Budget 2007 — new or old money?

by Michael McKeon, Nursing Lecturer, Dublin City University

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Funding for new and enhanced intellectual disability services was outlined by Inclusion Ireland in a recent newsletter. The core issue found is that funding being planned in terms of ‘places’, as you will see, is difficult to follow from year to year—to weigh up whether the government is using new or old money over and over again. Inclusion Ireland’s report followed Minister for Finance Brian Cowen’s Budget speech on 6 Dec 2006, when he announced an additional €100m to fund health-related disability and mental health services in 2007. This funding incorporates the 2006-2009 multi-annual funding promised under the National Disability
Strategy. Below is a breakdown of the additional funding, from the Department of Health and Children:

€41m for new services for people with an intellectual disability or autism to provide:
– 255 new residential places
– 85 new respite places
– 535 new day places.

€2.2m is earmarked to transfer people from inappropriate settings. The same number of new places were promised for 2006 and figures available from the National Disability Strategy Stakeholder Monitoring Group show places that have been created by 30 Sept 2006:
– 193 residential places,
– 66 respite places
– 433 day places.

Also by 30 Sept 2006, a further number of places were enhanced (i.e. service was upgraded)
– 112 residential places
– 9 respite places
– 35 day places.

While new development funding is always welcome, there is some unease about funding being planned in terms of ‘places’ rather than individual needs. Clarity is required as to the relationship of new services created with numbers on waiting lists for services. For example, the 2005 report of the National Intellectual Disability Database (NIDD) Report shows that just 284 people were on a waiting list for a day place, yet 433 new day places were created. Equally, the 2006 NIDD report shows that 264 new day places will be required in 2007, but 535 are planned. There are a large number of individuals who require a change in their day placement this year and next year. However, according to the 2006 report of NIDD (Page 76) these places should already be in the system and do not need to be newly created.

Through the National Disability Strategy Stakeholder Monitoring Group there is a need for clarification on all new service developments and enhancements. It is important that any new funding will be used to develop innovative services that meet individual need, not simply statistical ‘places’. It is worrying to note that according to the NIDD reports of 2005 and 2006, there is a decrease of 50 people in supported employment services.
The remainder of the €100m additional funding will be allocated as follows:

  • Service developments for persons with a physical disability will be allocated €12m.
  • €25m is allocated to Mental Health Services, including commitments in A vision for change.
  • €15m will be allocated towards the introduction of Part 2 of the Disability Act, i.e. the assessment of need process, which begins in June 2007 for children under 5.
  • €5m will be set aside to fund voluntary service providers who have identified core-funding deficits.
  • €2m will be provided to fund an increase in the

Rehabilitative Training Capitation Rate.
It is difficult to follow and understand funding arrangements at national level within the intellectual disability sector. It is always going to be difficult to equate the millions of euros with individuals’ needs. Has the time now come for individual funding for individual needs?

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