Ms Derval McDonagh:

I echo what Dr. Foley said. If we are to move on fully from institutionalisation and institutional thinking, it is a move from a system to a person-led response. We are a long way off that, although there are pockets of it happening around the country and there are people who have personalised budgets and are in control of their own lives. Mr. Alford's story speaks of that. We are a long way off that but we have to edge further and further towards it. If we do not take that seriously and do that well, we will end up creating group responses to issues that are deeply personal and create more institutions. They might be smaller and look a bit nicer but there will still be the same kind of institutional thinking within them, where people do not have real choice or control over their lives. We have to push that boat and move towards more individualised responses to people, looking at what people want in their lives and trying to build the services around them. That includes everybody, from someone who needs a couple of hours of PA support every week to live a good life to those who need around-the-clock support to access their rights. That should include everybody. Sometimes people feel very left out of that picture. They see personalised budgets as only being for people who are going to go into paid employment or who might only need a certain amount of support. That has to include people with much higher support needs as well, if we are to really look at unpicking institutionalisation. There are a lot of disability activists around the country and there is a slogan about getting a life, not a service. Our supports should be enabling that for people and supporting them to have a good life. Dr. Foley mentioned access to family, friends and community in whatever way people choose to do that. That is how we unpick institutionalisation and institutional thinking. We have to have vision around that. Dr. Begley mentioned leadership as a core element of any plan. We need to see a vision and we need to see government, politicians and society pushing for that.