Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I am delighted that the transfer of functions of specialist community-based disability services to the Department of Children, Equality, Disability, Integration and Youth from the Department of Health took place on 1 March. I thank the Chair and the committee for their forbearance in working with me and interviewing two Ministers of State, at times, about the same topic. I thank the committee team. For the first time, responsibility for co-ordinating and steering an all-of-government policy to promote the equal participation in society of people with disabilities has been brought together with policy responsibility and funding for specialist disability services in one Department. There is now a significant opportunity to pursue strategic policy development, investment and reform of disability services. I look forward to progressing this agenda with the Minister, HSE colleagues and all of our partners in the disability sectors across government. I am committed to ensuring that the transfer of functions to the Department of Children, Equality, Disability, Integration and Youth is as seamless as possible, maintaining the provision of services during the time of transition. Specialist disability services continue to be provided by the HSE and a range of other providers to children and adults in residential, day and respite settings, as well as children's therapy services, personal assistance, home support and other community services and supports. Consistent with a mainstream-first approach in the provision of integrated service delivery, all other health and social care services ordinarily available to people with disabilities will continue to be supported and provided as before. I aim to strengthen and improve oversight and performance management structures with the HSE. This will involve building relationships between officials in the new department and with key personnel in the HSE and other partner organisations to better understand opportunities, constraints and plans for improving performance delivery and oversight arrangements. The Department is putting in place an oversight agreement with the HSE which will reflect the Department of Children, Equality, Disability, Integration and Youth's responsibility for funding, policy and performance oversight. It will provide a supporting framework for the implementation of relevant legislative provisions and governance arrangements, including robust financial governance and service performance arrangements.

One challenge of the transfer was accessing accurate and consistent information and data related to disability services. Much of this was down to current constraints in the HSE's system and the nature of health service delivery. We will work and support the HSE to improve data and build the strong evidence base critical for future reform and investment in the sector. Building on the work undertaken in the Department of Health, the transfer will facilitate the transition from a medical model of support to a holistic, person-centred approach that supports people with disabilities to live autonomously. A review of disability social care demand and capacity requirement up to 2032 was published in July 2021, which sets out additional capacity required in specialist disability services in light of anticipated demographic changes and addresses the gaps between available services and the level of unmet need. The action plan for disability services was developed by an interdepartmental working group to progress action on the findings of the disability capacity review. Now that the transfer is complete, I intend to accelerate progress in this area. Developments planned for 2023 within the available funding will improve services for some but the scale of need identified in the capacity review report will require agreement on the implementation of the action plan for disability services.

In 2023, we will continue to drive the reform of disability services through the implementation of the Transforming Lives programme, including New Directions, progressing children's disability services, personalised budgets and the neuro-rehabilitation policies. Advancing the PDS roadmap related to children's services will see a critical priority focus on access to services, staff recruitment and retention, communications and engagement with families and address assessment of need backlogs. The number of children still awaiting assessment of need is unacceptably high. Reducing the assessment of need waiting list is a key priority of mine. Funding has been provided in the budget to significantly reduce the waiting times for children seeking an assessment of need. I recognise the recruitment and retention of staff in disability services is a significant challenge for the HSE, which has a large bearing on the achievement of service delivery targets. We will encourage and support the HSE to implement a series of actions to improve staff retention and recruitment performance to increase base staff levels in line with funding received.

I will outline the areas I am committed to progressing in 2023. I will continue to prioritise the delivery of therapy services to children with disabilities and their families. In day services, additional funding in 2023 will support approximately 1,250 people with disabilities leaving school to transition to adult day services. I will provide for residential placements in line with policy to respond to increasing need through the programme of decongregation and the provision of emergency placements and care. I continue to provide supports to keep people in their homes for as long as possible and out of residential care. The funding provided will deliver an additional 70,370 personal assistant hours to expand and enhance supports for people to live self-directed lives in the community. Respite care is a key priority as it provides important supports for families in maintaining their caring role. The funding provided will establish five additional respite services and increase one service from part time to full time, providing 27 additional in-home respite packages to children and young adults in a full year and to provide 265 day-only respite packages to 180 people in a full year. We aim to increase the number of those under the age of 65 moving from nursing homes to community settings. The HSE will continue to work with community support teams to provide safeguarding supports to vulnerable adults with disabilities. Mindful of this, the Government's priority is to deliver comprehensive on-site health and social supports to all special schools. I am pleased to that the HSE has commenced the process of prioritising the allocation of approximately 136 additional staff such as speech and language therapists, occupational therapists and physiotherapists to these schools. I am delighted to work with the Minister and the team in his Department to progress on these commitments in 2023 for persons with disabilities and their families. It is also important to state that it will be my ambition to leave no money unspent in any of my budgetary lines in 2023, whether it be in revenue or capital.