The Department of Health and it’s ministerial team held a press conference after the budget yesterday to talk about the budget and the estimates for health expenditure in 2013.   I am surprised at the lack of  focus on the very serious problems emerging from the Department or indeed being hidden from view.

Minister for State with responsibility for Disability and Older people Kathleen Lynch released a press statement.

The Minister said that she is very mindful of the enormous challenges facing Government and the Health Services. In such circumstances she also particularly welcomed the commitment to restore the core community services of home help, home care packages and personal assistant hours. She said

“Community Services are the services that keep people well at home, where they want to be, and out of hospital and residential care. A key element of our overall health reform plan is to keep and treat people at the lowest level of complexity. In moving towards this model of health care provision, community services will continue to play a key role”.

It’s not clear if people who have lost hours will have their hours restored or, equally significantly, if the way in which hours of support are assessed will be changed. In the last few weeks the HSE has been cutting hours of support based on assessments which stop home care  helping with so called non essential tasks like shopping, cooking, cleaning, laundry, organising a household.  It has become a service of minutes rather than hours.

Does this restoration of budget mean that people will get help with these vital tasks?  And will Personal Assistance continue to mean supporting the philosophy of independent living so that people with disabilities can have people to help them attend employment, education and have social lives.

There were two cuts to community support budgets in 2012 in January and also in September.  Again it’s not clear which cut has been restored.  There were no figures.  From the cuts experienced this year the national figures published and the experience of the reality of local implementation are very different things.

The ‘restoration’ of the community supports budget also will not help the many older people or people with disabilities who have no service, who never had a service, indeed the many who are in acute hospital settings (690 people in August before the second set of cuts – some for more than 6 months waiting ) and would like to return home.  Those on waiting lists for services whether in the community or needing residential supports are not being heard in this recession.

The Ministers would not provide information on the HSE budget for 2013 and it has not been published. So we do not know for example what the aids and appliances budget for 2013 will be. We also do not know what the cut to the overall Disability budget is. For those who require respite there is no information on whether there will be any reveral of the massive cuts to services. (This is seperate to the 20% cut to respite grants paid to carers)

We do know that there must be a €900 million cut to the HSE budget in 2013.  €900 million.  And if hospitals overspend the budget on all other aspects of health – ie primary care and community support gets cut. There is no ringfencing of that money from being taken and spent elsewhere. The cost of homehelp hours saves the 500k per night cost of acute hospital care.

Those on medical cards face a 200% increase in prescription charges and also many items are removed from the Medical card scheme entirely and have to be paid for in full.

Watching the press conference there were many questions but few answers and it will take several weeks if not months before we are clearer on what this will really mean for people with disabilities.  For those who have no services or need more supports then what they have they may never get answers or even questions asked.  There will be lots of bandwagon jumping about the ‘most vulnerable’ but little reflection on the reality, the administration, the decision making and priorities of those who make decisions. The Ministers may commit to inclusion and equality but how it is being delivered locally through funded agencies and what is happening in the daily lives of people with disabilities is still not being heard or listened to.