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

I move amendment No. 1:

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

“values the role which people with disabilities play in Irish society and is committed to facilitating the full inclusion of people with disabilities in the life of the community through access to individualised personal social supports and services;

recognises the Government’s commitment to ensuring that the quality of life of people with disabilities is enhanced and that resources are allocated on the basis of need;

affirms the Government’s commitment to the provision of effective and responsive public services for people with disabilities;

notes that the Government spends almost €5 billion annually on disability services and income supports (in addition to expenditure of over €1 billion on income supports for illness and invalidity); and the health service alone will spend €1.4 billion in 2014 on health and social services for people with disabilities, including:

— residential services to over 9,000 people with a disability;

— day services to over 22,000 people with intellectual, physical or sensory disabilities and autism;

— respite residential support for nearly 6,000 people with disabilities; and

— 1.68 million hours of personal assistant/home support hours;

notes that additional funding of €14 million has been provided to address priority needs within disability services identified by the Minister for Health and advised to the Health Service Executive, including:

— €7 million for additional places for school-leavers and rehabilitative training graduates;

— €3 million for emergency residential placements; and

— €4 million to support the development of services for children with disabilities under the National Programme on Progressing Disability Services for Children and Young People;

acknowledges the key Programme for Government commitments and recognises the progress to date in implementing them, particularly in:

— the publication of an implementation plan for the National Disability Strategy;

— the publication of the Value for Money and Policy Review of the Disability Services in Ireland which lays the foundations for a person-centred supports model which will allow people to exercise greater choice and control, enabling them to live fully inclusive, active and independent lives within the community; and

— the introduction of independent inspections for residential services for people with disabilities;

acknowledges the range of income and work-related supports provided by the Department of Social Protection for people with disabilities, and notes that:

— expenditure on the Illness, Disability and Carers programme is estimated to be €3.33 billion in 2014, which represents 17 per cent of total Departmental expenditure;

— the purpose of the Illness, Disability and Carers programme is to provide an income for persons in the event of short and long term illness or disability and to support the valuable service provided by their care givers; and

— social transfers, such as Disability Allowance, help to support people to participate in society in a positive way and prevent poverty for those with serious illnesses and disabilities;

recognises the central role which work plays in the lives of people with disabilities and is committed to the development of a comprehensive employment strategy for people with disabilities, which will be published this year, as set out in the Action Plan for Jobs 2014;

notes that the Department of Education and Skills spends approximately €1.3 billion, or 15 per cent of its entire budget, in support of children and young persons with disabilities and Special Educational Needs and, despite the significant economic challenges of recent years, has continued to protect this investment; and

recognises that the Department of Education and Skills is focused on ensuring that all children can have access to an education appropriate to their needs.”

Like other speakers I thank Deputy Finian McGrath for introducing the motion and the Technical Group for allowing the matter to be chosen. It probably always has been and will be one of the issues that rounds off a term in the Dáil. Every year it is either health, mental health or disability, but that is a good thing as we need to continue to focus on where we need to be.

I welcome this opportunity to state once again the Government's commitment to the provision of effective and responsive public services for people with disabilities and to strongly reaffirm the Government's commitment to the national disability strategy. The Government is also committed to the implementation of the reform programme for the disability sector, as set out in the value for money and policy review.

Deputies Donnelly and Pringle raised the ratification of the UN convention. We signed it, and as we have always done with conventions, we then put in place the various pieces of legislation in order that when we ratify at least we will not be like other countries that ratify and do not put the legislation in place and when they are called to account do not live up to the promise they gave in the ratification process. We are currently dealing with the Assisted Decision-Making (Capacity) legislation. Members will have an opportunity to deal with it. That is the biggest aspect of what remains to be done. It is not the case that we ratified the convention and did not bother to do anything else. We intend to complete the legislation. When we tidy up another few aspects of the Bill we will be in a position to ratify the convention.

That intention has been highlighted again in the Statement of Government Priorities 2014 - 2016, which has just been published, which states:

The Government will implement the report of the value for money and policy review of the disability services programme, which recommends a significant restructuring of the disability service by linking budgets to activity, outputs, quality and outcomes for service users. The new model of personalised, community-based service must provide greater choice for people with disabilities.

Certain people might be have a mild, moderate or profound disability but in all categories there are usually people who cannot advocate on their own behalf. I was not involved in the decision on funding but I had already committed to speak to the Department of the Environment, Community and Local Government to see what could be done. I do not promise anything. I do not do that, but I will definitely take up the matter with the Department. Deputy Catherine Murphy and Deputy Maureen O’Sullivan are particularly interested in the issue and it is important that such issues would be examined.

I have often expressed my strongly held view that people with disabilities are not ill and do not require to be fixed. What people with disabilities need is for us to break down the barriers society puts in the way of them living a full life - a life that is worth living. They also need the supports necessary for them to live a fully inclusive life. That is the aim of the national disability strategy, which was launched in September 2004 and which continues to be the focus of Government policy for the sector. The programme for Government contained a commitment on the publication of the first ever implementation plan for the strategy and to the achievement of even greater levels of progress. With that in mind, I established, and have been personally chairing, the national disability strategy implementation group, which was tasked with developing and monitoring the implementation plan.

The objective is to engage with the disability sector and build on the constructive and co-operative approach of the community and voluntary sector. Acknowledging the current economic climate, this implementation plan seeks to ensure available resources are used to best effect in ensuring people with disabilities have more choice and control in their lives and more support in achieving their aspirations for the future.

Collaboration is key to progressing the national disability strategy and the value for money review. I am a passionate exponent of the motto "Nothing about us, without us". I have always been committed to working with people with disabilities and to opening channels of communication wherever I can. As another means of engagement with the disability sector, I set up a disability forum under the stewardship of the National Disability Authority. One of its first tasks was to provide an input into the development of the national disability strategy implementation plan. Progress on the implementation plan is reviewed by the implementation group through thematic meetings which deal with specific issues. This brings me to an issue of key importance - employment. The next thematic meeting of the national disability strategy implementation group will focus on employment. The importance of work to an individual's psychological as well as the financial well-being is well recognised, and that applies in equal measure to people with disabilities.

We know that people with disabilities are only half as likely to be in employment as others of working age and that the reasons for this are complex and multifaceted. The national disability strategy implementation plan contains a commitment to publish a comprehensive employment strategy for people with disabilities. To progress this commitment, I requested the National Disability Authority and Mr. Christy Lynch, who is a founder member of the Irish Association of Supported Employment, to lead on the cross-sectoral development of a comprehensive employment strategy. The strategy will bring together actions by different Departments and State agencies in a concerted effort to address the barriers and challenges that impact on the employment of people with disabilities. Significant work has been undertaken to date, in consultation with relevant Departments, disability organisations, employment organisations and social partners. I reviewed the first draft in conjunction with the national disability strategy implementation group in June and identified certain aspects of the strategy that need further development. Work in this regard is ongoing and, as I previously mentioned, a themed meeting on employment is scheduled for September and will progress this matter further.

To further support the mainstreaming of this initiative, we have included its publication in the Department of Enterprise, Trade and Employment's action plan for jobs. This is where it belongs as this must be a cross-departmental initiative. Its subsequent implementation will be overseen by the Cabinet committee on Pathways to Work because it is important not to divide and stigmatise people with disabilities. Supporting people with disabilities to live a fully inclusive life is also fundamental to the value for money and policy review of disability services funded by the health sector, which I published in 2012. The review is pivotal in progressing and supporting the implementation of significant elements of the national disability strategy and echoes the health care reforms signalled in Future Health, the Government's blueprint for the restructuring of health services. Implementation of the review is being monitored and guided by a steering group, which is undertaking an ambitious work plan for 2014 to 2015 with dedicated resources provided by the HSE.

A key aspect of Future Health is the emphasis on treating people at the lowest level of complexity. One of the bulwarks of this reform will be the strengthening of the primary care system. The statement of Government priorities for 2014 to 2016 commits to the publication of a new primary care strategy that puts primary and community care at the heart of our health system and that prioritises access to primary and community care for those with medical needs as resources become available. This is a commitment that will be of great relevance to those with disabilities, who will receive more and more of their primary care services in the community as the implementation of the disability reform programme progresses.

This is a time of major change in the delivery of social care in this country and we have embarked on a transformation programme that will put the citizen at the heart of everything we do. This change can best be illustrated by the disability services provided by the health sector, which is migrating from a segregated, group-delivered service to a person-centred and individually chosen supports model. The implementation of this new model requires a more effective, transparent and accountable use of the €1.4 billion annual health budget for disability services. The HSE must maximise the provision of services within available resources and maintain a consistent level of service compared to last year. Both the HSE and the voluntary disability service providers have introduced significant efficiencies over recent years and are continuing to examine further ways of streamlining governance arrangements and maximising operational efficiency as part of the implementation of the value for money review and the Haddington Road agreement.

Despite the difficult economic conditions in which we find ourselves, there can be no compromise on the quality and safety of the services we deliver. The scheme of registration and inspection of residential services came into operation on 1 November 2013. The regulations, which are being enforced by the Health Information and Quality Authority, HIQA, seek to ensure that the unique and complex needs of each child and adult with a disability in a residential service are met in an appropriate and effective manner by service providers and staff. This is a positive development for everyone concerned and will set the bar for quality care in the years ahead. I have mentioned that the way in which we support people with disabilities to live normal lives is undergoing a seismic change. The HSE's report entitled Time to Move on from Congregated Settings proposes a new model of support where people will move to housing in ordinary communities provided mainly by housing authorities.

The process of moving towards a community-based model of residential services has been happening gradually for a number of years and is now gathering momentum. Together with the Department of the Environment, Community and Local Government, the Department of Health has developed a housing strategy for people with disabilities and an implementation framework which aims to support people with disabilities to live in their communities with maximum independence and choice. The framework that supports people with disabilities in living in their own communities is an excellent example of cross-sectoral work and the whole-Government approach that is a central theme of the national disability strategy.

The health sector has invested significant resources in services for children with disabilities, including autism, over the past number of years. In addition, the HSE has recognised that there is a need to standardise early intervention services and services for school-aged children with disabilities. To this end a major reconfiguration of therapy resources for children aged up to 18 years with disabilities is currently under way.

The HSE's national programme on progressing disability services for children and young people from zero to 18 years, to which Deputy Tom Fleming referred, aims to achieve a national unified approach to delivering disability health services so that there is a clear pathway to services for all children, including those with autism, regardless of where they live, what school they attend or the nature of their disabilities. The programme aims to provide one clear pathway to services for all children with disabilities, according to need. It also seeks to ensure that resources are used to the greatest benefit of all children and families and that health and education strategies work together to support children in achieving their potential.

An additional €4 million has been specifically allocated in the national service plan for 2014 to drive implementation of the programme. The HSE has decided on the allocation of an additional 80 posts, including speech and language therapists, occupational therapists, physiotherapists and psychologists. In addition, during the remainder of the year some funding from the allocation will be utilised on a targeted basis to tackle priority waiting lists at local level, using capacity within the public, voluntary and private systems. I do not have specific details on the area mentioned by Deputy Tom Fleming but I will get them.

This Government has defended spending on special education needs since coming into office and has given it the highest priority. The level of resources devoted to supporting children with special educational needs has been protected and in some areas has been increased in 2014 to take account of demand and demographic growth. Some €1.3 billion will be spent in support of children with special educational needs this year. This level of investment represents approximately 15% of the entire educational spend of the Department of Education and Skills and means that the majority of pupils with special educational needs can continue to be educated in an inclusive environment in mainstream schools along with their peers. It also means that pupils who require intensive interventions in a specialised environment, special classes and special school placements can continue to receive the services they need.

There is now a greater number of resource teachers and special needs assistants, SNAs, in schools than at any time previously. Last December, the Government announced it was increasing the number of SNAs available for allocation to schools to reflect demographic growth and increased demand. By the end of the year there will be almost 11,000 posts available, which is the highest ever level of SNA allocation. The number of special classes has increased by over 60% since the 2010 to 2011 school year. The Department also makes provision for enhanced capitation payments for special schools and special classes, specialist transport arrangements and assistive technology support.

Every year young people finish their formal education and progress to the next stage of their lives and Deputy Finian McGrath spoke of children progressing from first and second-level formal education. For most children, including those with disabilities, the aim is to progress directly to further education, vocational training or employment and I have described the resources provided by the Department of Education and Skills to facilitate this. However, for around 900 young people who have higher support needs, the requirement is for life skills training or day supports provided by the HSE.

After following an appropriate life-skills training programme many of this cohort will also progress in time to mainstream training and employment, with personal social supports provided by the HSE where needed.

The HSE national service plan includes an additional €7 million and 35 posts to provide training places and day services for young people who will finish their formal education this year. The provision of services to more than 900 young people and almost 450 life-skills graduates has been challenging even with the additional funding. Not alone does the provision of these new services stretch resources as far as they will go, but the logistics of putting new services in place for so many young people in a tight timeframe provides the HSE with a major challenge every year. To meet the challenge the HSE has implemented a new centralised application process and national operational approach to school leaver placements.

Three years in a row I stood here and asked why it came as a surprise every year that young people leave school and need a place. In the normal course of events if a child is to continue to third level education he or she fills out a CAO form and one knows in advance. We asked for a similar system and we have it this year, which is why Deputies are not receiving the usual torrent of phone calls. It was simply a matter of putting the process in place. I hope it will work well and will become embedded in the system. I am very pleased to say this process has been completed for 2014, and the HSE has assured me that in all but a very small number of cases, school leavers and their families have been notified of the placement which will be available to them in September. In the remaining cases, the HSE, service providers and families are still in discussions regarding the most suitable placement for the school leaver and strenuous efforts are being made to reach a satisfactory resolution for each young person concerned. This is a significant achievement by all concerned and a great improvement on the position in recent years.

Training is only part of the journey people with special needs must face 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 through activation measures, income supports and work-related supports. 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 barriers in this area. Services for people with disabilities include the Employ Ability service, which is a supported employment programme, the wage subsidy scheme and the disability support and awareness grants and schemes. Other measures include funding for innovative disability projects and grants for reasonable accommodations in the private sector which aim at encouraging the employment of people with disabilities. In addition, the Department initiated a disability activation project, with funding of more than €7 million, which aims to identify the optimum approaches to mainstreaming labour market activation measures for people with disabilities.

As well as activation measures, the Department of Social Protection also provides an illness, disability and carers' programme which provides an income for persons in the event of short and long-term illness or disability and supports the valuable service provided by their care givers. Social transfers such as disability allowance help to support people to participate in society in a positive way and prevent poverty for those with serious illness and disabilities.

In total, the Department of Social Protection will spend an estimated €3.33 billion this year on the illness, disability and carers' programme, which is 17% of the Department's total expenditure for the year and is a very considerable and tangible testament to the Government's commitment to provide income supports for people with disabilities and their care givers.

I welcome the opportunity provided by the debate to put on record the Government's position on services for people with disabilities. There is an onus on us all to use the substantial resources committed to disability services throughout the public sector more effectively, and to achieve better outcomes for this funding and to bring about a real and substantial improvement in the lives of people with disabilities. This is a central tenet of the national disability strategy and a high priority for the Government and one to which I am fully committed.

The most significant developments with regard to disability in the past 12 months have been the appointment of a director with sole responsibility for social care, which is disability and older people, and the fact people now fully control their own budget and are enabled to have the flexibility to use it in a way which rewards but which also penalises people who do not deliver the type of service to which we feel people with disabilities have a right.

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