Dáil debates
Tuesday, 22 February 2005
Disability Bill 2004: Second Stage (Resumed).
5:00 pm
Jimmy Deenihan (Kerry North, Fine Gael)
A large number of people, including myself, attended a meeting in the RDS on 8 February to discuss this Bill. Most contributors were incensed by the content of the Bill which they were convinced confers no real rights on people with disabilities. They were also very annoyed — some speakers were outraged — at the Government's intention to push through the legislation without consulting the various groups or listening to their concerns and reservations about the Bill. I realise there was widespread consultation before the Bill was introduced but I understand the Minister has yet to meet a large number of groups who have requested meetings. He may confirm this. This question has already been asked by a number of speakers. I appeal to the Minister to meet with these groups as soon as possible. There are genuine concerns about the Bill which must be resolved before Committee Stage.
Almost 90% of more than 30 organisations that made submissions to the Joint Oireachtas Committee on Justice, Equality, Defence and Women's Rights were highly critical of the Bill, particularly its narrow definition of "disability" and obvious resource constraints. While the Minister for Finance is in the House, I would like to say that while everyone welcomes that he committed multi-annual funding to the tune of €894 million up to 2009, it is not ring-fenced for people with disabilities. Perhaps the Minister will clarify this aspect. I listened to the Minister say on radio this morning that the health budget may have to be cut back if there are significant payouts to people in nursing homes and their families because of charges that must be repaid to them. Could any cutbacks in the health budget affect the €894 million funding for people with disabilities? I would like clarification on the matter as people are concerned about this aspect.
Speakers expressed concern about a large number of issues with some of which I wish to deal. The disability legislation consultative group, DLCG, was established in 2001 following the withdrawal of the Disability Bill 2001. That group carried out extensive consultation with State agencies and so on across the disability spectrum and it is concerned about the provisions of this Bill. I take that group's views seriously. The DLCG believes that the definition of disability is too narrow. It is concerned that the definition excludes, as mentioned by a number of speakers, episodic conditions and early intervention needs.
I point out to the official present that the definition of disability that everyone seems to want included in this Bill is the one recommended by the DLCG and used in the Equal Status Act and Employment Equality Act. I ask the Minister why that definition was not used. There are two definitions of disability, the definition included in the Bill and the definition included in the Equal Status Act and the Employment Equality Act. When it comes to deciding which definition to use, which one will get preference? There will be confusion surrounding the definition in the future. Who will differentiate between the two definitions? Why should we not insert in the Bill the definition recommended by the DLCG, which I am sure Deputy Stanton will propose on Committee Stage? I hope the Minister will accede to this request before Committee Stage.
Assessment of needs is very much at the core of this Bill. Some people have referred to this Bill as an assessment Bill. It is important that it provide a clear right to an independent assessment of needs, but it does not do that. It must also provide for an individual's right to progressivity on unmet needs identified in an independent assessment report. This must be done annually or wherever there is a change of circumstances.
The complaints system is far too complex and needs to be simplified and made more accessible. The appeals system needs to be independent of the Department of Health and Children and perhaps it should be the responsibility of another Department. The independence of the appeals system has been raised by a number of individuals and bodies. If it comes under the remit of the Department of Health and Children with officials from that Department reviewing appeals on which they would have made decisions, that would seem to present a conflict of interest and a contradiction. Responsibility for the system should be moved to another Department or the system should be entirely independent.
I mentioned to the Minister for Finance before he left the House that the Bill must provide for a ring-fencing of disability specific resources. There was widespread welcome from Members on all sides of this House and from all the disability groups and organisations for the €894 million announced in the budget for this area, but if such funding is not ring-fenced, it could be spent elsewhere at any time over the next four to five years. If the Minister were to proceed with his threat to reduce health service funding, which I heard him mention on radio this morning, this multi-annual funding could be under threat. It is important to clarify that such funding will be ring-fenced, although there is no mention of such a provision in the Bill. Provision in this respect is quite open. It strikes me that disability groups and disability services will be provided for only when the money is available, that more or less everything else will be provided for first and then people with special needs and people with disabilities will be looked after. It is important to clarify the ring-fencing of resources for this area over the next four to five years.
The Bill should also provide for a clear statutory duty on all Departments and public bodies to include people with disabilities in their plans and services with appropriate monitoring and accountability. Where people are making decisions on the needs of people with disabilities, intrinsic to all decisions should be the view and voice of people with disabilities. It is important that those people who are affected in various ways are involved in the assessment process and the appeals process if it is to work. Unless one is affected in some way by a disability or working closely with people with disabilities and special needs, it is difficult to comprehend what those people go through and the various ways they are affected. Provision in that respect is also important.
There has been much change in terms of provision in the disability area in the past ten years and certainly in the past 20 years. I accept many strides have been made, but any legislation enacted should be subject to review after a number of years, say three to five years.
The issue of assessment is important. On reading through the presentations made by the various bodies, it is important that appropriately qualified people will carry out the assessments. Headway Ireland outlined in its presentation those who should carry out the assessments and it included a large number of disciplines. Currently, there is a scarcity of psychologists, sociologists, speech therapists and those in various other disciplines. An individual could be entitled to 20 services but may only get five of them. Where is the commitment to the provision of those other services? It is important that is addressed.
The qualifications of the people who will carry out such assessments have not been clearly defined. In terms of the composition of a board that will be set up or the individuals who will carry out the assessments and the availability of staff, will resources be available to provide assessments in a reasonable period for the large number of people who will seek them? There is no guarantee that the necessary staff will be available. There is a major scarcity of speech and language therapists across the country, although 24 individuals are currently being trained. There is no speech and language therapist in the Nano Nagle school in Listowel where there are 90 pupils, and it is critical that such a service is provided. Who will make the assessments? If the service statement outlines 20 services, how will they be provided? If 15 services are not provided, what will happen?
The Bill is defective in two key areas — the way in which it addresses the provision of specialist services for people with disabilities and the changes it proposes for public services to ensure people with disabilities are included as equal members of society. The Bill fails to ensure that people with disabilities have access to the high quality specialist support services they require to participate in and contribute to society. The Bill offers a flawed and bureaucratic system that offers little more than what is already available.
The definition of "disability" in the Bill is too narrow and restrictive. It may exclude many people with disabilities who require supports and services, including many who are currently receiving services. There is widespread support for the use of the definition contained in other legislation such as the Equal Status Act.
The Bill does not provide for an independent assessment of needs, services and complaints. Assessment officers are responsible for deciding what services a person needs and liaison officers are responsible for arranging the delivery of those services. As such, they have enormous powers but they will not be truly independent, as the Health Service Executive will employ them. The complaints and appeals system is so complex and bureaucratic that it will discourage people from using it. The complaints officers will also be employees of the Health Service Executive and thus cannot be deemed truly independent. Many people with disabilities and their families have enough to deal with without having to fill in endless forms and attend meetings.
The Bill prevents people from going to the courts when they are being denied a service except in certain circumstances. In these circumstances, where access is allowed, it is limited to the right to go to the Circuit Court if the health or education authority fails to implement the findings of an appeal. Access to the High Court is limited to the right to challenge the outcome of an appeal solely on a point of law.
The assessment, liaison and complaints officers should be independent of the Health Service Executive so they can put the needs of the person first rather than being influenced by their relationship with the executive that must deliver the service. There should be an independent and straightforward complaints system, including the Ombudsman's office or the Equality Authority, and people should have more reasonable access to the courts.
The Bill does not provide for an individual to have unmet needs met on an ongoing basis. When a person receives his first service statement based on his assessment of needs, some services may not be available at that time. It is vital that if these unmet needs cannot be met immediately or in the short term that they are planned for and eventually met. These unmet needs must be reviewed and taken into account on a regular basis or there is a danger they will be forgotten. The Bill should progressively address the unmet needs of people with disabilities. The Bill should clearly state that unmet needs will be reviewed at least once a year and that the cumulative unmet needs will inform national planning for disability services.
Most importantly, the Bill does not promote the inclusion of people with disabilities in all public policies and services or oblige statutory bodies to provide for them. It does not oblige all Departments or publicly funded bodies to ensure that all services provided are available on an equal basis to people with disabilities. There will be six draft sectoral plans by different Departments, plans which will be vague and that will not include important issues. The plan for the Department of the Environment, Heritage and Local Government will not even address how it intends to respond to the housing needs of people with disabilities. It is vital if the Bill is to succeed that people with disabilities are at all times involved in the consultation and decision making process.
The sectoral plans should be extended to include areas covered by the Department of Arts, Sport and Tourism. There are 30 million people in Europe with a disability, representing major potential for this country if it became tourist friendly for people with disabilities.
Part 10, which details building requirements and access to public places gives a narrow interpretation and will not work. Currently, access is provided at the backs of buildings in areas that are difficult to get at. There are wheelchair ramps but they are unsatisfactory. I will return to this on Committee Stage.
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