Oireachtas Joint and Select Committees

Wednesday, 4 November 2020

Joint Oireachtas Committee on Disability Matters

National Disability Inclusion Strategy: Discussion

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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I welcome members, and I welcome viewers who are watching proceedings on Oireachtas TV, to the second public session of the newly formed Joint Committee on Disability Matters. The purpose of the meeting is to discuss the progress on the national disability inclusion strategy and the UN Convention on the Rights of Persons with Disabilities, UNCRPD.

On behalf of the committee, I extend a warm welcome to the Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman, and the Minister of State with responsibility for disability, Deputy Rabbitte.

Witnesses are directed that only evidence connected with the subject matter of these proceedings is to be given. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way as to make him or her identifiable.

I invite the Minister to make his opening statement.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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I thank the committee for the invitation to attend the meeting today, and I look forward to a strong relationship with the committee in my role as Minister. Disability will fall within the new extended remit of my Department. By bringing responsibility for the delivery of disability services from the Department of Health and responsibility for equality policy from the Department of Justice, we are seeking to take a wider view of the lives of people with disabilities based on an understanding that disability is not solely a health matter, but something far more all-encompassing. We are in the process of moving responsibility for service delivery from the Department of Health to my Department. We hope to achieve that fully by the first quarter of 2021. At that point, the Minister of State, Deputy Rabbitte, and I will be working directly in the same Department. Until then, statutory responsibility for disabilities service delivery remains in the Department of Health.

The Government is committed to improving the lives of people with disabilities. The national disability inclusion strategy, NDIS, is our key framework for policy and action in this regard. This takes a whole-of-government approach to improving the lives of people with disabilities and creating the best possible opportunities for people to fulfil their potential. The NDIS steering group oversees implementation of the strategy. The group is chaired by the Minister of State and meets quarterly. It includes representatives from Departments, the National Disability Authority and members of the disability stakeholder group.

Since the launch of the NDIS in 2017 there has been significant progress across a number of key areas. The most notable achievement was the ratification by the previous Government of the UNCRPD in March 2018. The strategy also includes a range of actions to support people with disabilities to enter and remain in employment, and expanding opportunities for people with disabilities to participate in employment is a key priority for me. There has been progress in other areas as well, such as improvements in transport accessibility, including the reduction of the notice period for DART and train users, and improved accessibility in some train and bus stations. Obviously, more work has to be done in that area.

A mid-term review of the NDIS was published earlier this year. It was completed following consultation with disability stakeholders and relevant Departments and agencies. The stakeholders indicated that they wanted to see a focus in the next years on implementing existing commitments within the strategy. They are particularly interested in those elements that are essential for the implementation of the obligations that arise from our signing and ratification of the convention. As such, advancing those points that are relevant to the ratification of the convention is a key priority. Our approach to meeting the obligations of the convention is one of progressive realisation and each year moving forward on key reforms.

As we continue to advance the implementation of the convention, it is vital that the Government hears the voice of people with lived experience of disabilities. The experience and perspectives of people with disabilities are essential to enable us to develop policies and programmes that meet their needs most effectively. That is why the Government is funding a disability participation and consultation network as one of the key actions to fulfil our responsibilities under the convention. The Minister of State announced that earlier this year. The aim of this network is to provide new opportunities for persons with disabilities to be involved in the development of policies and legislation. One of the network's first tasks will be to engage with the State's first report to the UN on our progress in implementing the convention. Following an open competitive process run by my Department, Inclusion Ireland has been selected as the organising member for this new network. Inclusion Ireland will work with four other organisations, the national autism organisation AsIAm, the Disability Federation of Ireland, the Coalition of Disabled Persons Organisations and Mental Health Reform. These organisations were selected competitively to act as grant-funded members of the network. There will be a further selection process for individuals or organisations to be involved in the network.

A consultation process will shortly be launched on the State report that Ireland will submit to the UN Committee on the Rights of Persons with Disabilities. It is the Government's intention, as indicated in the programme for Government, to ratify the optional protocol to the convention once the first reporting cycle has been completed.

Another important step towards the full realisation of the commitments in the convention will be to commence the Assisted Decision Making (Capacity) Act 2015, enact the disability (miscellaneous provisions) Bill and enable the decision support service to become fully operational. I secured an increase in the budget for the decision support service of €2 million, bringing its budget up to €5.8 million.

We want to see effective structures which allow persons with disabilities to fulfil their rights. This extends from the Houses of the Oireachtas to the courts and throughout the everyday life of the individual. The Minister of State, Deputy Rabbitte, and I are determined that our new Department will be rooted in human rights and social justice and we will drive these changes in government. Our aim is the needs of children and adults with disabilities. Their families will have their needs addressed and will be able to participate more fully in society. I look forward to questions from the committee and further long-term engagement with all the members.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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I thank the Minister, Deputy O'Gorman, and invite the Minister of State, Deputy Rabbitte, to make her opening statement.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank the Chair and members for inviting me. I look forward to working with the joint committee which has been established specifically to deal with disability matters.

Unfortunately, many people with disabilities and their families saw schools, day services and respite services close during the pandemic. I completely understand that people might feel they have been forgotten but I want the committee to know that I have been working hard to ensure that people with disabilities and their families are listened to and are at the heart of decisions made by the Government.

My sustained efforts, with my colleagues in Cabinet, secured an additional €100 million in budget 2021 to assist people with disabilities and their families. In addition, on Friday last, I and the Minister for Health, Deputy Stephen Donnelly, announced €20 million in once-off funding for voluntary service providers. This will be used to achieve additional measurable progress, for example, in reforming disability services, improving the quality of life for those who rely on these services and building capacity of disability organisations. This will happen under three different strands. Eligible disability organisations can apply to the HSE disability services by 18 November giving details of their proposal, the budget required and the rationale for what the relevant organisation expects to achieve. The panel of assessors, which will be established by the HSE, will review applications and issue funding approvals by the end of November. Larger grants of over €25,000 will be issued in three different stages. When the budget day announcement was made, we stated this measure was part of transforming lives and it comes under the agenda of transforming lives. This is in addition to the more than €2 billion that the Government provides to fund disability services on an ongoing basis. This sum is significant and I hope it reflects to the committee the importance the Government places on ensuring people with disabilities can return to a normal and safe life within the confines of Covid-19 restrictions at every level of the living with Covid plan.

I will address the impact of Covid-19 that people with disabilities and their families faced during the Covid-19 crisis. It is a challenging time for many people with disabilities and their families whose services were forced to close earlier this year. Unfortunately, people in our services, both staff and service users, especially in residential services, contracted illnesses. Approximately 8,400 people with disabilities live in HIQA registered disability services ranging from single apartments to group homes in the community and campus based facilities. The Health Protection Surveillance Centre, HPSC, has confirmed that, as of midnight on 31 October, there have been no outbreaks of Covid-19 in more than 80% of the centres. Outbreaks have been recorded in 143 residential disability centres, of which 104 or 73% have now been cleared or closed after 28 days with no new cases. The remaining 39 remain open. A total of 709 people are laboratory confirmed Covid-19 positive and it is estimated that 54% of those affected were staff and 46% were residents. Unfortunately, 13 people died, all of them residents. I extend my sympathies to their families on the passing of their loved ones.

Visiting guidelines have been developed outlining when visits to people in residential settings can be permitted, while seeking to strike a balance that emphasises that these facilities are home for the people living in them. The importance of maintaining family connections with loved ones, from a holistic person-centred approach, is underscored. In general, visitation was restricted to outdoor visits only for level 3 and above in the living with Covid plan. However, the guidance also recognises that in residential disability services, in our own-door supported accommodation or small group homes for people with disabilities, in particular, where residents are younger and do not have medical vulnerabilities, the risk is lower than in larger congregated care settings for older people and additional visits can be managed, especially if there is one nominated visitor who complies fully with the measures of reduced inadvertent introduction of Covid to these residents. At a framework level, critical or compassionate visits may occur subject to a risk assessment in each case.

Our best line of defence against Covid-19 is planning for infection prevention and control and this is done through the public health department in the HSE. By working together, the HSE and service providers have developed guidance on the safe return of services. While the manner in which services are delivered has probably altered, nonetheless children's services, adult day services, respite, personal assistance, PA, and home support are now deemed essential services and it is my intention that we will remain open at all levels of living with Covid.

There was substantial early engagement on infection prevention and control, leading to regular updates to guidance and infection prevention and control as well as dissemination of the information through dedicated webinars for the staff in all disability residential settings. HIQA has also developed an infection prevention and control assurance framework, which includes a self-assessment tool that will be supported by HIQA through an outreach training and support programme.

Many people with disabilities live at home with their families and loved ones and many saw their routines and way of living completely up-ended causing much distress. Some people lost services for in excess of 20 weeks. That was a phenomenal and unbelievable upturning of their lives. Some families with older parents who are vulnerable and at risk were not comfortable with receiving even the outreach model that we wanted to put in place. There was a great deal of stress and frustration among families and service users with disabilities. It is important to acknowledge that the families of some service users are still not comfortable using services again due to the underlying conditions or profound disabilities of their loved ones.

Many services have had to fundamentally re-examine how they deliver services, from room size to types of activities, transport options and so on. It is likely that some of the targets in the 2020 national service plan cannot be met. However, as I indicated, service providers have not been found wanting and have been admirable in putting the safety and needs of people with disabilities at the front of their response.

Complete compliance with both the letter and the spirit of the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, will not be achieved immediately. There will be challenges but, despite Covid-19, we are moving in the right direction. As I mentioned, the health budget will allocate an additional €100 million in new funding to enhance services and supports for people with disability focusing on key areas that have been affected by the Covid-19 pandemic.

Covid-19 has been devastating for many families. I am sure we all know people who have been affected. Members will have been inundated with representations and emails from constituents expressing frustration, upset and despair, as I have. The Government is committed to working with the Minister for Health, Deputy Stephen Donnelly, the Minister of State, Deputy Roderic O'Gorman, and other colleagues to move towards returning to normal daily life in as safe a way as possible. We want to support people providing vital services while protecting service users and staff. We will get through this together. I look forward to working with the committee to help ensure that we focus our resources on prioritising the lived experience of people with disabilities.

We are still living alongside Covid, which has not gone away. During the early weeks of the pandemic, the HSE, service providers and the Department worked together very well. It is important to acknowledge that.

The collaboration was unbelievable and I would like it to continue in that spirit. I will continue working in that way with my colleagues, the Ministers, Deputies O'Gorman and Donnelly.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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Covid-19 has been particularly difficult for people with children with autism or disabilities. I have been contacted by people whose family members are affected by autism, although we are very lucky in Carlow that we have great facilities. There is the Delta Centre and the Holy Angels Day Care Centre and we are very lucky with our services there. I welcome the €100 million allocated for services and the additional €20 million for improving them. In regard to funding, will staffing be a big issue? Respite was one of the biggest issues for families that faced all Deputies during Covid. Some family members found it difficult to cope because their loved ones were not in their normal routine which is a part of life. The problem was that the family members themselves did not get a break. Even though services have returned, many of them are offering only three or four hours a day and are not back full time. In Tullow in County Carlow, there is a lovely respite centre and we were promised two years ago that there would be overnight respite there. I have been contacted by many families who are seeking overnight respite for their children following the lifting of level 5 restrictions. I understand we have to be very careful in our behaviour at the moment, but will the Minister of State examine whether we can get overnight respite at the centre?

Staffing will be the biggest issue going forward. While it is great to see all this money, we still have to get staff and doing so will be challenging. The Minister of State might revert to me on that matter. Bus services are another big issue. Again, I understand this is no one's fault and we are in a different time because of Covid. Nevertheless, I have been contacted by people who do not own cars and who use the various bus services. They have found it very difficult because they have not been able to get their children on a bus. This funding is so important but it is about how it can be accessed. The Minister and the Minister of State are so determined that they will get the matter right, but for my area - I can speak only for my area - a structure needs to be put in place. Having spoken to people who have approached me, I think the HSE needs to work with the Departments on guidelines and information for the parents. We need to try to find out what is happening, when it is happening, how services can be accessed and what families can do. All of us working together need to play a part in this. Everyone's life has been touched. We are exceptionally lucky in Carlow and people travel for a half an hour to access our services because there are such great services, but the problem now is that everything has been shut down.

In summary, do our guests expect staff to be an issue? What will happen to the bus services? Can we provide greater overnight respite besides getting children back to their normal routine of going to their everyday services? I reiterate that Covid-19 has a significant part to play.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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In the budget that was outlined, €100 million has been left aside. One of my priorities related to respite, for both adult service users and children. Many members will be aware that during Covid, some of our respite centres were used as isolation hubs. One of the first tasks I took on with the HSE involved ensuring that those isolation hubs would be stood down and could return to use for respite services, given that overnight respite had been lost. That was because, at that time, isolation hubs had to be at a standard defined by HIQA in order that people could stay in them. If someone was self-isolating there for 14 days, the accommodation had to be of HIQA standard. In many of the community healthcare organisations, CHOs, where there are multiple providers, the HSE is itself allocating isolation hubs such as the one in the Chairman's home county. The HSE is working with the two CHOs in question and the hubs will provide isolation facilities. That will address the need for respite and put some support and structure in place for families.

Going forward, of the €100 million allocated in the budget, respite will be a significant aspect in three phases. We want to build capacity into it, by building new units and getting more units up and running that need staffing funding to be delivered, and to increase the number of planned places and emergency places. The crisis has put a great deal of pressure on what would normally have been planned because of emergencies or family circumstances and so on. Respite is part and parcel of the funding. It will be delivered under a service level agreement with HSE and the nine CHOs, which we are planning to deliver in the first week of December.

As for staffing, one good aspect throughout this crisis relates to the pool and panel that the providers have. They are in a position to increase some of their contract hours to ensure there are more staff who can work. I have spoken to a number of the providers in various parts of the country, and while they may have had some staff on shorter hours, they are now in a position to have them work longer ones.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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I ask the Minister of State to conclude because we want to allow time for everyone.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I ask the Minister of State not to forget the Holy Angels issue.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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We might return to that.

Photo of Pauline TullyPauline Tully (Cavan-Monaghan, Sinn Fein)
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I welcome the Minister and the Minister of State to the meeting. I, too, welcome the formation of the committee. It was called for for a long time but did not happen until now, so it is great that it has happened. As the Minister noted, disability is not just a health issue; it is a much broader issue and I fully agree with that. We have to be careful not to overlap with the other committee but rather work with it, as we said earlier we would. It is the job not just of this committee and the other to deal with disability but of every Department. The Minister sits at the Cabinet and has to ensure, on behalf of every person with a disability, that every Department meets the needs of those in our community who are disabled.

Deputy Murnane O'Connor mentioned transport. In my area, if somebody needs a wheelchair-accessible taxi in a rural area, he or she will charged twice that of someone who needs a regular taxi. Public transport is not available in many rural areas.

Whose responsibility, ultimately, is the closing of congregated settings? It had come under the remit of the Department of Health. Is that still the case or is it a matter for the Minister's Department? A deadline of 2018 was set for closing congregated settings but that was not met. It has now been moved to "ultimately" happening at some stage but that is very vague and needs work.

That brings us to the issue of supported independent living, not just in congregated settings. Many adults aged 20 to 60 live at home with their parents, but that is not fair and does not respect their dignity and independence. They need supported independent living but it is not available or achievable. On the other hand, there are older parents, many in their 70s and 80s, who care for their loved ones, and their main concern is what will happen to them after they pass away. That is not a matter to be left until they do so; it should be dealt with now. People should be given the respect and dignity they deserve. Many people, especially those with a physical disability, need a personal assistant service to live independently, but again that is very difficult to access and is not being provided. What procedures are in place to deal with that?

Disability allowance and carer's allowance seem to be some of the most difficult payments to secure from the Department of Social Protection. The carer's allowance takes months for some reason. It is very difficult and often it will have to be appealed a number of times before being granted. The same is true of the disability allowance. I was disappointed the disability allowance was not increased in the budget because the cost of living with a disability is much higher than the allowance reflects.

The Covid payment is €350 per week whereas the disability allowance is only €203. They also have extra costs of medication or other services they might need on top of that. This should be dealt with too.

The issues are huge and there are an awful lot of them, but I would like Minister and the Minister of State to answer the questions. We will be working through the different issues as we go along. I hope this committee will also hold other Ministers from other Departments to account to make sure they are playing their role in making us a disability-friendly nation.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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As the Deputy has said, putting the needs of, and giving voice to, persons with a disability has to be absolutely at the core of what we achieve in this committee. When the Minister of State, Deputy Rabbitte, and I were initially appointed, we met representatives of disabled persons organisations in late July and August. The Disability Federation of Ireland really flagged with us that its members wanted to see this committee formed because they were aware there was an existing commitment to have a specific disability committee formed and that this had not been acted upon. We wrote jointly to the Ceann Comhairle before the Dáil resumed. It was in train anyway but it was important. We saw that it is recognised by the disabled persons organisations that this committee will have a really important function both in holding to account and in ensuring Government is working together.

The Deputy also made the point that the job of advancing the rights and needs of persons with disability does not just fall to me and the Minister of State, Deputy Rabbitte; it falls to every Department. One of my jobs at Cabinet is to remind everyone of that as much as possible. Even in the context of the presence of the Minister of State, Deputy Madigan, at the Department of Education, there is a much more holistic approach to it being taken by this Government. The creation of this Department is an important step in that for the first time. In the previous Oireachtas, the Minister of State, former Deputy Finian McGrath, did a really good job as the junior minister, but I believe there was an understanding that rather than having a junior minister across a number of Departments maybe the best way to work was to bring responsibility for policy and service provision together in one Department, which is what we are seeking to achieve.

The Deputy listed a few specific points such as, for example, the end of congregated living. That will be a role of this Department. The remit is still with the Department of Health at present because service provision has not moved over yet but the entire health responsibility will be moving over in the next months and will rest with this Department.

The issue was raised about the difficulty in accessing carer's allowance, which is one of those areas I need to raise with my colleague, the Minister for Social Protection, Deputy Humphreys. The Deputy might come back to me with some specific examples and I could speak to the Minister about that area.

Deputy Tully raised a number of points, all of which tie back to the idea of giving persons with disabilities the greatest independence possible, whether it is people in rural Ireland who have a disability and for whom public transport is not an option or if it is a personal assistance service. We engage with a number of organisations in that regard, including Independent Living Movement Ireland, and they have pushed for that. We have met a number of people whose lives are transformed by the provision of the personal assistance service. We are conscious of that.

It is a big change in responsibility and it is taking a little while to move services from the Department of Health to our new Department. We believe in taking the time to get it right. There will be a new relationship between my Department and the HSE. There will have to be an accountability relationship and that will involve some changes to the health Acts and some changes to primary legislation. A very significant disability services budget of €2 billion will be moving, as the Minister of State, Deputy Rabbitte, has outlined. It is taking a little bit of time but it is worth taking that time to get it right and to get the structures in place. It is our intention to make it work.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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On the congregated settings, I answered a recent question by the Deputy, which may have been a Topical Issue matter in the Dáil. We are committed as a Government and it is in the programme for Government. At present, there are approximately 2,000 people who have to be decongregated. There is provision within the budget to support this. This year alone, even with Covid, 66 people moved out from congregated settings. It is a priority. As the Minister, Deputy O'Gorman, has said, we met representatives of Independent Living Movement Ireland, who spoke about the value of the personal assistance. We have taken that on board and it is also being provisioned for within the budget as part of our service level agreement.

Photo of Mary Seery KearneyMary Seery Kearney (Fine Gael)
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I thank the Minister and Minister of State for their opening remarks. I really welcome the inclusion of disability and equality under the same roof. It makes absolute sense. It resonates with the Equal Status Act. When I think of all those rights, it is fantastic. The lawyer in me gets absolutely thrilled with the notion of this Department. The Minister has a fantastic vision for it and I congratulate him on it.

I deal with an organisation in this regard, whose motto on the provision of services is that it wants the people with whom it engages to "live their best life". In everything I do with engagement with regard to disability, that is also my guiding principle. How does one ensure that a person can live their best life? With the Minister and Minister of State, and with the Minister of State, Deputy Madigan, I see that we have a cradle to elder years provision here now, finally. That is a fantastic vision. I really embrace it. It looks like money is following it also, which is fantastic.

I shall now turn to a few issues of concern for me from the moment of birth, let us say. Given that there are both pre-Covid and since-Covid situations, and naturally there are other issues around maternity and women giving birth at the moment, but even pre-Covid, the diagnosis of a disability and parents being told their child has a disability has, on occasion, been done in the coldest of ways, on corridors, lacking compassion, in a matter-of-fact manner that might be reasonable to healthcare professionals who are used to it. To be fair, this manner is not synonymous with the professionals' personalities but I have heard horror stories of people being told fairly life-impacting and major news in the coldest way. I would like to see a training programme provision in the supports to ensure sensitivity to what it is for parents to receive that news and everything that flows from that. This would also look to make sure the care packages come in immediately. There seems to be a delay at the moment. In one instance I am dealing with at present, the baby was born in July and will be perhaps next February before the medical card is available to them. The parents must prove that their child has a disability, when it is very obvious that the child has a disability. There seems to be some sort of bureaucracy around that, which I would love us to break through and deal with.

I love the Minister's embrace of having representative groups at the policy table, which is very important and I really honour that. We need people whose lives are impacted to have an absolute say in the making of policy from day one. Making sure that organisations such as AsIAm have a seat at the table in everything that affects autism is really important, for example, with regard to having seats on boards and having statutory instruments amended.

Another issue is a transport matter that I have brought up on a few occasions in the four months I have been in the House. The criteria for the primary medical certificate fall far short of what they need to be. People who are amputees who are missing only one upper limb suddenly do not qualify for that. The criteria are completely outdated and antiquated and this matter needs a review, please.

I am curious about, and would love the Minister's comments on, his compellability. Is it merely advocacy at the Cabinet table or just how much does he get to command response from other Departments? How much has the Minister been empowered?

I wish to make two points on employment. The Houses of the Oireachtas ran the Oireachtas work learning, OWL, programme with WALK in Drimnagh. This was a fantastic success that was really celebrated. Obviously, the programme has been arrested because of Covid but could we look at working with that organisation to have its feedback on how the model worked? It was certainly fantastic.

However, people with disabilities such as dyspraxia on community employment, CE, schemes are afraid to ask about their security of tenure so they and their families live in fear of what will happen next. What happens at the end of the CE scheme and they are relying on extension after extension? We could have something more bespoke working beside them. Well done; this is fantastic. I am very excited about what we can do in this regard.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for her comments and good wishes. I will take on board what she said regarding point eight - training, support, sensitivities and how people can communicate life-changing events along with breaking through the bureaucracy. This is why I am Batwoman alongside Robin here at the moment. I am trying to break through that bureaucracy for the simple reason that it is not just a health issue. We must engage with all the other Departments. It is not different from what was said by Deputy Tully. This is the start. We are breaking away from it being just a health issue. The issue of people with disabilities is about more than health. It relates to the rights to employment, transport, education and housing. It involves tying all this in. How do we command on that? This is why there is a movement out of health into the new Department and why a junior Minister is going into that Department with sole responsibility for disability with the support of a senior Minister in Cabinet. This is how it will work. My focus for the next number of years is on the points I raised with the Senator. It will involve wrenching it out of the Department of Health, sending it over to the Department of Children, Equality, Integration and Youth and then starting to make progress on employment and housing. When I talk about housing, I mean planning and how we provide it as part of decongregation - embedding within the community and giving comfort to families that plans are there and their loved ones can be set and well-established so that they do not have to be at home as they are growing hold wondering who will cater for them if they were to pass away. That is progress. It involves looking at how disability is viewed. That is the vision. We hope to work well together on this so that it is not just an aspiration but transforms people's lives. It is not just advocacy; far from it. A budget of €100 million is not advocacy.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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"Command" is a big word but it is about working together. My ability and that of the Minister of State within the Department and across government is seen in the very significant delivery of funding for disability in this budget. The Minister of State led the charge on that. That €100 million is very significant for next year. It is not commanding; it is just working together and pointing out. The Taoiseach feels very passionately about this issue as well.

I agree regarding the importance of getting disabled persons' organisations involved in the setting of policy. The network set up by the Minister of State will be essential but that is also a key part of our responsibilities under the convention. It is because of signing up to the convention that we are now setting up this network to bring disabled persons' organisations into the process in a way that has not been done previously. One thing we learned when we engaged with groups early on was a sense that they had been marginalised in the process up to now. It is my hope and intention to ensure that this network reverses that.

Photo of Neasa HouriganNeasa Hourigan (Dublin Central, Green Party)
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I start by saying well done on budget 2021. That level of funding will be transformative for many disability services. It is really important. I have a number of questions. If the Minister and Minister of State do not have the answers, they might come back to me at a later date or write to me. I would like an update of where we are with regard to the Disability (Miscellaneous Provisions) Bill 2016. This was to have been put through the Dáil but, obviously, fell in January 2020. All of us on this committee are grappling with how we use the UNCRPD as a mechanism to improve how we deal with disability services and strengthen statutory instruments in place. For example, we are quite unique in the EU insofar as we have a centre for excellence in universal design that has a statutory underpinning. I have visited that centre. There is great knowledge. How do the Minister and Minister of State envisage us harnessing the kind of services we have? Organisations such as the National Transport Authority do not always utilise statutory instruments like that pertaining to universal design? How can we, therefore, use this committee to strengthen those kind of mechanisms? That will be enduring impact of a committee such as this.

I read through all the briefing notes for today. Something that struck me is that, as per usual, we have a significant number of good ideas around disability but many of them are geared towards input. We have a plan, we have a report, and this is how we are going to do things. I wonder whether over the lifetime of this committee, we can focus on outputs. Bearing in mind Deputy Tully's point about asking in different committees, I have been doing that for disability. When the Department of Public Expenditure and Reform appeared before the Committee of Public Accounts, I asked it to write back to me about how many people in the Civil Service report having a disability. The Department's target is 3%. We did not get a departmental breakdown or what those disabilities are. When the Department wrote back, it said that the figure was 4.3%. That does not sound too bad. It must be remembered that the Civil Service is expected to be one of the better employers. It would probably be interacting with the National Disability Authority and utilising all the recommendations from the comprehensive employment strategy so it is probably doing all the right things. A figure of 4.3% does not sound too bad. More than 10% of staff in the civil service in the UK report having a disability. We all know that Ireland has incredibly low levels of employment engagement in the disability community. The EU average is something like 57% whereas the figure is 36.5% in Ireland. I guess it is an open-ended question. How can we ensure that with all the good reports and good intentions we have and that incredible funding we can set up mechanisms that are based on outputs? Are those numbers moving up? Are we putting funding in the right place?

I will pick up on Senator Seery Kearney's point about the primary medical certificate because I raised it at the Joint Committee on Health with the Minister for Health. Assessments for a primary medical certificate are suspended at the moment, which is incredibly serious. I stopped short of asking the Minister to put people in a room and not let them out until that is solved but I am pretty close to that. It is urgent. Could the Minister and Minister of State could give an undertaking to work with the Minister for Health to sort that out as a matter of extreme urgency?

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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Regarding primary medical certificates, following a court hearing in July, the decision was taken to suspend all further applications. The reason, with which I agree, was that the criteria were so narrow. Deputy Canney and I have constituency colleagues in Galway who advocated very recently about it. It is very limiting. A blind person can never apply for a primary medical certificate. I welcome the decision to suspend and review it. Believe it or not, this comes under the remit of the Minister for Finance. He instructed the Minister for Health to suspend all applications until we saw the outcome. I will liaise with the Minister for Health and make it a priority because it impacts on so many. The scope of it was very narrow.

Photo of Neasa HouriganNeasa Hourigan (Dublin Central, Green Party)
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I agree but people can sometimes not access particular services if they do not have access to that certificate.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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That is correct and we will take that on board together.

I said earlier that employment is one of my focuses.

There was a commitment to the programme for Government to increase the number of staff in the public sector. It is one of the five themed areas I will be working on.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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Deputy Hourigan makes an important point on output legitimacy in these strategies. It is one that we are noticing in all the equality strategies. I will chair four other equality strategy bodies, while the Minister of State, Deputy Rabbitte, chairs this one. The European disability strategy ends in either 2020 or 2021 and the national disability inclusion strategy ends in 2021. We may need to look at exactly how those are framed for the next strategy. As regards the current strategy, we are not without support for it, for example, the Irish Human Rights and Equality Commission, IHREC, is giving us support. I have met IHREC and our discussion focused specifically on the public service obligation as regards employment of persons with a disability. I will engage further with the Department of Public Expenditure and Reform on that, initially with a view to having a circular issued to all Departments, and later across the public service, setting out further guidelines on how that obligation should be implemented. IHREC identified a gap as regards supporting Departments in doing that. The Deputy is right that the public service and Civil Service should be the best in ensuring we meeting and exceed these targets.

We are looking to increase the target to 6% in the context of the disability (miscellaneous provisions) Bill. That is one of the provisions in that legislation, which also contains other technical provisions on the National Disability Authority staff. We hope to introduce provisions to strengthen our obligations around the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD. We are looking at removing from mental health legislation the concept of persons of unsound mind and allowing persons with a disability to serve on juries. The decision was taken then to allow the existing Bill to lapse and it is a priority of my Department to introduce a fresh Bill. A number of matters are consequent to that particular Bill being brought through the Oireachtas.

On the use of existing mechanisms, when we have the very strong guidelines on universal design in place, the committee will have an opportunity to bring before it State agencies, Departments and private sector bodies to ask why these guidelines are not being followed. We will look very closely at the conclusions of the committee’s hearings to see what we can do, whether that is a legislative issue, an administrative issue, as appears to be the case with the public service obligation, or a resource issue. It may also be a case, as the Deputy suggested, of bringing people into the room and locking the door until we find a concrete resolution to an issue.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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I thank both the Minister and the Minister of State for their attendance. It is great to have a committee dedicated to this issue and making things happen. So far, the Minister of State, Deputy Rabbitte's engagement with disability support services and people with disabilities has been really refreshing. Many of the providers in my area are very grateful for her engagement and I thank her for that.

Many of the issues I intended to raise have already been raised. Deputy Tully, for example, raised the issue of the payment being lower than the pandemic unemployment payment, which has highlighted the shortcomings in that regard, and Deputy Hourigan raised the issue of employment. For this reason, I will not go into great detail on these issues as they have already been discussed.

The Minister referred to the ratification of the United Nations Convention on the Rights of Persons with Disabilities under the previous Government. While that is great, it is very important to the committee that the ratification of the optional protocol is included in that because people with disabilities need to be able to exercise their rights. Many different supports and infrastructures need to be in place for that to be possible and we all need to be held to account on that. One way of achieving that is to ratify the optional protocol, which is essential. A rights-based approach is very important.

The Minister of State referred to people living in nursing homes and unsuitable congregated settings and noted that, sadly, some people had passed away as a result of Covid-19. This highlights an already existing issue from which we will have to learn. If we are to take seriously the United Nations Convention on the Rights of Persons with Disabilities and hold ourselves to account with that, the need for independent supported leaving will be paramount. This committee cannot just make that happen. We have to liaise with the Department of Housing, Local Government and Heritage. The Minister of State also referred to liaising with the Minister for Health, Deputy Donnelly, and other Ministers. It is very important that the Department of Housing, Local Government and Heritage is consulted from the outset. Every Bill should include independent supported living. I do not know if the position varies throughout the country but in my constituency, getting independent supported living is not possible for persons with disabilities. That is sometimes possible for older persons but even then it is very challenging. From the outset, we must work with the Department of Housing, Local Government and Heritage to ensure people actually have a right to live independently because if that does not happen, people will not be able to exercise their rights.

On employment, there are organisations that are very well-funded through the Government on issues such as employability. In speaking to these organisations, they argue that if they had long-term dedicated funding, instead of being funded every year, it would be of great benefit as they would know with certainty that the funding was coming. They are rolling out programmes lasting for longer than the funding they receive. They do not feel that enough people who could use their services are aware of them. An awareness campaign on all the various services the Department is funding and providing could make a significant difference to the lives of people who may not necessarily know that the services are available. Joined-up work on employability opportunities throughout the country is needed because we have so many services operating independently and people are not always aware of the great service they are providing.

On access to speech and language therapy, this is a nationwide problem and we have heard about the representations being received by Deputies and Senators. Parts of west Cork are two hours from Cork city and people have to travel to the city for half an hour of speech and language therapy. This short session is so essential and important to these people. Many of the people travelling cannot be in a confined space for a two-hour journey with many stops along the way to attend a 30-minute session. This is likely to be the responsibility of the Minister for Health, Deputy Donnelly. It is very important that we focus on these essential services at the point of need. If one speech and language therapist was available for two days a week in rural areas, it would make a great difference. This is one of the points I am hearing most about from my constituents.

My main questions relate to the ratification of the optional protocol and the need to work with the Minister for Housing, Local Government and Heritage on independent supported living.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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On the optional protocol, the ratification of the convention is a step of great importance and we are already seeing the ripple effects of that in the context of creating the network of decision support services, which is all as a consequence of that. The benefit of the optional protocol would be to allow individual persons with a disability to petition the UN committee and to allow the UN committee to undertake inquiries to establish whether there are major issues in Ireland with regards to failure to meet requirements under the UNCRPD. The commitment in the programme for Government is to ratify the optional protocol and the intention is to allow the first reporting cycle to be completed first. My Department is working on the drafting of the report. That report has to go to the network and will then be published as a public document for public commentary and consultation before being concluded and submitted to the United Nations committee for its scrutiny. It will then come back with a response and at that stage we will be bring forward the ratification of the optional protocol. This is clear commitment in the programme for Government.

On the issue of employment, the Minister of State, Deputy Rabbitte, has identified that this as a priority for us. Deputy Cairns flagged that there may be a lack of knowledge on the part of persons with disabilities about what services are available. There is also a lack of knowledge on the part of employers about the supports the State can provide. These supports are significant. Employers may be nervous about taking on what they may perceive to be something that will be difficult to manage for them. We need to support employers, particularly in the private sector. We are bringing forward an awareness campaign and will back that up with a website and a new approach to getting that information out to employers. One of the areas the Department recognise in respect of objective 5.1 of the comprehensive employment strategy is that not enough has been done on that particular point.

We are looking to pilot a programme of supports for more intensive, dedicated job employment coaches for people with disabilities to assist them in the entire process of curricula vitae and interview preparation and to provide them with ongoing support. We are taking baby steps with that but it will be significant if we can run a successful pilot, and then we can mainstream it.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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That builds on the back of the ability access programme which received funding under the then Department of Employment Affairs and Social Protection three years ago. The feedback from that programme has been very positive.

During the summer, the Minister and I also met the Ombudsman, Peter Tyndall, who addressed the issue of people with a disability aged under 65 years who were living full-time in nursing homes. We are committed to addressing this in the budgetary funding provided to us. We are also looking at ways and means of working with the Department of Health and discharge co-ordinators in hospitals to see how we can integrate people in the communality rather than considering nursing homes as the first and only option.

On housing, after this meeting, I will meet the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, to start a conversation on housing. We are about to embark on building large numbers of houses and it could be a missed opportunity if we do have a conservation on disability and ensure it is part and parcel of planning. Advisers tell me that when they go to purchase or reconfigure a property, objections are received. It is also considerably cheaper to build a property from the foundation up rather than to reconfigure one that has been built. We are starting a conversation with the Minister on that this evening to find a way forward.

Photo of Seán CanneySeán Canney (Galway East, Independent)
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I welcome my constituency colleague, the Minister of State, Deputy Rabbitte, and wish her well in the role. I have done so already in the Dáil. We will work together for the benefit of people with disabilities. The same applies with regard to the Minister, Deputy O'Gorman. The committee was established so that we can hold the Ministers to account. However, as well as observing, we will contribute in a positive way to ensure that, at the end of this Dáil, we will be able to look back and say we did something positive which had an effect on people's lives. As a Deputy from a rural constituency, I have come across many things that one would not be proud of as a politician.

Deputy Hourigan made a point about primary care services being suspended. The motorised transport and mobility grants were suspended in 2013. There is great concern that suspending this scheme will keep it in abeyance for a long time. When the scheme is reviewed, it should be expanded to make sure the grants are given to the people who need it. The rules around the scheme have been questionable. It has taken a mother to bring the Department to the High Court to prove it was a shambles. When I asked a question in the Dáil, I was told it was up to the Minister to review the scheme. It is important that the Minister engage with Department of Finance to ensure the necessary steps are taken to get the scheme going again.

The Minister of State will be aware that there are no overnight respite services available for children in Galway. If parents want a respite night, their child has to go to Limerick. That is not acceptable in this day and age. Is the €100 million for providing respite services capital funding or will it be used as current expenditure?

On transport, the Minister referred to a reduction of the notice period for DART and train users and improved accessibility in train and bus stations. That is commendable but there are many places in my constituency that do not have a bus service, a bus station or a bus stop. We do not have proper support for people with disabilities in rural areas. Only a month ago, a local councillor was ferrying people into a service in Galway because the service provider and the HSE could not provide the transport to a necessary service. The service is available and has been assessed as needed. I hope that when the Department has been knitted together, there will be joined up thinking to prevent that kind of farce happening again.

The carer's allowance is a marvellous scheme but it can take 15 weeks after application for a decision, which is invariably a refusal. It might take another five or six weeks for a review and a successful outcome. That is wrong. We talk about cross-departmental work and the Cabinet. This issue needs to be examined by the Department of Social Protection. There is no need for applications to take 15 weeks to assess. The application process is simple and applications should be processed in a more realistic timeframe. I accept that the payment is backdated but that is of little comfort to people who have to provide care for 20 weeks because they feel trapped when they do not know what they will get. Caring at home and the carer's allowance save the State money.

Housing was mentioned. The local authorities administer the mobility aid and housing adaptation grants. They do a great job but the money is very small and the local authorities receive a limited budget. When the Minister of State speaks to the Minister for Housing, Local Government and Heritage, that matter should be examined. If someone with a child with a lifelong disability is building a house, he or she will want to build a house that suits the child. It might cost an additional €50,000 or €60,000 but there is no funding available other than a mobility aid grant from the local authority, which would not cover a fraction of that cost. That needs to be considered in the context of the €2.1 billion being spent on services.

I have a major gripe about cases involving children who are born blind. Each time parents make an application for a grant or additional service, they must prove that their child is blind. There is something wrong with the system. This unnecessary requirement creates considerable bureaucracy. It is very demoralising and drags down parents when they have to go through this process every time they look for something for a child who is blind from birth and is permanently blind. Amputees must also have to provide proof over and over again. A change of attitude is required across government to address this.

There are many challenges. Putting on my Committee on Budgetary Oversight hat, my main point is that when we spend money or plan to spend money, for example, the €100 million I referred to, can the committee be given a breakdown of where it is being spent? We could then see where it is being spent and examine outputs. That is important. We spend a lot of money on health but we find it hard to see how it is being spent and where the return is because the sums involved are so big. Large sums are being spent in the area of disability. I hope that, together, we will achieve greater efficiency and better outcomes for those who need it. Work being done on employability is to be commended. The targets are in place. We should have targets and try to meet them in both the public and private sectors.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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The Deputy is correct about the importance of being able to trace where the money is being spent. We hope that removing the €2 billion disability budget from the Department of Health and bringing it into the new Department will strongly enhance traceability.

It is still a significant sum, but taking it out of the existing €90 million budget will enhance the ability of committees and the public to see where it is being spent, particularly ensuring that we are getting outcomes for it, as Deputy Hourigan stated earlier.

I am happy to engage, as I stated earlier, with the Minister for Social Protection on the carer's allowance issue to see what simplification of the existing bureaucracy and speeding up of the process we can undertake there. I am hopeful that the creation of the network and the bringing into the policy and legislation-making process of the voices of disabled persons' organisations will make a real difference. Whether it is highlighting the fact that these process are taking so long or highlighting the fact that the parents of a blind child or an amputee are forced to undergo the indignity of proving the child's disability time and time again, these are consequences of a system that was about disabled people but not involving disabled people. One of the core points underpinning the UN convention is to preventing that. The network we are introducing is designed to be the practical realisation of that to bring those voices in. When the Minister of State and I are working on a particular policy, people are able to bring their lived experiences and point out that something is Civil Service-speak or politician-speak, that is not how things work and we need to change that particular element.

I recognise what the Deputy said regarding the different needs in transport. I think I acknowledged it when I was responding to Deputy Tully. I fully acknowledge that the needs of transport are different in different parts of the country.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Canney. I agree with him that there is much not to be proud of and much change needs to happen. He is dead right. Coming from Galway county and from east Galway in particular, when people do not have respite services for children and they must ship them down to Limerick to get an overnight stay, it is not good enough. Unfortunately, we are not unique. That is the sad part about it. I would like to think that Galway was the only place that did not provide respite. There are many other such places around the country. Some of the funding I have secured is for capital expenditure to build or repurpose them and to ensure that every CHO will provide at a minimum a respite house. Every CHO will have one, whether for adults or children, by the time I am finished. I plan this year to build approximately six respite houses throughout the country an i hope the CHO in Galway will come forward for one. This applies to other CHOs, not only Galway, as well. It is up to them to put a plan in place for their service level agreement. They should know where their requirements are. I want to work with all of them to ensure that at a minimum we have respite services in every CHO.

The Deputy also asked about the funding, how the funding is spent and holding us to account, and he is dead right. One of the biggest shocks I got when I went into the Department was when I asked where was the €2 billion and one of the officials turned around and said to me that €1.3 billion is spent straightaway in residential care. Another 20% or €500 million is spent on adult day services. That is €1.8 billion of my €2 billion. After that, it is easy to make it up through what is spent on multidisciplinary therapies, respite and other community services. Those are the strands of funding. What we are trying to do in this budget is create more capacity, which is building buildings and procuring more capacity to put the service people into it and also to ensure that we have the therapists to deliver and to work on the children's network disability teams outside of geographical location so that there we would have network disability teams and right of access and equality for everybody wherever they living in the country. That is the priority.

Photo of Fiona O'LoughlinFiona O'Loughlin (Fianna Fail)
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I thank the Minister and the Minister of State for being here and for their commitment to disability services. They have a large task with many challenges ahead of them. Indeed, we as a committee have a large task as well in helping to identify those challenges and trying to work collaboratively to make practical recommendations that will make people's lives easier because that is what it is all about.

The Minister of State talked about transforming lives. It is about helping people live their lives and allowing their families live their lives. We also must have a situation where we can give hope to those with disabilities and their families and help them reach their potential and live their best lives.

The most important aspect by far when we are dealing with disabilities is early assessment and early intervention. That is absolutely crucial. That has to be the number one priority, for us as a committee and for Deputies O'Gorman and Rabbitte given their ministerial responsibilities.

I made a few quick notes on what they said in their opening remarks about issues, which I welcome. I could not agree more with disability issues being taken out of the Department of Health. It is not only a health issue. Equality, education, social affairs, employment and transport in terms of access are also most important.

I welcome the fact that the Minister of State will chair the network. There is mention of various different Departments involved. It would be useful to have those Departments listed because all too often we see, as in the national disability inclusion strategy, where actions are assigned to Departments and public bodies without defining them and it is difficult to monitor and examine the impact when we do not have the Departments and public bodies specified. There is no doubt we need robust reporting and monitoring and accountability in that regard.

Regarding employment, during the Thirty-second Dáil, three committees came together to look at the challenges and the barriers - the Joint Committee on Education and Skills, the Joint Committee on Employment Affairs and Social Protection and the Joint Committee on Health. We made some very strong recommendations.

The barriers that exist for employers that the Minister of State is talking about are important and linking in with both IBEC and chambers of commerce will be most important. In Kildare, KARE started an initiative to do just that. I visited one of them two years ago. It was so well organised but far too few employers came. We need to link in strongly with the business community. I have no doubt that with the proper understanding and supports, businesses will come on board. I was involved in setting up the Oireachtas Work and Learn, OWL, internship for which we had 12 students from KARE and WALK in Walkinstown. After the first year, four of the 12 got full-time jobs. If anything, that is an incredible testament to giving people opportunities.

The Minister referred to accessibility. Just because some train stations have a bridge does not mean that bridge is in working order. I found that to be the case on a regular basis at my station in Newbridge. Irish Rural Link does an incredible job in rural Ireland. It should be given more support and more resources to help those with disabilities. The structure is there. We need to have it.

On housing, I certainly welcome that the Ministers will meet the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien. A percentage of housing is social and affordable and a percentage of those houses should go to people with disabilities in every local authority area.

I welcome that the Minister is looking for the experience and perspective of those with disabilities. That is something we are doing as a committee. It is also important to look for the perspective of family members who are caring for those with disability. We cannot lose that.

I am glad he mentioned the commencement of the Assisted Decision Making (Capacity) Act 2015, which is long overdue. Perhaps he could give us a timeline for that.

Everything the Minister said in that regard is rights-based. That is something for which many people have fought for a long time. I refer to former Independent Senator, John Dolan, who did significant work in that area.

I refer to the issue of respite, which has again been raised. In taking the whole context of Covid, the lives of families have been so difficult. They still have not had the opportunity for respite. In January, I attended an emergency meeting with KARE and the Muiríosa Foundation in County Kildare, which is in CHO 2. They are two wonderful organisations that do so much. They stated they would have to stop providing respite as a result of the proposed 20% cut. Thankfully, that cut was reversed by the current Government. However, there is still a problem. I am talking about two different perspectives, one from somebody-----

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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The Deputy's time is up.

Photo of Fiona O'LoughlinFiona O'Loughlin (Fianna Fail)
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Okay. The Minister and the Minister of State will get my message.

The final issue I wish to mention relates to personal budgeting. That can be a good way forward. We should remember the volunteer-based organisations other than the section 39 organisations. I refer to Down Syndrome Ireland. The work of that organisation in County Kildare is absolutely fantastic. It runs wonderful horticultural projects and the Special Olympics. It is all volunteer-based. It too needs support and funding.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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Deputies need to stick to their allotted time because we have two hours for the meeting and we have to try to allow everybody in.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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The Senator referred to holding other Departments to account and asked how I would do so through my chairing of the steering group. I have a solution to that issue, which I discussed at a previous meeting of the committee. Every second meeting of the steering group will be thematic. I will take a thematic approach at those meetings. For example, if the issue of transport is being discussed, there will be outputs in terms of holding various Departments to account, as referred to by Deputy Hourigan. The Departments will be held to account by identifying the outputs and what has been achieved with regard to each issue. The group will address the various themes while I am chairing it throughout the year. The Departments with responsibility for issues such as employment, transport and housing will come before the group and set out their stall. The steering group will then follow up on that. It will take a thematic and accountability-based approach seeking solutions.

The Senator made a great point with regard to engaging more with IBEC and the chambers of commerce and so on. We need to support employers and let them know how they can engage. It should not be the case that only the service user or person with a disability has the responsibility to go to their employer. When we show we are serious about this issue and bringing more employers on board, more will follow, which will be an improvement on the small numbers at this moment in time.

The Minister and I have discussed the issue of Irish Rural Link ad nauseam. We recognise the role the organisation can play. The Minister of State, Deputy Noonan, has shared with me some really good and innovative ideas he has for County Kilkenny. It is about how we expand the rural scheme. In fact, the main issue currently in not providing service to persons who need to get to their workshop or day service is that there are so many vehicles in the fleet providing access to day services that they are crossing over each other's routes. We need to work more efficiently. One of the biggest issues raised by providers is that of the cost of transport. We are looking at initiatives whereby that would not be part of their bill but, rather, would come out of the Department of Transport's budget, for example. We look forward to working with other Deputies and Ministers who have experience in that field.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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On the Assisted Decision-Making (Capacity) Act, the key is to get the decision support service in place. That is the blockage at the moment. Members will have seen that the budget provided a substantial additional funding in that regard. An extra €2 million was provided for next year, bringing the total funding to €5.8 million. The key thing we need to do is to provide for an ICT service because it will be quite ICT-intensive to link the various individuals who are looking to avail of this service. The commitment is that by mid-2022 we will have the decision support service fully operational. It was identified that one or two of the measures in the 2015 Act need to be streamlined somewhat and, as such, we will be seeking to bring forward legislation to address that. The prime element is to get the decision support service up and running. Significant additional funding is in place to so do.

As regards transport, there is a fund in place to assist with the lifts at stations around the country. I am very aware of this issue. I rely on public transport much of the time. One often sees a message that the station lift is out of order. It is no good to people who are in a wheelchair or have some sort of physical disability to get the message at that stage. These issues arise frequently and they need to be addressed.

Photo of Violet-Anne WynneViolet-Anne Wynne (Clare, Sinn Fein)
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I welcome the opportunity to address the committee. I wish to express my delight at being appointed as a member of the committee. As all present will be aware, people with disabilities have for far too long been treated as an afterthought or even as second-class citizens, as they have identified. There has been reference to various challenges, some of which I wish to touch on.

I hope the committee will be able to address the issue of how people with disabilities feel they are being treated. It is not just a feeling; it is a fact. Access to transport has been mentioned, as have the issues of education, employment and so on. It is about the individuals who realise that no provision has been made for them in terms of housing and the other important supports we need in our lives to have a balanced lifestyle and feel part of society. I know how one can end up in a space where there is no support or where one is in a difficult situation. That is often the case for people with disabilities and their family members. I hope this will not become a talking shop but, rather, will provide for action to be taken.

I welcome the comments of the Minister of State regarding the thematic meetings which she will chair. She stated that every second meeting will be done thematically, which will provide an opportunity for Departments to come in, specifically focus on issues - that is what the Minister of State is getting at - and take that as a whole. That will be very important for the likes of County Clare, for example. There is an Irish Rural Link service there which is a bit different from most other such services. It was set up as Clare Bus. I am sure those present are aware of that organisation, which has been in the news many times in recent weeks. It lost many of its routes due to an ongoing situation with the NTA. The situation has not been resolved. I hope that if I send more information on the matter to the Minister of State, she will be able to raise it at the thematic meeting on transport. The situation is deeply worrying for this not-for-profit organisation that was set up by good people who have continued doing their good work. I know how much effort and commitment they have put in. All of the organisation's buses are accessible, low to the ground buses. They do not have to bring down a ramp at the back of the bus in the way that is necessary for many rural Local Link buses. The organisation specifically sourced low to the ground buses in Scotland and Wales and imported them. It was very smart in how it tackled the project. It picked up second hand parts for buses and stored them as a preventative measure to avoid it being too costly to fix the buses. I specifically wish to bring that to the attention of the Minister of State because it is not progression. For this organisation to lose routes, especially given that its buses are already fitted for all passengers to access through the same door, which is a significant part of why the buses are so important going forward, is not the direction in which we should go. I would like that issue to be considered.

Ireland has come a long way in recent years by ratifying the UN Convention on the Rights of Persons with Disabilities but, and this is not to point fingers, people waited 11 years for that ratification to take place. There is a great deal of hurt and pain because of that. The Minister referred to the optional protocol and I was a little disappointed that there are no specifics or dates. People watching the proceedings today want to know the specific date the optional protocol will be ratified. They would ask why we have to wait for the report at the end of the year for that to happen. Perhaps we can get some information on that as well, because that has been their main focus.

I will conclude as I have gone over time. I wished to mention many other things, but the time management is my own fault. As regards the isolation hubs, Clare County Council does not have any. I have talked to the housing department and the officials said it has no isolation units at present. I was wondering whether we could use them for adaptive housing. We have five in Clare who are still in nursing homes.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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As regards the optional protocol, I have set out a clear pathway towards when we will do that. I cannot give an explicit date today, but we want to see the first cycle of our membership of the convention go through first. Once the UN committee responds to our State report, there might be a need to do other pieces of work or a requirement for other legislative measures which it identifies in its response to our report. We could do that in the context of the work to be done to implement the optional protocol. However, there is a clear commitment in the programme for Government. We recognise that with all UN bodies there is a bundle of rights contained within the original convention, but there are optional supports and processes that enable the better vindication of those rights. In this case, it is the ability of individuals to petition the convention to highlight a problem in Ireland, potentially, and for the committee to investigate an issue if it considers it necessary. They are essential elements of this process and we are committed to ensuring that they get ratified.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I will discuss the local matters outside the committee if that is okay.

Photo of Ivana BacikIvana Bacik (Labour)
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I welcome the Minister, Deputy O'Gorman, and the Minister of State, Deputy Rabbitte. I congratulate them on their appointments and wish them well. I thank them for giving us a comprehensive overview of the work they are doing. There are some positive proposals and developments and it is helpful to have time lines. My first question is about the transition to the new Department. The Minister, Deputy O'Gorman, outlined the way in which the Department's new remit will incorporate disability services from the Department of Health and responsibility for equality from the Department of Justice. This reflects the reality that disability is more than a health matter. It will reflect a rights-based approach and I welcome that. However, it is a mammoth task. That has been emphasised in previous briefings from the officials. The Minister of State, Deputy Rabbitte, spoke about the massive budget. For people with disabilities, it is crucial that the transition is smooth and as swift as possible.

Deputy Rabbitte is aware of an issue I raised with her in a Commencement Matter in the Seanad concerning a child with a serious disability in my constituency of Dublin Bay South and the difficulty we have had getting accommodation for that child, who appears to be falling between different Departments. I am concerned that as a result of the transition, the period within which we see so much budget and so many staff transferring between Departments, people have been left high and dry. That is a major concern and I ask the Minister and Minister of State to be very wary to ensure that people do not get left this way. In the case I raised, and we can speak separately about it, there is a real concern about the transition in that regard.

Second, other members have raised respite care. Clearly, it is a major practical concern for many people. The Minister of State has designated children's services, day services and respite and home support as essential services during the pandemic, but can the Department provide details of the targeted supports which can be provided to services unable to open due to social distancing and other public health guidelines? In respect of respite care, specifically, can we say when community social day care facilities for older persons are expected to reopen and when respite care facilities for older persons and their families will open? Those are the concerns people have.

I have a third question about residential care facilities for persons with disabilities, an issue other members have mentioned as well. This is an issue I have raised in the Seanad and I have met many of those involved, former residents and staff, with St. Mary's Centre Telford, a care home in Ballsbridge run by the Sisters of Charity which is currently in liquidation. There is a major concern that the residents, who are persons with vision disabilities, are effectively being left abandoned and that there is no clear pathway for their future care. I have raised one case and it is a matter of public record, but there are other centres as well. There are reports in the newspapers today of HIQA having concerns about conditions in another care centre in Clondalkin for persons with disabilities. We must ensure a much better continuum of care for persons with disabilities in residential care, particularly where these have been people's homes for many years in some cases. The Minister of State, Deputy Rabbitte, has spoken about that, but I wished to raise the issue to hear what is the future plan for that.

I welcome the timeframe the Minister, Deputy O'Gorman, has given for ratification of the optional protocol, as well as the establishment of the disability participation and consultation network and the commitment to ensuring that persons with disabilities and disabled persons organisations will have a strong voice in the process. In the mid-term review of the national disability inclusion strategy there was a concern that the findings of the consultation process indicated many people with disabilities were simply unaware of the national disability inclusion strategy. What is the plan for communication and ensuring that people with disabilities will be given the opportunity to have a voice in this process and that we do not see too much bureaucracy? In this sector there are many organisations providing valuable services - many other people have spoken about this - and many of them are staffed by volunteers, yet there is a lack of an overall consistency of care and provision of services and, again, a feeling that too many people are falling between the cracks. The Minister and Minister of State are well aware of that and I appreciate their commitment to improving the situation, but the important point is that we do not leave anybody behind in this process.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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We are still working on the case we discussed in the Commencement Matter, as the Senator knows. Hopefully, we will get a meeting with the Minister of State, Deputy Madigan, to try to progress it.

I welcome the Senator's comments on the fact that it is rights based. That is where the Minister and I are coming from and it is the reason we are excited about it moving to the new Department. For people with disabilities and families who have persons with disabilities it is more than just health. I will also ask the Minister of State, Deputy Butler, to contact the Senator about care of older people. That is not fobbing the matter off, but she is responsible for that area and can give the Senator an update on it.

On St. Mary's Centre, a colleague of Deputy Tully's raised the matter in the Dáil. I was going to go out to meet the residents in St. Mary's but, unfortunately, we were put on level 5 and I did not get the opportunity to do it. I would still like to meet and reassure them in whatever way I can.

Finally, the Senator is absolutely correct about the number of organisations. I could not get over it. After being spokesperson on children for four years, with approximately five organisations representing childcare, on moving to disability matters I discovered there are in excess of 400 organisations representing people with disabilities. It is a mammoth task to get to meet them, but they do fabulous work. Some of them are unique in their particular representation.

That is why we held back on the announcement of how individuals can come forward to the next tranche of participation. We are trying to address the whole communication piece around it. I held a meeting recently online only to discover that Zoom would not work. I apologise to any of the viewers watching but we have learned from that. Every day is a learning day for some of the things we are doing. However, we are trying to work to ensure that as many people as possible can participate. We are working on the communication piece so we can include as many as possible. All of the disability CHOs have disability consultative forums as well. That is something I will work on with the HSE in order to promote participation.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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With regard to the transition, the Senator is right that it should be as smooth and swift as possible while, at the same time, taking the necessary time to undertake such a big restructuring of Departments and of departmental responsibility, which includes the important aspect of relationships with State agencies, particularly the HSE. There will now be a new reporting relationship between my Department and the HSE which did not exist before. Previously, the HSE's sole reporting relationship was with the Department of Health. We are putting in place the structures to make sure that operates well. I refer, for example, to the transfer of a very significant amount of money out of the health Vote. The transfer of staff also needs to be done right.

I take the point that it is vital no one gets left behind in that transition, and I do not believe that is happening. Since she took on this role, the Minister of State, Deputy Rabbitte, has visited services up and down the country. Despite all of the difficulties we are all facing, she has been on-site and has gone out and met with services, and would have met with the particular service in the Senator's constituency but for the introduction of level 5. It is very much a hands-on approach. Those visits to see the specific issues that individual services are experiencing have been incredibly valuable. If there are specific instances, or if the Senator feels any individual is potentially slipping through the cracks, she should bring that forward to myself and the Minister of State, Deputy Rabbitte, and we will do whatever we can to address the issue.

Photo of Alice-Mary HigginsAlice-Mary Higgins (Independent)
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I thank the Minister and the Minister of State for the presentations and for the genuine enthusiasm they are clearly bringing to this role. Of course, I also thank them both for making clear that they take a rights-based approach to the area of disability.

In that regard, I know we are pressing the Minister continuously but it would be useful for him to give us an indication of when - for example, in which quarter of next year - he expects to have reached the stage in the process that would allow us to move forward with the ratification of the optional protocol. I say that because the ratification of the UN Convention on the Rights of Persons with Disabilities took such a long time that people are necessarily keen to make sure the optional protocol does not get delayed in the same way.

The UN Convention on the Rights of Persons with Disabilities is very important for the individuals but it is also a kind of mandate for the transformation of society. People have spoken about what powers the Minister has, and there are soft powers in terms of things like universal design and statutory resources, but I would suggest that there is also a public duty with regard to equality and human rights. Will the Minister indicate how he plans to ensure that disability-proofing, which is already an existing requirement in terms of the public duty on equality and human rights, is something that Departments are engaging with actively? I am thinking as well in terms of the strategy statements that Departments are making at the moment and in terms of their procurement of services, which is very important. In the area of transport, for example, we have seen that contracted services in some cases do not meet disability standards, and have not done so in terms of buses. How do we make sure it is followed through the full way?

There is the disability (miscellaneous provisions) Bill and it was mentioned that another new Bill is coming through. It may be that a few Bills are required in this area but when can we expect the first disability (miscellaneous provisions) Bill to come to the Oireachtas? Again, the timing for that would be useful. The Minister will be aware that the former Senator, John Dolan, and I were the co-signatories of a Bill that was previously put forward on disability and community participation. It sought to translate the UN convention into actual participation measures, for example, in regard to inclusive playgrounds and inclusive public spaces or parks. The Minister might indicate if that area of community participation is one we might be able to engage on. Of course, there is also cultural participation for people with a disability. As well as those areas of essential services and supports, there is the issue of how we change society so it is an inclusive, participative society.

I have a few specific questions, some of which have been touched on. In terms of employment, I was a member of the employment affairs and social protection committee when it found that the reasonable accommodation and workplace adaptation grants run out very early in the year. It is not just an awareness issue, but also a resourcing issue. There may also need to be a redesign, so those resources come with the person. In a context where we are looking at remote working hubs and a change in how the workplace is configured, we need to make sure the participation of people with disabilities is considered in the design and that there is a scaling up in resources for workplace adaptation.

There is a concern with regard to the continuity of support after working age. There is a particular concern that persons with a disability lose their disability allowance and their visibility as a person with a disability when they reach retirement age. It is an example of another issue that needs to be taken up with the Department of Social Protection. It is a real concern.

Another key transition point is when people turn 18. We found that when people move from education, or between education and training and work, the age of 18 is a point where people lose services and lose opportunities.

There is also the key transition point mentioned by others in regard to early identification diagnosis and support. There is a massive concern in the context of Covid that because of the redeployment of key healthcare officials and professionals like speech therapists and occupational therapists, people are not getting diagnostic support or arrows to supports at an early point. Can the Minister indicate what measures are in place? Obviously, people are free to seek employment where they want, but we need to encourage those in occupational therapy and speech therapy to remain in those roles and to scale up employment in that area. I worry that late assessment is going to cost many children opportunities in later life.

Personal assistance services were another area of concern during Covid. I was in NUI Galway on the day the first lockdown was declared. One of the people I was talking to was a person with a disability whose first concern was whether, if they were not in the university, they would still have personal assistance access. Given the use of agency work around personal assistants, there is a real concern on that point.

On independent living, will the Minister confirm he is not looking at changes to smaller congregated settings but at independent living supported, for example, by personal assistance?

Photo of Erin McGreehanErin McGreehan (Fianna Fail)
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There is a question of where to start and where to end on this issue. I thank the Minister and the Minister of State for attending and I welcome their commitment to looking at the entire disability services as a rights space, in particular a human rights space. As a society and as a world, we have excluded people with disabilities from taking part in the normal day-to-day things that we all take for granted, such as getting on a bus, going to work, going to a playground or going to school. In all of this, we have created a disability without looking for their abilities. I greatly welcome the commitment on human rights.

Many speakers have referred to the Minister's priority to get people with disabilities into employment.

There is one significant stumbling block. The grant is not applicable to the public service. I know a person who works for local government and begged her line manager, and was told she had to justify her existence to get assistive technology. If she was in the private sector, she could apply straight-up for that. She has been sidelined for career prospects. She has been put down because she does not have access to that technology. To encourage that grant for State bodies would be of benefit. People in them cannot apply for that grant and funding comes out of the bodies' own budgets.

Another problem that I mentioned to the Minister of State, Deputy Rabbitte, on a different occasion is the problem with intellectual disabilities and mental health. If one has an intellectual disability, one does not get access to child and adolescent mental health services. I have met with many groups. Many children with intellectual disabilities suffer from anxiety, autism spectrum disorders and obsessive compulsive disorder, which there are no services to deal with. This is traumatic for the families. They are not able to cope with the disability or with mental health concerns.

One thing that came to me was the fact that there is not enough residential care. Families are in crisis. We have mentioned it here. People are told by the HSE to go to the gardaí and there is nowhere to go. A mother is not going to go and tell the gardaí to take her child away because she cannot cope. There is crisis care but we need to get to a point where we do not have to get to that crisis. A mother who has been attacked by her child should get some help. It seems that there are silos, and people fall between the cracks. Many of us have spoken about falling between the cracks. People know that their children will turn 18. They know their date of birth. There is a significant problem between teenage care and getting into adult care, and they will be adults for much longer than they are children. We need to provide for that.

People fall between the cracks later in life. Senator Higgins mentioned rehabilitative care. If one is under 66, one will get rehabilitation if one has suffered from a stroke, but not if one is over 66 because one is not thought of as a valuable worker who can deliver on a job. That silo of care is troubling. I welcome the Minister's awareness campaign about employment. At council level, I tried to get the economic committee to take on disability-friendly towns, since we have age-friendly towns. We should make this a real focus. We should bring in local enterprise offices and make this part of our mainstream. Disability should not be a niche but part of our lives. They are our brothers, sisters and parents. I welcome the enthusiasm of the Minister and Minister of State, as well as their ability to listen and take matters on board. I look forward to seeing the future of disability under their watchful eye.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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I could keep members here for an hour speaking about the disability sector. There is one issue that should be dealt with right now. Specialised people in speech and language services have been deployed for the purposes of contact tracing. As colleagues said earlier, there are not even ten minutes available for kids in occupational therapy and speech and language therapy. It is absolutely unacceptable. I will leave it at that because we are out of time. We have about seven minutes, so the Minister and Minister of State can wrap up. We look forward to engaging with and working with them. There is much work to do.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I will respond to Senator Alice-Mary Higgins first. I will speak to some points and the Minister, Deputy O'Gorman, will address the legal side. The Senator talked about community participation. This year, for the first time ever in the budget, we managed to get a line which acknowledges the funding for disability community integration. Even though it was within a health budget, we will be launching it when it moves over to the new Department with the Minister, Deputy O'Gorman, for the simple reason that it is all about integration in the community. It will be welcome, exciting news. While the money may not be substantial to start with, it is a step in the right direction and I look forward to working with members on that. I thank the Minister, Deputy O'Gorman, for his intervention to ensure that happened in the budget this year.

Senator McGreehan has touched on many issues. What it boils down to is building capacity. Let us be proactive as opposed to being reactive. One has to look at the disability capacity review. Much work has gone into it. I hope that it will be brought to the Cabinet and published in the near future. It will lay out how we should plan our services as opposed to being reactive and with poor parents feeling they have been left with no option, and possibly having to abandon their children because we have not built in respite or residential places. We should not always be price takers in the Department. We should have it done right.

The Chairman raised speech and language therapy. It is a focus. We met with Paul Reid in the last fortnight to discuss this issue. It is a concern of mine. I met with the CHOs yesterday to discuss making disability a priority, and returning clinicians to deliver essential services for persons with disabilities.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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I thank Senator Higgins. Regarding the optional protocol, once we have submitted the report to the UN committee, I hope to bring back a timetable in my first engagement in the new year with this committee. On legislation, we are looking at a disability (miscellaneous provisions) Bill and at bringing a memorandum to the Government early next year for approval to prepare heads of Bill. We will move on from there in 2021. I take the Senator's point about the importance of disability-proofing across all Departments. I gave one example about having to engage with the Department of Public Expenditure and Reform regarding a circular on the public service obligation. We should look at widening those to ensure that disability has been regarded in the statements of strategy, which all Departments are busily working on at present.

Regarding reasonable accommodation, remote working and the issue with the employment grant not being available in the public service, under the national disability inclusion strategy, my Department is creating a working group to look at assistive technology. That could be particularly significant. We may see a significant society-wide transition to working at home. That can only be to the benefit of persons with a disability whose home environment is probably already designed to cater for their particular needs. We can address issues regarding that.

I take the point regarding transition points. One of the goals in creating this Department is that, from cradle to grave, there is a seamless approach to the issue of disability by our Department. As the Minister of State, Deputy Rabbitte, said, we will continue to follow up on that because we are very aware of it and there is significant pressure on services. We are working on hiring contact tracers whose sole job will be to do that. We need to get specialists away from doing that and back to their jobs.

Photo of Michael MoynihanMichael Moynihan (Cork North West, Fianna Fail)
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I thank the Minister and Minister of State for an engaging discussion. We could go on for another two or three hours if we opened up properly. We intend to and we will be back on this day week, 11 November, with a pre-meeting discussion at 3.45 p.m. and the public meeting at 4.30 p.m. I thank everyone for their participation and insight. I thank the Minister and Minister of State.

The joint committee adjourned at 6.30 p.m. until 4.30 p.m. on Wednesday, 11 November 2020.