Ms Louise Loughlin:

On the matter of congregated settings more broadly, Senator Higgins asked about the discretion, space or ability for people to participate in community life. The experience she had resonates very strongly with NAS. We have all had those experiences of working with people in residential services and finding that, even in 2021, people are still living in institutionalised settings that are not part of the community. They are in a village but not in a village and are not integrated into the community. Part of our work is to try to support people to have access to community life in whichever way they wish to express it. It is important not to lose sight of people who are still living in those types of settings.

We look forward to the commencement of the Assisted Decision-Making (Capacity) Act and the decision support service. I understand it is due to be commenced in June next year. There is a significant cultural change that still has to happen and one of the issues in that regard is how staff and others in settings will support people with disabilities to access their rights under the Act. That is one of the significant challenges. It is complex legislation and requires significant integration across multiple Departments and State agencies. It is really important that, come June next year, we do not lose sight of supporting people to understand that they may have a right to seek discharge from wardship more easily or to set up one of the decision supporter arrangements that might make a difference. Ms Byrne's point relating to the vaccine highlighted for us the ongoing misapprehension about the non-existence of the right of a next of kin to make decisions for a person with a disability, how important that is and how it impinges on the cultural, political and community life that the committee is currently considering.

As regards Deputy Cairns's question in respect of other issues of interest, I refer to ensuring that access to advocacy is available to people and is adequately resourced. Under the current system, there is a requirement in the HIQA regulations for residential services to demonstrate an access to advocacy but there is no clear definition of what that actually looks like or what it means.

A related piece to consider in the context of the vaccine issues and the finance issues that were mentioned is that advocacy is critical in picking up matters that might otherwise be missed. Another part of that is safeguarding. The HSE currently has an updated safeguarding policy for adults who may be in vulnerable situations but the policy has not yet been implemented. I know that is something the HSE is keen to do but it is complex because it is now going to go beyond disability services and move into mental health and community settings, which is really critical but it does require support for the HSE to enable it to deliver on that.