Further disability cuts are inexcusable
As budget overruns continue throughout the HSE, the most vulnerable citizens have once again been targeted, but how much more can service users take. My Medical Independent column from 12 September 2013. On 4 September 2012, a small group of disability activists stayed overnight outside Dail Eireann, protesting against the ways the HSE planned to “save” an additional €130 million in 2012 to avoid a budget deficit of over half a billion euro and adhere to promises made to the Troika.
These included cuts to the personal assistants (PAs) budget, home care packages and home help hours. The HSE also said that the impact of these reductions would be minimised through “greater efficiencies and direct patient care”. At the time, the HSE admitted that such “cost saving measures” would affect some front-line services.
Disability activists organised the protest to coincide with the politicians’ first day back at the Dáil. The sight of a small number of people, mostly wheelchair users, many with severe disabilities in the September sun was a powerful one. The images of them still there after a cold night, was every politician’s worst nightmare.
Central to their protest were the cuts to PAs for people with disabilities. PAs allow people, often with profound disability, to get up in the morning, to go to college or work, to live their lives as independently as possible, to actively contribute to society. They argued that cutting those millions would cost more than it saved, as well as being an infringement of their human rights.
Within hours of the overnight protest, the activists had been invited in to meet the Minister for Health, Dr James Reilly, the Junior Minister with Responsibility for Disability, Ms Kathleen Lynch and senior HSE officials. Within days, a u-turn was announced with the PA budget reinstated as the “savings” were found elsewhere.
The cuts to the homecare packages and home help hours were also officially withdrawn. However, these announced u-turns were merely a fob off. The HSE 2012 Service Plan promised 10.7 million home help hours, when in fact 9.9 million hours were provided. In 2008, the HSE provided 12.6 million home helps hours.
Disability services have not been immune to cuts since the economy buckled in 2008. Disability services have received cumulative cuts of 15 per cent since 2009. The large voluntary providers have also been hit a 17 per cent reduction in fundraised income.
People with disabilities have also borne the brunt of generic cuts and the transfer of costs from the State to people, which have been the hallmark of cuts through the six austerity budgets. People with medical cards have to pay €1.50 for each prescription item, while those without have seen a 44 per cent increase in what they pay for prescription items as they are only reimbursed after €144 is spent, this threshold was €100 in 2010. Disability Allowance was cut by 4.1 per cent, while the respite care budget was cut by 20 per cent this year.
In August, the HSE admitted that it was €49 million over budget and it expected to be over €100 million over budget by year end. Not coincidently, during the last two weeks of August, more cuts to people with disabilities emerged. Young adults with disabilities who turn 19 were no longer guaranteed day services, those with the most profound disabilities, who need the services most, were most affected. Just €4 million was allocated to such services in 2013, compared to €10 million annually in previous years. At the time of writing, the Government was busy doing a u-turn on these cuts, assuring parents that all young adults would get placed, but it remains to be seen if each of these young people will get the services they need.
A week later, the CEO of St Michael’s House wrote to families of its 1,600 service users announcing an additional cut of one million euro imposed by the HSE in August under the guise of the Haddington Road Agreement. The net effect will result in many service users contributing more to the cost of their care, as well as cuts to respite and transport services and no new residential places will be available.
While these new cuts were getting an airing, Minister Reilly, Minister Lynch and Minister Richard Bruton have written letters to families of people with disabilities ensuring them that the “Government has not targeted disability services” for cutbacks.
Obviously, the Government learnt nothing from last year’s misguided cuts to disability services. It is continuing a policy of cuts by stealth (or what they think they can get away with) on some of the State’s most vulnerable citizens. Whether, the Government has targeted cuts on disability services on purpose or by blunder is not evident. Whatever the reason, it is inexcusable.