Irish Examiner view: Change in respite care puts cart before the horse

Social care, like many other industries and professions, has failed to train and retain enough people to meet the accelerating needs of society.

The reasons for the ongoing crisis in respite care in Co Cork and in other parts of the country are both well-rehearsed and well-understood. 

There is a shortage of beds, and of trained staff who have the necessary clearances to work with young people in what can be challenging circumstances requiring both patience and experience.

Nor is the shortfall confined to the public sector. While agency staff might in the past have been called in to fill the gaps, they are not available either. 

Social care, like many other industries and professions, has failed to train and retain enough people to meet the accelerating needs of society.

It is sometimes the description of individual cases which brings home the impact of these planning and recruitment miscalculations and persuades people to double down on their determination to ensure that matters improve as swiftly as possible.

One such case involves our report today of the circumstances of the East Cork mother who has to sleep with her bedroom door locked and hide all the knives in the home because of the behaviour of her 15-year-old son.

Despite threats of violence against his mother and declarations of wanting to be infamous for causing harm to neighbours, the mum says her son retains the emotional traits of a young child.

“He is a boy in a man’s body, but with all of those urges and hormones,” she says.

It would take a heart of stone not to recognise the anxiety in this account of a parent who has nowhere to go with her problem.

She has been applying for support since 2019. Her GP wrote to the HSE in 2022 requesting “urgent consideration of emergency respite” for her son, stating that she “is struggling as his behaviour has become more challenging in recent weeks”.

“Mum has been unable to leave the family home” and her son has “been unable to attend school due to the deterioration in his mental state and behaviour,” he added.

Cork Kerry Community Healthcare acknowledges it has a problem and says the services “are hugely important for young people with disabilities, and for their families. We sincerely apologise to young people and families affected by difficulties in accessing respite in the Cork area.”

Attempts are continuing to reopen respite beds which have been closed and to increase overnight availability. Which begs the question as to why those beds were removed in the first instance?

As with the changes to emergency department provision which have overwhelmed University Hospital Limerick, is it another example of implementing developments that might look appropriate on paper but don’t work in practice because they are premature? 

And which leave hard-pressed individuals and families, as in our report today, in diminished circumstances and ever more desperate?

The old carry political weight

Readers can be forgiven for thinking that they are sometimes bombarded with data. Separating the wheat from the chaff is no easy matter when thousands of news stories per week emerge from print, tv, radio, and social media.

It would have been easy to miss a series of items midweek that may prove to have a decisive influence on the next general election which must be held, by the latest, in March 2025. That is some 20 months away.

In a survey carried out by the charity Alone, nearly three-quarters of old people said their standard of living had been reduced by the cost-of-living crisis. Another 11% preferred not to comment at all. Some said they could not afford to turn on the heating, while one person reported that their electricity bill was €300 higher than their monthly pension.

State pensions, as opposed to private schemes, cannot be considered over-generous, although neither is it a pittance.

But it should be benchmarked against the cost of living in line with previous commitments and the complicated tranche of additional benefits — fuel allowance, telephone support payment, living alone allowance — should be simplified.

Alone’s pre-budget submission was entitled One Million and Counting, reflecting the fact that there are now more than 1m people over the age of 60 living in Ireland. This is roughly 20% of the population and it will increase.

Around nine in 10 said they received no positive impact from Budget 2023, and more than 35% said they were now worse off. Alone is calling for the establishment of a commissioner for older people, and that would be a useful step. But the party that positions itself as the best champion of the old may well achieve a workable majority the next time the country goes to the polls.

Robot taxis

San Francisco, some say, gave us the greatest cinematic car chase in history. Brooklyn has its supporters, with the eye-popping 90mph 25-block chase under the elevated railway in the 1971 Oscar-winning The French Connection. The video game Grand Theft Auto has many admirers. 

However, it is usually the 1968 duel between a Dodge Charger and the Ford Mustang driven by Steve McQueen’s Detective Frank Bullitt that takes the checkered flag for 11 minutes of excitement.

Fitting then, that the streets of the Golden Gate City should provide another marker with the final approval for two robot taxi companies, Waymo, part of Google’s parent company Alphabet, and Cruise, part of General Motors, to provide paid rides 24/7.

After rigorous local opposition, but also a surprising level of support, California’s Public Utilities Commission voted 3-1 to put autonomous driving services into direct competition with Uber and Lyft with a rollout in California due to follow. The cars use AI technology, radar, and cameras.

Hundreds of supporters and opponents attended public meetings to make their points. Critics pointed to incidents where vehicles stalled, blocked traffic, and interfered with emergency services.

However, many (including a disabled lobby) said they felt autonomous vehicles were safer than human drivers and gave more independence. One engineering professor said: “We still have 30% to 40% of fatality accidents associated with a drug-impaired or a drunk driver. We wouldn’t have those kinds of issues with autonomous cars.”

The safety argument proved to be a clincher. Now we will see whether the numbers match the rhetoric.