Éamon Ó Cuív (Galway West, Fianna Fail) | Oireachtas source

I compliment the Technical Group for tabling this motion. I do not believe we can discuss disability issues too frequently in the Dáil.

There are hard choices to be made when money is scarce. The idea that we should throw endless money at a problem is a fallacy. However, there are things we could tackle and things we could do better. I believe the Minister of State, Deputy Kathleen Lynch, is genuine in her concern, so I will put forward a number of ideas that could be taken on board and point to where I believe things have gone wrong.

The first thing we must do is ensure that the primary care budget, from which disability money is provided, is totally immune from any overspend in the hospital sector affecting that budget once it has been decided for the year. Time and again over many years, the hospitals have overspent and the hand is put out to the primary care budget. People involved in primary care tell me that is exactly what happens. When the hand goes to primary care, one cannot get rid of all one's fixed overheads half way through the year.

I will now address home help hours and all the other areas where it is easy to make a cut. In using the word "easy", what I mean is that one can make adjustments because the people in question do not have permanent, long-term contracts. When the most vulnerable sectors are cut, it always impacts on the disability sector. At one stage, I suggested to my colleagues that we should have two separate Departments of Health, one for hospitals and one for primary care, as this would prevent the perennial robbing of the primary care side to fund the overspend in hospitals.

The mobility aid fiasco did not arise overnight or without warning but is indicative of the lack of urgency that bedevils the system. Whereas everyone knows there is a problem, one cannot get the system to deal with it or provide a viable answer. The result is that one hits a wall which, in the case of mobility aid, meant the Government pulled the payment. Some have argued that we should issue people aged in their 30s, 40s and 50s free bus tickets in lieu of mobility payments. Such arrangements are not a substitute for cash payments because the mobility payment provided a flexibility that other arrangements cannot provide.

On the issue of social welfare reform, as Minister for Social Protection I was criticised for cutting the disability allowance. I explained the dilemma I faced in my contribution on the relevant budget. The reason I had to cut disability allowance and invalidity pension was that the number of recipients of these schemes was so high that failure to reduce the two payments would have prevented me from achieving a raft of savings and resulted in migration between schemes. I stated that I was working on a concept to which the Department was strongly wedded that would have categorised recipients of the invalidity pension and disability allowance as profoundly, moderately and mildly disabled. This proposal offered many advantages. For example, the creation of a mild category with a payment set at a level similar to payments for the unemployed would eliminate the temptation to secure a disability rather than unemployment payment. One could then shield people with profound or moderate disabilities because the numbers in these two categories would be small and one could target available moneys at people with more significant disabilities. If we are not willing to make these types of decisions, the numbers involved will be so large that the Minister will not have any room for manoeuvre when faced with budgetary pressure.

As I stated, one also must face up to the migration issue at the margins. We all know from our constituency clinics that people just about manage to get over the line to qualify for a disability payment. Such individuals are much different from people who cannot walk, talk or do anything for themselves, but the system does not recognise this distinction. The model I proposed was being developed and is evident in the partial capacity benefit, about which I hear very little. The model I proposed should be implemented now.

I would prefer to take €1 from everybody than take the Government's approach of writing to everybody on invalidity pension and domiciliary care allowance informing them that their entitlement is being reviewed. Large numbers of people have had their payments withdrawn. Most of them appeal the decision and in 90% of cases they win their appeals by presenting overwhelming evidence. The sudden withdrawal of a payment from people who have depended on payments for years is causing serious worry. This issue needs to be addressed. In cases where people have a payment reinstated on appeal, they should be classified in the manner I outlined in order that we can protect them forever and a day, except at the margins.

Disability allowance should not be paid to children. As Minister, I intended to switch this payment to a domiciliary care payment because I considered it wrong to give a disability allowance payment of €188 to a teenager. I planned to hermetically seal this money in the domiciliary care allowance budget. It would have been paid directly to parents because no one under the age of 18 years should receive a direct payment of that magnitude from the State. This argument was made to me by many parents of children with disabilities when I was Minister. I would have decreased the payment for 16 year olds and allocated the money saved to early intervention. In other words, I would have maintained the budget and allocated savings to three and four year olds. By providing additional money to parents, one allows them to pay for early interventions that would have long-term benefits for children. As I indicated, I do not agree with giving any substantial payments directly to young people under 18 years. The payment should be made to parents rather than children.

See this speech in context