Alice-Mary Higgins (Independent) | Oireachtas source

I offer my huge thanks to Mr. Tyndall for what was a very moving and important report and to all the witnesses for contributing today. There seems to be two strands when we talk about phased realisation. There is one aspect of phased realisation, which is the gathering of information, the auditing of people's preferences and that survey of work, which is understandable to an extent. There is then the idea of phasing in terms of resource-based dripping through. What I hope has come across very strongly from this committee is that we do not accept an incrementalist approach based on resources to what is a rights issue and an obligation under Article 19 of the UN convention. It is one thing to look to best practice and how we can extrapolate from that but it is certainly the incrementalist approach. That applies on two levels - in respect of this issue and the linked issue of the time to move on and away from congregated settings. I note that €4 million was mentioned for 144 places. I think this should be €40 million extrapolated very clearly even to get towards a fraction of what is needed next year. To be clear, it is one thing when the phased approach is used in terms of good practice but it is certainly not acceptable if it becomes a delay in rights.

I am also concerned about what is happening in the interim. I wanted to highlight a few of the specific recommendations from the Wasted Lives report. Point 2.1 talked about codes for local placement forms - that they would have very clear codes - while 6.2 talked about an alert system. I was extremely concerned when we heard that numbers have gone up by 20. We have been told that there is a pilot to remove 18 people from the situation but we know already this year that there are 20 more people in that situation so we are still moving backwards. What measures will be taken to ensure that over the next year and two years while this is being addressed, we do not see more people under the age of 65 tied into the fair deal programme inappropriately? We talked about individuals and that survey but we may need temporary actions in respect of the fair deal scheme. For example, should it be the case that if somebody is going into residential care - perhaps out of an acute hospital setting - he or she is not placed in the fair deal scheme for the first year or 18 months, especially when we know that a statutory home care scheme may become available, so that there is an interim arrangement or a clear exit pathway from fair deal built in from the beginning? People are particularly vulnerable for a six-month period. I would imagine this applies to many older people in the fair deal scheme as well. I looked at how someone exits fair deal. There is no clear exit pathway if someone chooses to go another route. This is needed. It is about how we ensure that we do not have more people effectively signing into fair deal in this 12- to 18-month period where the delay is on the part of the Government and the Department and there is a temporary measure.

I am also looking at the deductions under fair deal. For example, a dependent child in education is an eligible deduction but an individual's own education is not there as a deduction. It is part of the wrong tool being designed. It is not a tool that envisages somebody under 65 in residential care who wishes to engage in education. In terms of health expenses, it is not clear whether personal assistants or therapeutic services are included in those.

What are the emerging interim measures to avoid a further damaging of rights and a further limiting of options, during the one- to two-year period in which we push for statutory home care? Could Mr. Tyndall please give a brief comment on personal assistants? We have talked a lot about the roll-out of statutory home care, but in respect of personal assistants. Recommendation 4.2 referred to their importance in ensuring that people can live lives with choice and with possibility