Mr. Damien Walshe:

I will respond directly to Deputy Canney on the rural-urban divide. To amplify what Mr. Kenny said, because we have never created a standardised system, it means there are significant numbers of disabled people who are unaware of a service that could enrich their lives and give them that freedom. There is also the pure lottery where disabled people are told the service is not provided in a certain area.

To take CHO 1 as an example, centres for independent living were established in Donegal, Leitrim and Sligo. There is a culture and awareness among disabled people that personal assistance is something they could access, notwithstanding the drastic years from 2008 to 2019 when there was no budgetary increase at all. It is through the agitation that Mr. Kenny spoke about that disabled people got the year-on-year increase. That is based on disabled people demanding it. If we take Cavan and Monaghan in the same CHO area, there is no PA service because there is no culture there. We have members there. One member has a direct payment but when other members apply, they are told there is no such thing as a personal assistance service in Cavan and Monaghan. We need to recognise that there is no system there. It is completely dysfunctional. We have a situation where disabled persons in Leitrim can access a PA service but across the county border in Cavan they cannot access one because there is no service provider in place. We need leadership from the HSE to define and standardise. It must decide to create and build a system and to ring-fence a budget that will be invested year after year. Disabled people should be made aware of that and how they can be assessed for it. Regardless of where they live, they should be able to access that support. In the absence of such support, a huge effort is required to drive demand from below and create structures and organisations to have that. That should not be the case.

As Ms Gaynor said, there should be a rights-based model in place to allow people to access the supports they need. Unfortunately, because a PA service was not provided in them historically, in large parts of the country people do not have the opportunity to access one. It is, as Mr. Kenny said, based on where there have been organisations in place that are led by disabled people. In other parts of the country, unfortunately, that is not the case.