Mr. Bernard O'Regan:

I thank the committee for the invitation to meet with it this evening. I welcome the opportunity to engage with the committee on the topic of planning for inclusive communities. I am joined today by my colleagues Mr. Brian J. Higgins, head of healthcare strategy - disability and mental health services, and Ms. Anne Ennis, general manager - national lead for the decongregation programme.

In my opening statement, I will address transitions from congregated settings, aligning housing and support services and inclusive communities and local area co-ordination. HSE specialist disability services strive towards the full delivery of the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD. Pertinent to today’s meeting is Article 19, which states that all individuals have the right to live independently and be included in the community. It is the equal right of all persons to live in the community and have choices equal to others. Article 19(c) states that people must have an opportunity to choose their place of residence and where and with whom they live.

The HSE Transforming Lives programme was established to implement the recommendations of the value for money and policy review of disability services 2012. The programme is a national collaborative effort to build better services for people with disabilities. It is part of the wider national effort for building a better health service. Time to Move on from Congregated Settings - A Strategy for Community Inclusion was established under the Transforming Lives programme. It is a model of support whereby people with disabilities are supported to move from congregated settings, often large institutions, to their own homes in the community with the supports they need. It is about supporting people to "live ordinary lives in ordinary places".

The 2011 Report of the Time to Move on from Congregated Settings, TTMO, working group defines a congregated setting as a residential unit where ten or more people with disabilities live together in a single unit or on a campus.

The working group ascertained there were about 4,000 individuals living in 72 centres which qualified as congregated settings. Progress since the TTMO report shows that 4,099 people were living in congregated settings at the end of 2009; 3,397 people by the end of 2012; 1,953 people remained in congregated settings by the end of 2019; and 1,532 people remained in congregated settings at the end of 2023. Using the HSE figure of circa 1,500 individuals remaining in congregated settings and in keeping with the TTMO policy of no more than four people per house, approximately 375 houses will be required to complete the programme of decongregation.

The Department of Children, Equality, Disability, Integration and Youth recently published a disability action plan to set out the developments that are needed across a range of services and supports to meet the needs of disabled people. It includes a significant requirement for housing and services to meet the needs of those transitioning from congregated settings and those inappropriately placed in nursing homes and to meet demographic needs. The development of the action plan included the Departments of Housing, Local Government and Heritage; Children, Equality, Disability, Integration and Youth; and Health and the HSE, among others. This reflects the necessity for a co-ordinated approach to ensure that housing and supports are developed in tandem. Critically, housing needs to be developed in local communities and those providing supports to meet the health and social care needs of disabled people must strive to ensure that people are being supported to be connected to their communities, to be able to access those communities and to attend work, education, leisure and other community activities, based on their individual will and preference.

The HSE is supportive of the local area co-ordination model and has been engaging with international leaders in this area to explore how it might be applied in Ireland. The disability action plan commits to this being piloted. Experience has shown that simply locating residential services in the community does not, of itself, lead to integration, inclusion and participation. Determined by the will and preference of individuals, it also requires effective supports that prioritise both the social and care needs of the person. It requires a whole-of-system approach that includes education, employment, social activities and recreation, along with housing and health and social care supports.

That concludes my opening remarks. Together with my colleagues I will endeavour to answer any questions committee members may have.