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

I thank the Deputies for tabling this motion I welcome the opportunity to restate this Government's commitment to supporting people with disabilities and their families and I confirm we will not oppose this motion. I welcome to the Gallery those involved in the disability organisations and those looking in tonight, many of whom I know well. I would like to acknowledge the work of the ILMI and its consistent work in trying to bring about positive changes for people with disabilities across society.

I attended the Clare Leader Forum conference in Ennis last month where we discussed the positive impact on the lives of people with disabilities and their families since the Disability Act 2005 was commenced. People with disabilities should be allowed to live an independent life of their own choosing, the same as any other person, and that is consistent with Transforming Lives, our disability reform policy.

I would like to address the points raised in this motion, and outline to the House work under way across all the different Departments. As Minister of State at the Departments of Social Protection, Justice and Equality and Health with special responsibility for disabilities, I am committed to providing services and supports that meet the needs of people with disabilities. These services and supports will empower them to live independent lives; provide greater independence in accessing the services they choose and; enhance their ability to tailor the supports required to meet their needs and plan their lives. This is Government policy and this is what I believe in. At the heart of this policy are the principles of access to mainstream services and community living. Disability is not a health issue, nor is it a transport issue, or an employment issue; it is an equality issue. We have had a whole-of-Government approach to disability for a number of years. The Department of Justice and Equality is the lead Department for policy co-ordination on disability and equality. Ireland ratified the UNCRPD on 19 April 2018 and I was the person who drove that ratification.

Work is now being undertaken within that context to improve access for people with disabilities to essential services and opportunities. The national disability inclusion strategy, NDIS, contains a commitment to a mid-term review, which the Department of Justice and Equality is currently undertaking. Policy on disability is being advanced within the framework of the NDIS 2017-2021, based on an all-of-Government approach broadly around eight key themes, including ensuring equality; choice; the provision of services; accommodation; health; employment; transport and; education. The NDIS provides a mechanism for joined-up working to deliver on Ireland's commitments to implementing the UNCRPD. The NDIS steering group, which oversees and monitors the implementation of the strategy, has an important role in guiding progress in this area. This group is committed to carrying out a mid-term review of the strategy by the end of this year and I emphasise this includes a number of consultations with organisations representing persons with disabilities and with persons with disabilities and their families. A refocused strategy for 2020 and 2021 will set out the policy priorities being sought by people with disabilities as well as the actions needed to enable Ireland to continue the progressive realisation of the UNCRPD.

The Government is working towards signing the optional protocol, including work to progress the required legislation, and the first national report on the convention is due to be completed in mid-2020. The Department of Employment Affairs and Social Protection, as well as providing income supports to people with disabilities, offers a range of employment support programmes, including the wage subsidy scheme, the EmployAbility Service and the partial capacity benefit scheme. The Intreo service is also available to provide employment support services for people with disabilities who wish to engage with the service on a voluntary basis. Action is currently focusing on improving the transitions for people with disabilities into education, training and employment. A collaborative project between the Departments of Employment Affairs and Social Protection, Justice and Equality, Education and Skills, and Health and the HSE is currently being developed, which will focus on supporting young persons with disabilities from second level education into further education, training and employment. Work is also being undertaken to raise awareness and to engage employers on employing people with disabilities.

Turning to health-funded services, I acknowledge the motion is correct that there is no inherent right to personal assistance or, indeed, to any other health services in Ireland. Let me explain why this is. Under the Health Act 1970, as amended, the eligibility framework places an obligation on the HSE to make a range of services available to people, rather than conferring on them an absolute entitlement to access such services. Section 7 of the Health Act 2004 states "The object of the Executive is to use the resources available to it in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public." In short, our legislation does not confer a right to particular services. Instead, persons have eligibility to access services while there is a finite budget the HSE allocates to best fit the needs of the population as a whole.

I am delighted to confirm the overall budget for health-funded specialist disability services in 2020 is in excess of €2 billion. This is an increase of more than €490 million since 2016 on my watch. The increased funding in 2020 will enable the health services to continue to provide a broad range of services aimed at improving the quality of life of people with disabilities and their families. The policy is to provide person-centred services based on need rather than diagnosis.

Let me explain how these personal assistance services are allocated. They are accessed through an application process or through referrals from public health nurses or other community-based staff. Individual needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made on the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with the prioritisation criteria and the level of resources available. The HSE provides a range of assisted living services, including personal assistant and home support services, to support individuals to maximise their capacity to live full and independent lives. From December 2018, the medical card earnings disregard for a person in receipt of disability allowance was significantly increased from €120 to €427 per week. Since 2018, medical cards have been automatically provided to persons in receipt of a domiciliary care allowance and that has happened on my watch. This benefited 35,000 families providing care for a child with a severe disability to forgo the medical card assessment process. The Department of Health is currently engaged in detailed work to develop plans for a new statutory funding scheme and a system of regulation for home care services.

The motion raises concerns regarding consistency of access. The HSE and I are committed to introducing a standardised assessment process to identify and assess the needs of people with disabilities. Work is ongoing at the HSE to select an IT-based single assessment tool, which will ensure consistency of assessments nationally. The Government is committed to protecting the level of personal assistance services and home support services available to persons with disabilities. In 2018, 1.63 million hours of personal assistance were provided to more than 2,500 people with a disability, which is more than 122,000 additional hours and 65 more individuals serviced than in 2017, a fifth consecutive annual increase. At the end of the first half of 2019, 824,467 personal assistance hours had been delivered to 2,550 people with disabilities. Personal assistance services and home supports are closely linked, given that many service users require both home support services and personal assistance. In 2018, the State provided 2.93 million hours of home support to adults and children with a disability, an increase of 180,000 hours on the 2017 target.

In my tenure as Minister of State with special responsibility for disabilities, I have sought to ensure that a greater number of people are given more personal assistance hours. In that short time, there has been an increase of more than 100 in the number of people receiving personal assistance services and there have been 129,365 additional personal assistance hours per year for people with disabilities. I am acutely aware of the value of personal assistance services to people's lives. It can often be the final piece in the jigsaw towards living a full, independent life. In my time as Minister of State, I have striven to increase the figures, and I will continue to do so to meet the increasing demand and to allow people with disabilities live fuller, more independent lives of their choosing.

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