Tom Clonan (Independent)
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I thank the Cathaoirleach. I welcome and applaud this legislation and all those involved in drafting it and putting it together. I agree with Deputy Naughten who said that unless it is legally obligatory for the State and its agents to provide services and supports for disabled people, they just will not do it. We know this. My primary concern on this is in regard to section 3(b) of the Bill which states that the strategy will “make provision for individual assessments of persons with autism spectrum disorder to be conducted by a cross-functional team of medical professionals comprising for example— (i) a psychologist, (ii) a psychiatrist, (iii) a speech and language therapist, (iv) an occupational therapist, (v) a behavioural therapist, (vi) where indicated, a social worker, and (vii) other professionals as may be deemed appropriate”. At the moment the HSE is unable to provide assessments of needs for disabled children and adults within a reasonable timeframe. Roughly this time last year, the then chief executive of the HSE, Paul Reid, admitted before the Joint Committee on Disability Matters that progressing disabilities for children and young adults had failed and was in failure. He was also unable or unwilling to answer any questions as to who the clinical lead on progressing disabilities was, and whether or not a risk assessment had been carried out on the foreseeable and likely damage to disabled children. I am curious where the Department is going to get all these psychologists, psychiatrists, speech and language therapists, and occupational therapists to carry out an individual assessment. Where is the Department going to get all these people? Considering the response to that, I would say that the Department of Social Protection published a proposal two weeks ago stating that all disabled citizens in receipt of disability allowance, of which there are 225,000, almost a quarter of a million, are to be medically assessed on the basis of their capacity to work. Where did that idea come from? I believe it came from an austerity measure that was introduced in Britain in 2008 which has been thoroughly brought into disrepute. It led to a surge in suicide among disabled people in England, Scotland, Wales and Northern Ireland, and to such an extent in Northern Ireland that last year BBC Northern Ireland did a "Spotlight" programme on it. For some reason our colleagues in the public service believe it to be a good idea for Ireland at the moment, notwithstanding the fact that services are in complete failure. Where is the HSE going to get all these therapists and professionals to carry out an individual assessment?

On completion of an individual assessment, is it the intention to implement or provide the services, supports, scaffolding and care that are set out in an individual assessment? At the moment, even though the HSE is legally obliged to carry out an assessment of need for disabled citizens, there is no legal obligation whatsoever for the State or its agents, the HSE, to provide any therapies or supports. From our lived experience, I can advise that none is provided. We see what has happened in Children’s Health Ireland with the spinal surgery crisis. That is because children have been left on waiting lists for years, so that they go beyond the therapeutic and developmental window for intervention. This is happening on the HSE head of operations' watch, on the watch of his predecessor who admitted that it was in failure and his predecessor. We are outliers in European terms. When the HSE tells me where it is going to get all these therapists to conduct these individual assessments, will it then tell me where it is going to get all the services, supports, therapies and care packages that are indicated in those individual assessments?

Earlier this year I introduced onto the books the Disability (Miscellaneous Provisions) Bill 2023. It is very simple. It says that all of the services and supports that are set out in an assessment of need will be provided, that the State would be legally obliged to provide and support those. That would bring us into line with our European Union partners and international best practice. However, from the responses of our witnesses, I got the sense that they think it is a bad idea for the State to be legally obliged to do anything. The formulative words used were that it would give us legal exposure. I would argue that is not a patient-centred approach. It is not one that focuses on the needs of our most vulnerable citizens. I realise the witnesses will answer the questions, but will they give me a timeline of when they think we can deal with people within the therapeutic or developmental window as they do in other EU member states? For example, in other EU member states, for somebody like Geraldine Lavelle who is 29 and has a spinal cord injury, it is routine for somebody like that to have a care package so that she can live independently in her home. She cannot, in Ireland. Neither can Daniel Airey. The autistic twins, Brian and Kyle Milne, started school this year at the age of 12. We are failing to fulfil the constitutional guarantees set out for the full participation of all of our children in society. We do not tolerate such discrimination on the basis of ethnicity, religious formation or sexual orientation but when it comes to disability it is not just tolerated but reinforced. I am curious to know whether the witnesses believe such legislation is a bad idea. Luckily for me, my colleagues in the Seanad, even though the Government has a substantial majority and despite the fact there was an instruction from Cabinet to kill the legislation-----