John Dolan (Independent) | Oireachtas source

I welcome the Minister and his officials and thank him for his opening statement. Equally, I note the Chairman's opening statement and welcome it.

New wine in old wineskins comes to mind. Deputy Billy Kelleher talked about perverse incentives. I am not being prophetic in saying that is what is happening. It is an absolute risk and danger, however. This report is wholesome and we are all committed to it. It is important, however, that it does not catch the old viruses in the system. That has to be watched morning, noon and night.

If one takes the broad family of people with disabilities and issues such as mental health and chronic conditions when they get to a certain point, it involves a minority of the population. However, it is the majority of those who face into the health system regularly and need support from it. We have the recent information from the Central Statistics Office, CSO, on the 2016 census. Compared to the 2011 census, the population of people with disabilities is up from 13% to 13.5%. The number of young people with disabilities has increased. Hopefully, they will have many years of life. However, it is years of living life with a disability. It is different from becoming disabled when one is 70. There is the good story there that people are able to survive and get on. Up to one third of older people have a disability.

I am concerned when I hear those involved in service delivery saying they do not have supports. Recently, I heard someone say they could not give a person with a disability support because they are waiting for someone who has the support not to need it any more. That is the case as we go into the fifth year after the recession. I am not pointing the finger at anyone but we are not able to keep pace with the level of need and expectation.

The Minister stated earlier that the report strongly supports a shift in our model of care, moving away from a hospital-centric approach to one focused on prevention, early intervention and providing the majority of care in the community. I absolutely agree with this. There was also reference to the human resources and staff in the system. Staff are an element of the human resources but not the total, however. The person with the disability or an illness is a resource. Their family, as well as the numerous voluntary and local support organisations, are also a resource. We also have 200,000 carers. There are more full-time carers than nurses in our system. These are real facts. A new approach has to look at the broader human resources issue and how we support those who are disabled and others.

There are outside resources such as the environment and the social determinants of health, as well as the rightfully growing expectations people have. I first saw that graphic about social determinants of health in the 1994 health strategy. If it was not in that one, it was in the 2001 strategy.