Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank all Deputies who contributed to this debate. I give them a commitment to listen to their points of view and to respond to the issues they have raised. I absolutely share the deep concerns Deputies have expressed about the care by the State of vulnerable people with a disability. This Government is committed to the protection and safeguarding of children and adults with disabilities and I am determined that historical issues will be comprehensively examined and addressed. We have to change the mindset in Irish society and bring in real equality for all people with disabilities and that is part of my broader vision for the reform of services for people with disabilities.

A range of measures have been put in place in recent years to improve the care provided to the most vulnerable citizens and this will be progressed and improved. The system is clearly far from perfect but the fact that these issues are coming to light and are being investigated points to the fact that our oversight and regulation are getting better. My Department will receive a number of reports and reviews in the coming weeks which will shape and direct the way the disability sector is regulated.

I will now deal specifically with some of the issues raised by the Deputies. Deputy Margaret Murphy O'Mahony raised the issue of abuse and I agree that we have to ensure the protection of our citizens. She also raised the issue of congregated settings and I totally accept that we need to focus on them. However, the process is being supported this year by €20 million in capital funding from the Department of Health while assistance with transitional costs is being provided by the service reform fund to the tune of €45 million, with support from the Department of Health and Atlantic Philanthropies. The Deputy also said we needed more reform and more positivity in our health and disability services and some of the reports I will be receiving will deal with these issues. I hope there will be evidence of this reform come the autumn.

I appreciate the support of all Deputies on this issue. Deputy Ó Caoláin asked about resources. The answer to his question is "Yes". Disability services have been devastated for the past ten years. We need to up our game and to invest in services. He also asked about the inspection of services by HIQA, a very important question. All centres had been visited at least once by April 2016. The Deputy also raised the case of a number of centres of autism being taken over by the HSE in recent months. This shows that the system of regulation works and that there is a procedure in place to deal with centres which fail HIQA standards. There is no exception in the case of centres covered by section 69 of the 2007 Act. HIQA will continue to monitor and inspect all centres and will expect centres with the greatest challenges to meet the standards that have been prioritised for decongregation. The centres with the worst level of services, where physical space is often the issue, will be prioritised in the context of decongregated settings.

Deputy Ó Caoláin also mentioned mobility allowance. The Department of Health has prioritised the development of the transport support Bill in line with the commitment in the programme for partnership Government. The heads of Bill are in an advanced stage of development.

The Deputy mentioned the resource issue with regard to the Health Information and Quality Authority, HIQA. That is an issue we have to fix; it is a reality. I give a commitment that I will support HIQA on access and resources, because it is the guardian of citizens.

Deputy Maureen O'Sullivan raised the issue of abuse. She acknowledged that we must have a strong, professional services but also acknowledged the good work that takes place. Many of us have experienced high quality services in the disability sector, but that is due to the staff - the right people doing the job in the right services. That issue continues to arise. I accept that Deputy O'Sullivan is disappointed about the extension, but I want to ensure that these services are up to standard. She also raised the quality of the day services. Yesterday, I met representatives of the National Disability Authority and they accepted that we had a very good discussion. We came up with a major programme for the end of December to examine the standards, because there is a variation of standards within day services. I am aware of many centres that have a structured day service with a high-quality timetable, and young adults with intellectual disabilities love the centres. Equally, in regard to other centres, I had a complaint recently where for one family it was costing the Health Service Executive €180,000 a year for a service that was appalling. The mother of that young person with an intellectual disability said that for half that amount of money she would get a better service. There is much inconsistency in the services, but we have high-quality day services.

I appreciate Deputy Catherine Connolly's support and I take her point. While I referred to a technical amendment to the 2007 Act, the wider view is that we have to ensure that respect for, equality and reform of the services must be developed. The Deputy asked whether the Government had learned a very important lesson from what happened in the past. I hope to God we have, because I have become very frustrated with some of the situations I have come across recently. I agree with the Deputy on that. Deputy Connolly also made a strong point about high costs. I know we will probably have to go down the road of a commission of investigation, but it annoys me that we have to spend that money. Who will get the money? It will not be the services for adults with intellectual disabilities; it will be sections of the legal profession, but that is another debate. We might have to do that in this particular case. The Deputy made the strong point that if we invest in high-quality services it will save us money in the future. That is a reality and a vision we need to bring to the issue.

When it comes down to savings and resource issues, as I said to Deputy Ó Caoláin, these are important things that we have to change, and we must change the mindset also. Disability has to be brought to the top of the political agenda. I try to do that every day. It is very difficult at times but we do make progress. I hope we will make progress on these matters. Those were the issues and concerns raised.

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