Dr. Alison Harnett:

I welcome the question about inflation because I think what members are hearing today is that our disability services are to some degree in a perfect storm of sustainability challenges, one of which is inflation. There is non-pay inflation, for example, the cost of electricity, food and transport has been rising. When you provide supports across the life cycle, which could be in residential supports that will be 24 hours a day, or in day services, where you want to be out in the community, there are costs associated with inflation. Fundamentally, the school leavers who have come in to supports and services have been, as Mr. Meany mentioned, part of a banding and profiling process. However, those bands and profiles have not changed over the past number of years. From an inflationary pressure point of view, that means what the banding for the lowest or highest level of support bought you three years ago does not buy that now. We are constantly chasing the number of issues the Deputy raised, whether those are the inflationary pressures, the fact that the supports cost more but the banding has remained the same, that there is a lag in pay for section 39 workers or that the changing needs of adults does not have a funding line.

At a broader level, what is really happening is that the fundamental stability of the services and supports provided in a disability context are actually in question. That is what is most difficult for members, when you add up all of the issues we are speaking about today. Our members are on what I have described as a precipice. We have a mountain and on one side, members have an option to make the most rights-based services and supports they possibly can and, on the other side, there is an imperative not to trade recklessly. At the bottom of that mountain is the governance of the organisations. There are rules and regulations that mean that organisations must adhere to financial guidance. They must also provide rights-based supports. At the moment, those stability and sustainability issues are causing very significant difficulties for the boards of governance of those organisations in maintaining stability and a rights-based focus, when all of the challenges that have been spoken about are added up together. It is not just even one of the challenges at a particular time but the one that was mentioned there, inflation, is a real challenge as well, alongside all of the things that members have been speaking about. That is one really key thing.

I will just speak a little bit as well about the regions and the restructuring. The HSE is moving to a new structure where there are six regional health areas. They will have an awful lot of autonomy. There is a regional executive appointed to each of those six regions. Later this year, the CHOs will be stood down and there will be six regions. A lot of the decisions in terms of funding will be made at those six regions. What we are very happy about is that the move to the Department of Children, Equality, Disability, Integration and Youth has meant that there is a commitment to continuing oversight of where the disability budget will be spent. That is a really good thing, so that we are not lost in the wider HSE when the restructuring happens. We will wait and see how that plays out in the restructuring but that is a big piece of change that is happening with regard to how our members will intersect at local, regional and national levels.