Ms Louise Loughlin:

I will take Deputy Cairns's second question first. The Assisted Decision-Making (Capacity) Act, even with the amending legislation, still does not make any specific legislative provision for advocacy. There is no definition of advocacy in the Act. As I mentioned in my opening statement there is one in the draft code of practice. In effect all the other players involved, individuals themselves as relevant persons, the different tiers of decision-making supporters, as well as recognition of other State players, are all defined and all have clear functions and responsibilities under the Act. There is no reference to advocacy. However when one reads the code of practice and looks at the at the decision support service's, DSS's, own prediction in terms of demand it is quite clear there will be a substantial increase in demand for advocacy services. The specific point we made was that because the only recourse we would then have, should there be an issue about access to advocacy, would be to make a complaint to the DSS, say about the activities of a decision-making representative. They could disregard advocacy services. We have had the experience over a long number of years that many actors who have statutory or regulatory functions can disregard what an advocate is saying because of our non-statutory basis. The importance of that is not about the advocacy service per se. It is important because the advocate is the only independent person providing that support to the individual. The individual may have very strong family support but that does not mean family members are not without their own interests. They may have strong informal advocacy from their service provider, such as the HSE, but there can be a perception of, or a real conflict of interest there. The advocate is the only one, by the nature of how the organisation is established, funded and how the service is provided, that is a truly independent service.

It is a real risk we would have when the Act is commenced. As it is not stitched in and embroidered fully into the Act, that could happen. We have been looking for that legislative amendment but unfortunately it has not yet been incorporated.

On Deputy Cairn's first question about the interaction between State services, it is absolutely true and it has long been our experience of people who have both mental health issues or psychosocial disabilities and another disability type falling between the stools and not being able to access appropriate supports. It is particularly the case for people with intellectual disabilities and mental health issues that there is often a disinterest by the HSE to provide those services. It often comes down to how the HSE's funding is structured. It will have a mental health budget and a disability budget. It is trying to contain that budget and if it sees that another side of the HSE, another division, could provide that funding, that will be the position it would take. It is part of the bigger picture discussed by Ms Grogan in the earlier questions and in her responses to Senator Seery Kearney's questions about the overarching structure and how it is all integrated but also in a very practical way in how services are delivered and how they are operated. It is really critical that we try to get out of those silos and say that one has to look at individuals and packaging for them as opposed to packages out of budgets.