Professor Malcolm MacLachlan:

I thank the Chair for the invitation to appear before the committee. I have been asked here in my capacity as co-director of the ALL Institute at Maynooth University and as research and innovation lead for the WHO’s assistive technology programme. I am not here in my capacity as clinical lead for disability, a role in which some of the committee members have met me before.

Everybody should have a language, that is, a way of understanding, expressing and thinking; a way of telling others what they need and sharing pains, hopes and joys; a way of meaning something; a way of being part of and belonging to others and a way of being able to commune and be a part of a community. Language allows us to mean something and to matter. The ALL Institute at Maynooth University has been at the forefront of promoting the importance of assistive technology for equitably achieving all of the sustainable development goals and realising each of the substantive articles of the UN Convention on the Rights of Persons with Disabilities, UNCRPD.

Globally, millions of people have no language. This is usually due to speech, hearing or vision difficulties, a combination of these, or other types of difficulties. The provision for "progressive realization" in the UNCRPD is recognition that very poorly-resourced countries will take time to fully implement the convention. Ireland is one of the richest countries in the world and one of the technologically most advanced. There are considerable opportunities for Ireland to show global leadership in this area, yet, ironically, there are many people in Ireland, both children and adults, who lack the opportunity to communicate, to mean something and to matter.

Our challenges will not be fixed by tweaking. We need a new approach altogether and this is exactly the time to develop it. With better policies, new structures, improved systems, more resources, better-trained staff and, above all, stronger user participation, we can achieve improved services.

Ireland has had an important role in shaping the increasing prioritisation of assistive technology within the WHO over the past decade. Ireland was one of the countries that sponsored the adoption of the priority assistive product list in the UN’s World Health Assembly in 2016; an Irish person chaired the international consensus meeting that established the first assistive product list and, in 2022, An Taoiseach was the prime minister chosen to launch the first global report on assistive products, the launch of which, the Minister of State, Deputy Rabbitte, attended in Geneva.

The global report makes several recommendations, some of which are particularly salient to us in Ireland. These include having an integrated or stand-alone policy on assistive technology, AT, with an associated budget; enlarging, diversifying and improving workforce capacity on AT; increasing public awareness of AT; investing in data and evidence-based policy; investing in research and enabling ecosystems; and actively involving users of AT and their families. It also recommends AT being key in humanitarian responses and international co-operation, pointing to the priority the Department of Foreign Affairs and Irish Aid should give to AT.

The global report mandates governments to act, embracing a rights-based approach, through putting AT users first, embracing co-design and the maker movement, and radically democratising access to and the development of services. Access to digital and assistive technologies must be part of the liberatory process of the human rights approach to disability. While appreciating the expertise and training of key professions, these professions must not form a bottleneck in access to services. They cannot be gatekeepers, but rather curators, supporters and facilitators for access to AT.

Ireland is recognised as the digital hub of Europe. We have an opportunity for Irish SMEs and multinationals to add value to AT and augmentative and alternative communication, AAC, products and to develop new ones for use in Ireland and globally. There really is a win-win opportunity here to create a step change in our own AT services, to empower service users and to open new markets for Ireland Inc. Our current provision of services is an inherited patchwork of well-motivated but inequitable provision. We have a postcode lottery, where service users and service providers are frustrated and often feel alienated from decision-making. This must change.

Digital technologies and AT are increasingly merging, presenting great opportunities but also challenges to inclusion. Therefore, socially just models of governance must be established before technologies can get out of sight of our ability to ensure they are put to good use. The assistive living and learning, ALL, institute in Maynooth University recently published a paper on what we call "Just Digital", and discussions on this concept have already occurred with some Departments. We need to be aligned with a range of new European legislation, including the European accessibility Act, the European medical device regulation, the Digital Services Act and the Digital Markets Act.

In Ireland, the response to Covid-19 has produced a bounce in digital literacy with the game-changing potential to extend the reach of services and the participation of service users. It has also reinforced the value of direct human contact and of being together in one space. The ALL Institute at Maynooth University is leading the largest European Commission-funded project ever led by an Irish university. It is called Smart and Healthy Ageing through People Engaging in Supportive Systems, SHAPES, and involves work across 14 European countries, with funding of €21 million. The project starts with lived experience and then explores how an open source platform can provide access to individualised technologies that meet personal needs, maintain people in their communities and keep them out of hospital.

This is very much in line with the ethos of Sláintecare. One of our partners in this project is the World Federation of the Deafblind and another is the European Union of the Deaf. Vision and hearing problems increase as people age, and the populations of Ireland and Europe are ageing. Minority difficulties which were historically pushed to the margins of society will become more central to our concerns. This is a good thing. By adopting the principles of universal design and being sensitive to individuals’ needs for reasonable accommodations in the context of AAC and AT, many more people can be included. The centre can hold, and hold more firmly, and the gyre need not widen but can bring in others from the margins too.

Some specific actions to achieve this would include new legislation on AT and AAC which recognises them as cross-cutting mediators of human rights and ensures a more systematic and appropriately funded approach across sectors; the development of an assistive product list, APL, for Ireland; and supporting a centre of excellence in this area which would bring together service users, service providers, researchers, educators and representatives of industry.

I commend this committee on addressing this important issue and I hope we may collectively grasp an opportunity to make real change here and now.