Oireachtas Joint and Select Committees

Thursday, 17 November 2022

Joint Oireachtas Committee on Disability Matters

Disability, Mental Health and Ageing: Engagement with Minister of State at the Department of Health

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Cathaoirleach and members for the invitation to this meeting of the Joint Committee on Disability Matters. I am joined today by Ms Siobhán McArdle, assistant secretary, of the social care, mental health and drugs policy division and Dr. Philip Dodd, mental health policy and clinical specialist, in the Department of Health; and by Mr. Niall Brunell, principal officer, disability policy unit of the Department of Children, Equality, Disability, Integration and Youth.

The Government is committed to providing universal access, under Sláintecare, to integrated, person-centred health and social care. We are also strongly committed to enabling people with care needs, at all ages, to live independently in their homes and communities for as long as possible and to reorienting the model of care towards primary and community care to support this. These objectives underpin policymaking and service delivery across the intersecting domains of ageing, mental health and disability, which are the focus of our discussion today.

Improving access to home support is a priority for the Government and home support hours in communities are increasing in line with enhanced investment. Next year, the overall home care budget will be more than €700 million and approximately 24 million hours of home care will be delivered. The dementia-specific proportion of new home support hours will increase from 5% in 2021 to 15% in 2023, valued at €5.2 million.

Delivering this enhanced capacity requires substantial recruitment. In March 2022, I established a cross-departmental strategic workforce advisory group to examine the challenges in front-line carer roles in the home support and long-term residential care sectors. The advisory group’s report was published on 15 October and makes 16 recommendations spanning across recruitment, pay and conditions of employment, training and professional development and sectoral reform. Implementation has commenced.

The development of a statutory scheme for the financing and regulation of home support services is advancing at pace with the development of primary legislation for the licensing of home support providers and of regulations to underpin the new licensing regime. HIQA is also developing national standards that will underpin the ongoing quality enhancement of home support services.

There will continue to be a requirement for long-term residential care for service users with very complex care needs and a range of reforms are in train to address this. These include community support teams to assist with infection prevention and control, as well as the recent launch of the national nursing home experience survey.

Many disabilities are acquired as we age. Article 25(b) of the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, indicates that states are required to provide relevant health services to people with disabilities and specifically highlights older persons in this regard. The Government is working to ensure that people with disabilities are enabled to live an independent life of their own choosing. There has been a consistent increase in the number of hours of personal assistant, PA, services delivered to people with a disability under recent HSE national service plans.

In day services, we have moved to person-centred support based on individual needs. This is a vital service for many people with disabilities and dementia and an important source of respite for family carers. The sum of €2.1 million has been provided in budget 2023 to ensure that dementia-specific day care centres can return to full capacity. This is in addition to €1.7 million for the continued provision of dementia-specific day care at home, which suits some people. Increased investment in dementia supports is already making a difference in the lives of the 64,000 people living with dementia and their families in Ireland today. The national intellectual disability memory service is in operation and we now have memory technology resource rooms and dementia advisers nationally.

Early next year, the HSE will launch a model of care for dementia, which will outline clear care pathways for people living with dementia, from identification of symptoms through to assessment, diagnosis, disclosure, care planning and post-diagnostic support. The UNCRPD makes no distinction between a physical or mental impairment and the convention applies also to persons experiencing mental health or psychosocial difficulties.

The Government and I are committed to the reform of mental health services in Ireland to ensure that everyone has access to the highest quality and most appropriate services to meet their needs. Since I took office in 2020, my focus has been to implement the five mental health clinical programmes on adults with attention deficit hyperactivity disorder, ADHD, self-harm and suicide ideation, eating disorders, early intervention in psychosis and dual diagnosis. I am also progressing the mental health intellectual disability model of care and the specialist model of care for mental health services for older people to provide more consistent and linked-in services across the country. I was particularly pleased to launch a new ADHD app for adults recently, developed by the HSE, ADHD Ireland and the UCD school of psychology.

The opening last week of the modernised National Forensic Mental Health Service in Portrane and the relocation of the Central Mental Hospital from Dundrum is also a very welcome development. Drafting of the new mental health Bill continues. This Bill will overhaul our mental health legislation, making it more person-centred and human rights-focused, taking into account our UNCRPD commitments and principles of the Assisted Decision-Making (Capacity) Act 2015.

Our national mental health policy, Sharing the Vision, sets out our reform-agenda for the period from 2020 to 2030. Its overarching objective is to enhance all aspects of mental health services, from promotion, prevention and early intervention to acute and specialist service delivery.

I thank the committee for its attention this morning.

Comments

No comments

Log in or join to post a public comment.