Ms Yvonne O'Neill:

There is common agreement on what needs to be done, the approaches to it and it being rights based. We welcome the opportunity provided by disability being under the Department of Children, Equality, Disability, Integration and Youth. We can use this as a foundation stone. We have worked on the transition to that Department, which only happened on 1 March. We have worked very closely with them on the action plan associated with the capacity review, which involves a rights-based approach. We are operating to a resource limit, so we will always have to prioritise within that. We fully acknowledge that the variation is not currently visible enough to allow us to outline how we are standardising.

Ms Hanley’s point about the introduction of standardised assessment is that it should be carried out in a visible way, and that output determines access to services and may also determine the basis of prioritisation. That is the part that the working group has to deal with. This is being done with the involvement of stakeholders, including people with disabilities, in order that they can inform the process. We do have approaches across disability services and older person services around standardised assessment tools such as interRAI. We have been trialling those. Ms Hanley referred to the balance between standardised assessment and having sufficient flexibility. In addition, Mr. Kenny made a point that flexibility is not supposed assist some sort of fudge when it comes to people’s needs being met. Let us be clear about that.

The databases relating to that and to interRAI will be supported by an assessment tool. It would assist with that significantly. Returning to the database, we use the data we have in the limited databases, which we have to try. We also have to tackle some of the points Dr. Carroll made about the report on unmet need and those who we know are not in receipt of services. We use that data in our Estimates submission to the Government each year. We estimate that between 280 to 300 additional people are in need of services. Those are new people rather than individuals who are in need of additional hours but who are already in receipt of services.

The Senator mentioned funding. To be fair, the Government and the relevant Ministers have been very supportive about trying to increase the budget, which has increased from approximately €80 million in 2018 to €110 million now. That is not to say that it is sufficient. Obviously, we want to work towards PA being a model of care that supports which is exactly the point the Senator was making. We have not done the health economics type modelling yet on the money that is saved by having adequate PA services but it could be done, as part of the working group, on a demonstration basis.

IHREC was mentioned. The HSE works with IHREC and it chooses the areas they are going to look at around discrimination. We worked with it recently around interpretive services. It defines its work programme and the HSE participates with it in its analysis, the production of reports, etc. That is part of how IHREC does its work with us.