Áine Collins (Cork North West, Fine Gael) | Oireachtas source

We all know people who have disabilities and their families have many challenges. We must ensure that the best services, in the most cost-effective manner, are available to meet their needs. Many communities through local fund-raising and Government help have built facilities within their communities ensuring that people with disabilities can, where possible, work and live among their own communities. The Government must continue to encourage that approach, as it is the best, most inclusive and cost-effective option.

Voluntary organisations, as Deputy Creed outlined, such as St Joseph's Foundation in Charleville and others throughout Cork, provide the best possible services. We must ensure that the service providers manage their operations in a way that provides full transparency and in the most efficient and effective manner. It must be our objective to ensure that the maximum amount of net funds go to the front line. We live in very difficult economic times and there is no doubt that in the past many inefficiencies that are still embedded in the HSE sector were caused by a system that threw money at the problem rather than solving the problem and looking seriously at long-term sustainability. The value for money and policy review of disability services which was published in July 2012 identified fundamental issues that must be addressed. They focus on the way in which HSE-funded disability services are managed and operated.

The changes the Minister wishes to introduce are consistent with his overall approach to health policy. This will be achieved by shifting choice and control from professionals and administrators to where it rightfully belongs, namely, the individual with a disability. To achieve that there must be a co-ordinated approach from many Departments. The Department of Education and Skills already spends 15% of its budget in support of children with special educational needs. The new training agency, SOLAS, must pay special attention to encouraging people with disabilities to participate in its mainstream training options while continuing to offer specially tailored courses for people with disabilities.

The Department of Social Protection plays a necessary part in providing support services. In addition to basic payment supports it provides an extensive range of income and work related supports for people with disabilities. More work must be done with employers to encourage them to participate in these schemes, and the wage subsidy must be significant enough to ensure their participation.

Community employment schemes offer many people with disabilities an opportunity to work and partake in local community activities. Local authorities must be more proactive in providing suitable housing that would allow people with disabilities the dignity of independent living. All these approaches from different providers must be overseen and co-ordinated to produce the most inclusive and efficient results at local level.

Some service providers such as St. Joseph's in Charleville are lean, efficient and deliver services far beyond the amount of funding they receive. Those organisations cannot be subjected to across the board cuts such as those affecting State run facilities.

We must examine also the new approach to the way we deliver multidisciplinary services to special needs children between the ages of five and 18. That greatly worries me. We have a duty to evaluate and ensure that there will not be a negative impact on these children. The value of the relationship between a therapist and an intellectually challenged child or young adult is essential and we must ensure that is not diluted.

I wish to refer briefly to cystic fibrosis and what happened in St. Vincent's Hospital last week and this week which was a perfect example of the intention being good but the delivery not happening on the ground. It is a subject very close to my heart as Members will know I have a daughter with cystic fibrosis. Thirty-four beds were built for isolation for cystic fibrosis patients. Twenty of those beds were dedicated full-time to cystic fibrosis patients and 14 were to be prioritised. I do not understand the reason the special delivery unit in the Health Service Executive when we know that people with cystic fibrosis suffer greatly at this time of the year when infection is at its highest, could not have allocated the beds to be isolated for this time of year.

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