Ms Eithne Fitzgerald:

I thank the Deputy. The Commission on the Status of People with Disabilities, which reported in 1996, very much emphasised the move away from the medical model to a social model of disability where we focus on what barriers people face and what supports they need to be fully included in society. That model goes across the board and is not just something that happens in the Department of Health or in the health service. Again, the commission said it was not going to go down the road of diagnosis or deal with particular forms of disability. Instead, it was going to deal across all forms of impairment. That understanding would have been incorporated into the Disability Act 2005 and its definition of disability, which is about a substantial restriction in people's capacity to participate by virtue of an impairment, rather than the much more medically based definition that is in the Equal Status and Employment Equality Acts. That has very much guided the way the disability support services are run. It is run on a needs-based approach rather than a diagnosis-based approach.

The job of the disability support services and the fact they have now moved from something with a health label to a Department with an equality and disability label is a positive move. What the amending legislation talked about was the movement of community-based specialist disability services. It was very much around supporting people to live in the community. We use the phrase to guide our work to support people to live ordinary lives in ordinary places. Those barriers and supports are two sides of the coin. One of the innovative pieces in the Disability Act 2005 was the setting up of a centre for excellence in universal design in the National Disability Authority. It is the only one of its kind in the world. It emphasises the need to design mainstream environments, services, information and communication in a way that they are accessible to anybody, regardless of age, size, ability or disability. Much good work has been done there. If we design a barrier-free environment and barrier-free services, that will go a huge way towards reducing the impact of impairments on people’s ability to participate in society.

The other side of that are social supports. Deputy Tully already mentioned the personal assistants. We know that much more needs to be done in that area. However, the philosophy underpinning the disability support services that the HSE delivers and that we are now funding and doing under the Department of Children, Equality, Disability, Integration and Youth is very much around how to support individuals to be out and about in their mainstream communities. That is the philosophy behind the New Directions reform of the adult day service programme, for example. It is the philosophy behind the Time to Move On programme around e-congregation. I worked on the Time to Move On report. We know there is still a way to go. It will not be delivered by just one Department. All Departments have a role and responsibility in it, whether it is the Department of Rural and Community Development around supporting and enabling communities; the Department of the Environment, Climate and Communications; the Department of Housing, Local Government and Heritage around accessibility of physical environments; or the Department of Transport around accessible public transport. Having all these working together is what gets us to the social model, away from a medical model. That is where we are trying to get to. The work we will do on the disability inclusion strategy to further advance the UNCRPD will be around the cross-departmental issue, asking what we can do to practically reduce barriers and increase supports for people, so that we are looking at a model based on inclusion, rather than a model based on diagnosis or a medical condition.

We wear glasses. Some people would say that signals a vision impairment. It is very easily accommodated. Similarly, we want to be able to accommodate people’s impairments by having a society and environments that accommodate everybody and accommodate diversity. We also hear about accommodating that diversity from the Department of Education in our mainstream schools.