Oireachtas Joint and Select Committees

Wednesday, 17 May 2017

Joint Oireachtas Committee on Health

UN Convention on the Rights of Persons with Disabilities: Discussion

1:30 pm

Ms Sarah Lennon:

On the last point, respite is an area that Inclusion Ireland hears about a lot. Through our community engagement we hear a lot about the need for respite and people in crisis. The question we have about it is why are we talking about respite at all? Why are we using that language and why are we talking about respite as a break? What it comes back to is that we must always have regard to the vision the convention sets out for us, which is of individuals with disabilities living their own lives, as the rest of us tend to do when we grow up. We leave home, we found our own family and we live in our own house in the community. If we are talking in the language of respite, burden and crisis, we are doing something very badly wrong from the start. That is not to suggest for a moment that people are not experiencing crisis situations, but if we just put respite places in place without looking at why we are having this conversation, then we will be stuck in a perpetual cycle.

On health and the Department of Health and whether it just picked it up, it comes back to a lot of public services being provided by the Department of Health or through the religious orders. With disability services, there is both. If we are talking about a medical model, we are also talking about a charity model. A consultation is going on as part of the comprehensive employment strategy for people with disabilities and, speaking from memory, the Departments involved are Health, Social Protection, Education and Skills along with the HSE. The critical Department, the Department of Jobs, Enterprise and Innovation, is not involved in this consultation. Why are we having a consultation on employment strategies without the Department of Jobs, Enterprise and Innovation being involved? It goes back to the fact that we are not serious about this. We are not genuinely trying to create workplace environments for disabled people, we are talking about how we rehabilitate people so that they are ready to go to work.

On community living, it is not just about bricks and mortar, although in Ireland bricks and mortar is a pretty big problem. It is not just about being there and being in the community, it is about community inclusion. The work of the task force is ongoing and we wait, I almost said with trepidation but anticipation is probably the right word. There would be very little point in us designing a personal budgets model if it simply allows people the choice they would have had anyway. That point has been well made but it is worth reiterating. One thing for which Inclusion Ireland has asked repeatedly was for service providers to sign up to having between 8% and 15% of their budgets, which are provided by the HSE through a service level agreement, to be ring-fenced for individualised and community based models of supports. In 2015, 22 service providers did so. What we were looking for was the buy-in. More than that, Inclusion Ireland would like to see is an independent commissioning agency in order that where services are being commissioned, that would be done on an independent basis.

I refer to the Disabilities (Miscellaneous Provisions) Bill as the mopping-up Bill, as it has the bits and pieces that we have identified that we need to do before we can ratify the convention. There are lots of problems with it but one critical issue ,which was raised here, pertains to "reasonable accommodation", which is a pretty central part of the convention. It is regrettable that we have said that we will enter a reservation. We have said that essentially, we will allow people with disabilities to be reasonably accommodated in certain places. If it is school we may allow them to bring in a service dog, we might allow them to have some sort of support but if they are accessing a private service, unless it only has a nominal cost to the service provider, they are not entitled to it, that is, that discrimination does not take place unless it is simply a nominal cost. That is not the standard of the convention. The convention asks us to reach a disproportionate burden standard. The point is being made that there is a constitutional right to private property with which the State cannot interfere. Inclusion Ireland does not believe that is necessarily true. There is obviously a constitutional right but it can be overcome in the public interest. We can make a compulsory purchase order for land, if we think it is in the public interest, and we would like to see some vision and leadership from the Government on this issue and to say that it is clearly in the public interest for all services, whether private or public, should be subject to reasonable accommodation provision. That is something that is in the public interest. The other thing, which I will touch on briefly although I could talk about it for a while, is that this Bill is from the Department of Justice and Equality but part of it has been given to the Department of Health to develop the deprivation of liberty safeguards. There has been no consultation on that part of the Bill. It is proposed that those provisions will be put forward at Committee Stage with no consultation and that is completely inappropriate and wrong.

The deprivation of liberty is a serious matter. These are people who arede factobeing deprived of their liberty, that is not in the legal sense; I am talking about people who are in institutional care or nursing home care who are monitored 24 hours per day, who are scrutinised and observed and who are not free to leave, by any reasonable measurement. They are being deprived of their liberty. Ireland has no safeguards in place for when a person lacks the capacity to choose. It is wrong to proceed to Committee Stage on this very serious issue without any meaningful consultation and this needs to be addressed as a matter of urgency.