Dr. Cara McDonagh:

I do not think there is any place for the criteria. One cannot just amend them and carry on as before. The person the Senator described would probably be happy if he or she got a grant to adapt his or her vehicle. That is what I was talking about earlier in terms of a graded scheme. Some people need a very much adapted vehicle into which they can bring a wheelchair and fix it in. There will never drive themselves so it is a matter of being transported. People like that often work. It might be surprising to people but I have patients who work despite quite significant disabilities. They need a vehicle. Most of them will qualify, but in the scheme there is only one benefit available. Most people want a swivel seat or an automatic car that might be a little more expensive. Alternatively, they might want a special seat or bigger car to separate the children because of behavioural problems. There are all sorts of reasons. The scheme should not be about ascertaining somebody’s diagnosis and whether he or she is wholly or almost wholly without the use of his or her legs; it should be about determining what the person is able to do or not able to do. For instance, the Irish Wheelchair Association's driving instructors assess people. Where I work, they are assessed along with an occupational therapist in the car and they decide what the person needs. It does not have to be a doctor doing this. Maybe a doctor will have a role in some cases but the scheme needs to be more tailored to what we now understand about disability and how we manage it. It should be about function rather than disability or dysfunction. Most people come to us and do not even realise what the scheme offers. They just say they want a swivel seat because it was really difficult for them to get in and out of the car. You might need controls or whatever it might be. Another request is for a bigger car or a special harness on a seat for an older child who needs to be properly seated in a car.

We have many ideas. At meetings of the subgroup, we communicate all this. Those concerned are taking it on board.