John Dolan (Independent) | Oireachtas source

I extend greetings to the new Minister of State, Deputy Jim Daly. I am also pleased to see the old ministerial faces from the Department. I submitted four questions to the Department, the first of which relates to the welcome commitment given by the Taoiseach in his first address to the Dáil following his appointment to ratify the United Nations Convention on the Rights of Persons with Disabilities by the end of this year. The Taoiseach's commitment allows the Minister of State, Deputy Finian McGrath, off the hook in the sense that the commitment he gave previously has been restated by someone else in government, which is good news. As the clock ticks towards 31 December, what work must the Department do to facilitate the implementation of this commitment? The Minister referred to the declaration of liberty, the decision support service and a small amount of work to be done on the Mental Health Act. He was shy, however, about setting specific dates by which the various measures required to facilitate ratification will be implemented.

I am unhappy about the failure to even attempt to answer my question in which I sought an estimate of the extent of unmet needs and supports for people with disabilities and mental health needs. In requesting an estimate, rather than precise figures, I deliberately asked a pass rather than an honours question, as it were, because I know it is not always easy to provide exact figures. Of the 11 paragraphs in the quarterly update, ten take us on a tour of strategy plans, current funding levels, pilot projects, policy orientation and commitments to standards and safety. While this information is useful, it does not address the question. The closest we get to an answer is in the final paragraph, which notes that the Health Service Executive is engaged in a review of current service requirements and crucial unmet needs in planning and prioritising service requirements for 2018. This, the statement adds, is informed by best practice and so forth. However, we are not given even a hint of an estimate of the number of people who may need personal assistance or the quantum of services required to enable people to continue to live in their homes, not to speak of in the community. How can the Department usefully engage in a review of current service requirements and unmet needs if it unable to provide these data or does it have the information but has decided not to release it? It is a serious matter when the Department does not even provide a guesstimate as to the level of unmet need in a range of core areas.

While I do not wish to stray into the issue of the Devereaux family, in that context we spoke earlier about the statutory underpinning of the fair deal scheme. I know people with disabilities aged under 65 years who are in nursing homes. Who can say there is not a connection between the lack of provision or planning for provision in the community and that fact? The Minister referred previously to the need for a statutory underpinning of the community side. This must be done across the board, rather than exclusively for older people, if we are to bring some balance to the equation.

My third question related to section 38 and 39 bodies. My sense is that the answer is very much about industrial relations and personnel development issues. I asked what was the impact for organisations related to the sustainability of person-centred services from which there will be greater staff migration to better paying roles. I was not asking about industrial relations or human resources issues. I am told that people working in section 39 organisations are not public servants. Are those working in section 38 organisations public servants? The point at issue is that we want to have quality public services. If an organisation on one side of the road is funded under one section of the Act and another organisation on the other side of the road providing the same services is funded under a different section, one could swap over. The issue is that staff will cut their teeth in one and then migrate to the other. While I wish them luck if they can do that, it leaves one organisation to face the problem of staff churn and related issues.

On 30 May last, when I raised this matter in the Seanad with the Minister for Public Expenditure and Reform, Deputy Donohoe, he stated he would "anchor this matter in current negotiations through the concept of affordability." He continued: "I am aware that the decision that we make about public service pay will have consequences for other organisations that are not of the public service but provide public services". Has the Department of Public Expenditure and Reform engaged with or knocked on the door of the Department of Health in the meantime given that an agreement has been concluded which could advance this issue?

My final question related to the determinants of health, although the word "determinants" was not used. I raised this issue as a result of a meeting at which representatives of a number of groups addressed the joint committee on the impact of services or lack thereof on other areas of health. The response brought me on another tour, this time of the national disability implementation strategy. This strategy, which is about to be published, should have been live a year and a half ago because it was intended to follow the strategy that concluded in 2015. This means there has been no strategy in place for the past 18 months.

The comprehensive employment strategy, which should have been introduced in 2013, did not commence until the end of 2015. To cut to the chase, may I assume that the Department has no issues regarding services in other Departments that would help people to migrate - I use that word advisedly - from the health area to education, employment and other supports in the community?

Are there no poverty issues? The SILC statistics show increased levels of poverty for people with disabilities. Are there no social housing issues? The information we have received has told us that difficulties in this regard have increased by 16% or 17% over the past three years. Employment is a chronic issue. If we are trying to move people on after school or people who become disabled as adults, how do we get them into work if nobody on that side is taking things up? Accessibility and transport are other issues. I thank the witnesses for their work but I do not find a lot of value in the text I have received.