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

It is great to have the Minister of State and the representatives from the Department of Health and HSE here today. The Minister of State is undoubtedly playing a pivotal role in the new configuration of disability services.

I want to query PA services, the congregation, the optional protocol and the transfer of the portfolio. I will get straight into it. I would like to ask Mr. O'Regan about the PA service. He mentioned the additional budgetary allocation in the past two years of 1.7 million personal assistant service hours. He also mentioned a figure for home support hours of 3.12 million, which is almost double. Based on all the delegates' statements, the consensus is that the aim is to transfer disability services from a medical model to a social model. How does Mr. O'Regan envisage that happening when the majority of funding is still being funnelled into home help? Is it the case that he genuinely believes home help is aligned with choice and control and will and preference, or does he believe the PA service is more aligned with these principles? PA services offer disabled people what they want when and where they want it while home support provided by an organisation can at times be far more restrictive. The latter often dictates when someone gets up in the morning, eats, showers and goes to bed at night. Although all this is happening outside the confines of an institution and in the person's own home in the community, it is, in a way, institutionalisation. The services have a place within a broader regime of supports but can place limits on young disabled people's lives. It can be quite astonishing to hear at first hand that people are being put to bed at a time that is not suitable for them and with which they are not satisfied. How can we justifiably continue to fund the less empowering and perhaps less UNCRPD-aligned service when advancing alignment with the UNCRPD is the ultimate goal?

Could the Minister of State outline how central the PA service will be in the new configuration of interdepartmental services? How does she envision the shift away from paternalistic home help to a PA service that genuinely offers the choice, control and empowerment that are enshrined in the UNCRPD?

Regarding decongregation and specifically around funding, I would love to seek explicit confirmation on how many of the 18 congregated settings that were mooted to be transferred into community settings this year actually were. More critically, in a response to a parliamentary question, I was informed that between allocations for transferring under-65s from nursing and decongregation in 2021 totalled just over €7 million, of which only €1 million was spent. Can the witnesses commit to that €6 million in unspent funding being a roll-over and ring-fenced accruing amount that will not merge back into the €115 million additional funding announced for budget 2022? This is extremely important. If I take one thing from this meeting, I would like it to be that. The disability capacity review recommends that 150 settings be transitioned yearly up to 2030 if we are to truly decongegate. We have significantly missed the seven-year target set in the Time to Move On from Congregated Settings report. We are in a situation that is as bleak in terms of independent living as it was almost a decade ago. What funding and preventative measures are being implemented to stop disabled people being accommodated in these inappropriate settings to begin with?

The optional protocol is the elephant in the room. It has felt like that since the UN special rapporteur presented to the committee. He stated as clear as the light of day that the Assisted Decision Making (Capacity) Act and the decision support service were not prerequisites for ratification, as the Government has claimed. The transfer portfolio is one and a half years behind schedule and the personalised demonstration pilot is three years behind schedule. The Minister of State stated the transfer will be finalised by March of next year. Could she confirm that the optional protocol will be ratified at least by the second quarter of next year? I reiterate the special rapporteur's point that it should have been ratified at the same time as the convention was ratified.

The Minister of State said the transfer could have happened 18 months ago. If I am not mistaken, she said in the Chamber recently that she will not transfer the portfolio until such time as she has full access to the budget. This raises several questions. Having consulted my disabled persons' organisation, DPO, on the matter, it made the point that this decision was not necessarily within the remit of ministerial power. Regarding discussion with DPOs, as per Article 4 of the convention, I appreciate how complex the transfer is but I hope the articles are being honoured in the protracted process. As the Minister of State said, "nothing about us, without us". Was whatever rationale was used to guide the decision to delay the transfer informed by direct lived experience? I invite the Minister of State to come to Clare and meet with our local DPO, the Clare Leader Forum, and clarify the questions it has. It has relayed to me that it does not necessarily feel represented in the disability participation and consultation networks. This committee received correspondence from the Minister to state that the delivery of services provided by the HSE section 38 and 39 organisations and for-profit organisations will remain the remit of the HSE. If this €2.2 million is staying within the HSE, which is contrary to what the Minister of State said here this morning, can she elaborate on this conflicting information? If the budget and delivery of specialist and mainstream services will remain within the HSE, why has the transfer taken 18 months?

I return to the information provided relating to the nine respite houses to be opened in 2022. I am seeking clarification of one of those will be in CHO 3. I also appeal to the Minister of State to ensure these centres are located in areas with appropriate infrastructure. For example, I am aware of one centre mooted for Clare that is in a very isolated area with no access to public transport. This is a major concern for everybody involved in that so I wish to highlight it here. I am very glad the Minister of State is here today to shed some light on these matters, which are of grave concern to everyone on this committee and all disabled people and their allies.