Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I move amendment No. 1:

To delete all words after “Dáil Éireann” and substitute the following:

“recognises:

— this Government’s commitments to people with a disability in the Programme for Government, including greater participation in employment, training and education in accordance with a revitalised National Disability Strategy; and

— that around €1.4 billion will be spent in 2012 on health and personal social services for people with disabilities – this is in addition to transfers to people with disabilities from the Departments of Social Protection and Education and Skills and other Government services;

notes that the Health Service Executive (HSE) National Service Plan for 2012 has been drawn up against the backdrop of significant funding challenges and that while the allocation for specialist disability services has been reduced by 3.7% nationally, in 2012 the level of service reduction will be less than the level of budget reduction as a result of the efficiencies that will be delivered;

acknowledges that some reductions in disability services have been unavoidable in 2012 and welcomes moves by the HSE to tailor such reductions in such a way that minimises the impact on service users and their families as much as possible; and

notes:

— that within the serious resource constraints imposed by the current budgetary and fiscal conditions, the Minister for Health is doing all possible to ensure that as much protection as possible is afforded to the disability sector and the social care area as a whole; and

— the publication of the Value for Money and Policy Review of Disability Services in July 2012, which includes recommendations to ultimately move to individualised funding for disability services so as to provide greater choice and control for people with disabilities.”

I thank the contributors thus far and note there will be many more. I welcome the opportunity to put on the record of the House the efforts that are being made to provide effective, accessible and responsive health and personal social services for people with disabilities. At the outset, I note that Members in government share the concerns of Members opposite and of the concerned parents, individuals, relatives and friends of people with disabilities who are present tonight and throughout the country. I strongly reaffirm the Government's commitment to the national disability strategy and to doing all that it possibly can to give persons with disabilities the services and support they need.

I will begin by addressing the national disability strategy and other current developments. The growing recognition by society of the right of people with disabilities to participate in and contribute to social and economic life has underpinned the development of services in recent years. In line with the commitment in the programme for Government to publish, following wide consultation, a realistic implementation plan for the national disability strategy, I have established and am personally chairing a new national disability strategy implementation group. This group includes representatives from across the Government, as well as the County and City Managers Association. In this context, I take on board Deputy Browne's point on where people with disabilities live and on what has the greatest impact on their lives. I believe local authorities do so, which is the reason the County and City Managers Association now has a representative on the national disability strategy steering group. It also includes representatives from the National Disability Authority, a broad range of disability organisations and a number of individuals appointed in their personal capacity to bring their lived experience to the table. I was astonished to find that until I was appointed Minister of State, the group did not include people with disabilities to speak for themselves. I also convened a disability forum, under the stewardship of the National Disability Authority, to ensure the voices of people with disabilities, as well as their needs and concerns, are being heard. In addition, a number of significant developments are ongoing, which touch on all aspects of services and supports for people with disabilities. These include strategies for transferring people with disabilities from congregated residential settings into the community, putting in place a system of registration and inspection of residential centres, reconfiguring day services and supports, implementing the recommendations in the national policy and strategy for the provision of neuro-rehabilitation services, reconfiguring autism services and services for children with complex disabilities and, of course, implementing the recently published value for money policy review of specialist disability services.

At a time when the Government is trying to achieve more with less funding, changing attitudes and leading by example often can be achieved without any additional funding. Some of the best practice on disability in both the public and private sectors has been as a result of a positive attitude, particularly if it comes from senior management. I see examples of this nationwide every week. The terms of reference of the national disability strategy implementation group include promoting positive attitudes towards people with disabilities and I will work with this group to develop an effective, measurable plan of action to achieve this.

The HSE's national service plan for 2012, drawn up against the backdrop of significant funding challenges, was designed to reflect the changing priorities of the new Government and the significant programme of reform being undertaken. The allocation for disability services has been reduced by 3.7% this year. However, the level of service reduction has been less than the level of budget reduction as a result of efficiencies that have been delivered. Again, this is very much down to the service providers. While the aforementioned service providers have achieved some efficiency savings, reductions in services also have been unavoidable in day services and in residential and respite services. The necessary reduction in 2012 unfortunately mirrors that applied across all areas of the health sector. However, it is timely for me to remind Members of the highly significant levels of service provided for people with disabilities through the substantial investment of €1.4 billion by the Health Service Executive in 2012. I note this is just part of what is spent on disability. Without deviating from the script, I continually make the point that were all the money spent on disability concentrated in a single pot, there would be better outcomes.

At present, more than 9,100 people receive care in residential places, most of whom are living in homes within their communities. Moreover, 6,300 people are receiving respite residential support, 18,600 people are attending day services and 1.64 million personal assistant and home support hours are being provided. Overall, the national intellectual disability database annual report for 2011 states that 26,831 people with intellectual disability were in receipt of services, representing 98% of the total population registered on this database and the highest number of people in receipt of services since the database was established.

A major issue for the Government is to ensure it gets the best outcome for people with disabilities from the resources it puts into the health sector. I published the report of the value for money and policy review on disability services on 20 July last. The objective of the review was to assess how well current health and personal social services for people with disabilities meet their objectives and to recommend how these services should be delivered in the future. Many of the most fundamental changes needed to support the full participation of people with disabilities in society will be achieved through the implementation of this review. From the outset, public consultation was an important feature of the review. The review team listened carefully to what people had to say, as well as to the advice of the expert reference group on disability policy and the thoroughly researched advice provided by the National Disability Authority. As a result, the review recommends a significant restructuring of the disability services programme through migration from an approach which is predominantly organised around group-based service delivery towards a model of person-centred, individually chosen, supports and implementation of a more effective method of assessing need, allocating resources and monitoring resource use. This will represent a seismic change in how services are funded and provided and will result in shifting choice and control from professionals and administrators to where it rightfully belongs, namely, with the individual with a disability or his or her family. Work is now under way to put the necessary implementation plan in place to move forward the recommendations of the review in 2013.

Even before the drawing up of the value for money review, major changes have been under way for disability services in recent years. There has been a definitive move from an institutional and segregated model of service delivery towards a community-based and inclusive approach that aims to support people with disabilities in community-based living with maximum independence and choice. A number of ongoing policy initiatives support this commitment. For example, in July, I jointly launched with the Minister of State, Deputy Jan O'Sullivan, the national implementation framework to support the Government's National Housing Strategy for People with a Disability 2011-2016. The development of the implementation framework underlines the successful collaborative approach involving my Department, the HSE and the Department of the Environment, Community and Local Government in addressing the housing and related support needs of people with disabilities.

While the Government continues to support people in institutional and other residential settings, the issue of standards and appropriate services arise.

I am pleased to say that progress has been made by HIQA on finalising draft standards during 2012. The most recent draft was subject to a five week consultation process which ended on 21 November. I expect to receive the final version of the standards document in the coming weeks and a likely launch date is envisaged in January 2013. Work is also under way on the regulations required to bring the standards into law and further discussions are taking place now on the resources and staffing required by HIQA from 2013, with a view to having the new regulatory system up and running by mid-2013.

The Government is fully committed to facilitating people with disabilities in achieving a greater level of participation in employment, training and education. In the area of special educational needs, the protection of front-line services for pupils is a priority. Approximately 15% of the entire budget of the Department of Education and Skills - some €1.3 billion - was spent in support of children with special educational needs in 2011 and on training initiatives which I will also outline.

In line with the Government's commitment to front-line services for pupils with special educational needs, the current overall level of funding for special education has been retained at last year's level. Services being provided from the education budget to support the care needs of pupils with special needs, including children with disabilities, include 10,575 whole-time equivalent special needs assistant posts in primary, post-primary and special schools; approximately 9,950 learning support and resource teacher posts to provide additional teaching supports; more than 1,100 teachers in specialist schools at much reduced pupil-teacher ratios; and early educational intervention for children with autism from 2.5 years.

The Department of Education and Skills now funds 76 early intervention classes for children with autism attached to mainstream schools, as well as the home tuition programme for children with autism who are unable to access placement in an early intervention class. Funding is also provided for school building adaptations, special school transport arrangements and enhanced capitation rates which are payable to most special schools and special classes. This funding underlines the Government's commitment to special education provision for children with special educational needs, including children with disabilities. In addition, the education sector is working very closely with the health sector on the HSE's national programme on progressing disability services for children and young people, which was the issue at hand last Saturday.

In the health sector, the needs of school leavers have also been met this year. Under the auspices of its national consultative forum, and with the co-operation of many agencies, the HSE has worked hard to accommodate the demand for school-leaver and rehabilitative training places, managing to find almost 670 places in 2012. I wish to thank the HSE disability service and service providers for achieving this without any additional funding. Contrary to Deputy Martin's comments, I have at no stage boasted about this. The effort came through very hard work and the people in question must receive thanks for it.

In the area of training needs, the aim is to facilitate people with disabilities in achieving a greater level of participation in employment and training. Along with the option of FÁS mainstream training, training places are also provided specifically for persons with disabilities through specialist training providers. In 2012, FÁS will provide the same volume of training places allocated to these providers as in 2011. The total FÁS budget for specialist training provision in 2012, including training allowances, is €53.7 million, representing 12% of the overall FÁS budget of €453 million.

Meeting training needs is only part of the journey that people with disabilities and special needs generally must face in order to obtain longer-term sustainable employment. In the area of disability activation, the Government is committed to supporting people to participate more fully in training and employment in view of the particular challenges faced by people with disabilities. The integration of the employment services and community services divisions of FÁS into the Department of Social Protection is enhancing the delivery of employment services for all people, including people with disabilities, and will assist in overcoming some barriers in this area. The Department of Social Protection provides an extensive range of income and work-related supports for people with disabilities and employers to facilitate greater participation in employment by people with disabilities.

The recently launched disability activation project, which aims to identify the optimum approaches to mainstreaming labour market activation measures for people with disabilities, is an important first step in this regard. Funding of just over €7 million has been allocated for 14 projects in the Border, midlands and west region to run until April 2015 which are aimed at providing practical insight into how best to engage with people with disabilities and increase their employment prospects. The four strands of the disability activation project include improving access to employment; progression for young people with disability; progression for people with an acquired disability; and innovative engagement with employers.

A number of programmes formerly operated by FÁS are now operated by the Department of Social Protection, including the Employ Ability service, which was formerly the supported employment programme; the wage subsidy scheme; the disability support and awareness grants and schemes; and community employment. The Department also operates a number of other income and employment support schemes, including the partial capacity benefit payment scheme mentioned by Deputy Ó Cuív, the back-to-education allowance and the disability allowance income disregard. The Department of Social Protection is committed to supporting people with disability to participate more fully in society and to become more self-sufficient by providing supports that address barriers that they may face.

I welcome the opportunity provided by this debate to put on the record the Government's position on the numerous and wide-ranging issues raised in the motion before the House. This is a time of change for the health sector as a whole and not just for people with disabilities. Although the changes we have signposted in the value for money and policy review are challenging in the current economic circumstances, they contribute towards the Government's overall vision for a more integrated health service, which can only be to the benefit of each and every citizen of this country, with or without a disability. During this time of change, the Government acknowledges that there will be significant demand for new services and a continuing requirement to make existing services more efficient. The Government is committed to working collaboratively to realise the vision of a more inclusive society for all, where services and supports will be tailored to meet the needs of the individual citizen while at the same time being provided in an accountable and cost-effective manner.

The Bills that will be dealt with shortly, taking in mental capacity and assisted decision making, will have a serious and positive effect not just on all of us but on people with disability. We will be legally obliged to listen to what such people have to say.

See this speech in context