Gillian Toole (Meath East, Independent)
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I thank the Minister, the Minister of State and the officials for meeting us. I congratulate the Minister of State, Deputy Higgins. I have a couple of questions, given that we are more commenting and querying and we cannot alter the outcome of what is before us for the Estimates process. The increase is undeniable and this is highly commendable, as is the focus of the Government and the dedicated section in the Department of the Taoiseach. A few issues ring alarm bells for me. Coming from the private sector, where we worked quite tightly with quarterly budgets, figures and retrospective cost benefit, this time period is quite tight. We are discussing the outturn for 2024 and then the Supplementary Estimate for 2025. How advanced is the ambition to move to multi-annual investment, planning and funding? What plans are there on digitisation and what changes in accounting practices and forward planning are taking place on the fiscal side?

From our work at the committee and meeting various people coming before us on the UNCRPD and our modules that relate to that, a recurring response from people is a preference for personalised budgets. When will the review of the personalised budget pilot be completed? What is the timeline for expanding the access? The person who was over this section has moved on to dealing with respite. I ask the Minister to allay my concerns that personalised budgets might not be as high a priority as they should be according to the feedback we get from people.

Has any work being done on the costs and potential savings of personal assistants vis-à-vis day services? Following on from this, day service funding is to increase. What assessments and reviews of the current content and quality of services have been carried out? I want to raise a flag in this regard, which Deputy Quaide has also raised. An investment company has created a company for the provision of services to people with disabilities across psychology, occupational therapy and speech and language therapy. This is about the shared concern regarding the move to increased privatisation. There is absolutely a need but I wonder about the checks and balances and how this can be monitored and altered swiftly enough. If I were to go for a nuclear suggestion, given the volume of outsourcing in place, is there a possibility of a direct link between the Department of Health and the providers, without the HSE in the middle, given there is an increase in section 38, 39 and private providers? This is thinking way outside the box. We are already at 80%. The Estimate is 80% of the total figure. In terms of getting ahead, is everything being looked at to achieve to multi-annual funding? I apologise if I am not explaining this properly.

With regard to respite care, I agree with the Minister that overnight respite is highly desired by families. We also get feedback coming to us, inside and outside the committee, on alternative respite and day respite. Is this possible? Can disability managers have discretion over, for example, the provision of alternative therapies, be they equine, music or drama, where there is capacity and there is an evidence base for the results? While we wait for recruitment in special education and healthcare, there are people who are ready to deliver services.