suggestion that frontline services for desperately needy families can be maintained under the proposed cutbacks is risible. Neither the Government nor the HSE can evade their responsibilities. The funding of respite care for people with intellectual and physical disabilities should be reviewed.