Violet-Anne Wynne (Clare, Sinn Fein) | Oireachtas source

I thank the witnesses for attending. They referred to a wide range of issues. I thank them for their time and knowledge. It has been really informative and also personal.

There are three main areas that I want to ask questions on, but first, I wish to mention several things that struck me in listening to the witnesses. I have been working with a local diabetes advocacy group, Midwest Diabetes Advocacy. Members of the group have been enlightening me as to the geographical lottery that exists even in terms of diabetes. There is an intervention and education programme, Dose Adjustment for Normal Eating, DAFNE, that is not available in University Hospital Limerick, for example, which means that people in counties Clare, Limerick and north Tipperary are the only people in the country that do not have access to this incredibly helpful programme.

Ms Ulpe told us that there is not one official ME consultant in the State, which is quite unbelievable. ME is not a new condition. I find it concerning that across the whole of the HSE, there is no specialist. Ms McGreehan mentioned that 50 years down the line, lupus still does appear on the long-term illness list. In respect of Parkinson's, I know that there are only three neurologists when there should be 11. This shortfall of eight massively impacts on access to services across the mid-west region. Can any of the witnesses speak to their experiences of that geographic discrepancy, or instances of consultants with a specific area of expertise only working from hospitals that are a great distance away? Is it fair to say that every witness has experienced this lack of access to expertise in their regions?

The theme of financial hardship was echoed across all of the witnesses' statements. It is incredulous that not only is there no costed disability payment, but that other essential payments, such as the mobility grant, have been cut in austerity times and have never been restored. I love the idea that assistive technology grants will be given directly to the individual and not to the employers. I would like to hear the thoughts of the witnesses on what the main asks should be in terms of lessening the financial burden on people with chronic illnesses. Should we be calling for a costed disability payment that is tailored to the specific needs of each individual, or is it better to campaign for each separate payment, for example, assistive technology, mobility grants, etc.?

Finally, I wish to ask each of the witness about personal assistant services. I find it interesting that such services were not referenced in any of the opening statements. I am wondering if any of the witnesses have had access to a personal assistant. Does it come back to the issue of the hierarchy of disability, and as mentioned by one of the witnesses, not being disabled enough? Is a personal assistance service something that would assist the witnesses to live their lives in a more supported way?