Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

On behalf of the Minister of State, Deputy Finian McGrath, who had to leave the Chamber I will respond to some of the matters raised.

We all share a common desire to have the best possible policies and services for all children, adolescents and adults with disabilities.

We all want everyone with additional needs to have access to the necessary supports in every aspect of his or her life to enable him or her to achieve his or her full potential, maximise his or her independence and live a rich and fulfilling life.

Government policy on disability services is set out in the national disability inclusion strategy which recognises the long-standing Government commitment to mainstream public services to include and serve people with disabilities. This is underpinned by the Disability Act 2005. In line with this policy, there are no disability-specific strategies, as to have such strategies would create inequity and could lead to calls for specific strategies to cover all types of disability. The Government is committed under the national disability inclusion strategy to ensuring people with disabilities are empowered by policy and programmes to participate meaningfully as citizens in Irish society. The strategy is driven by this basic but fundamentally important objective and is the most effective combination of legislation, policies, institutional arrangements and services to support and reinforce equal participation for all people with disabilities.

Across government in transport, housing, equality, health, employment and social protection services, we are working together to ensure children, young people and adults with a disability have the right to the same life opportunities as anyone else and live satisfying and valued lives. I share with my ministerial colleagues and other members of the Government a very strong desire to ensure people with disabilities are afforded every opportunity to realise their potential in every dimension of their lives. Whatever a person's abilities, talents or gifts, each one of us has something to offer. It is society's job to ensure we live in a society that encourages this and that people with disabilities thrive, fulfil their ambitions and contribute to their community. If that goal is to be achieved, people with disabilities must be central to all we do. To achieve this, it is important that people with a disability and their families can avail of the many opportunities to engage with policymakers in a wide range of Departments and statutory agencies. They include events organised within the context of the national disability inclusion strategy and the departmental disability consultative committees, as well as the carers' forum and pre-budget forum organised by the Department of Employment Affairs and Social Protection. The actions included in the national disability inclusion strategy generally relate and apply to people with disabilities and it also contains specific actions in the provision of personal assistance.

Significant resources have been invested in this area in the past few years. In 2019 alone, the Health Service Executive will spend €1.9 billion on its disability services programme. This is in addition to mainstream general medical services accessed in primary care and hospital settings. The breakdown of the budget for specialist disability services in the last full year is as follows. There is a figure of 64% for residential care services, 21% for adult day services, 5% for personal assistant and home support services, 4% for multidisciplinary therapies, 3% for respite care services and 3% for other community services and supports. As my colleague, the Minister of State, Deputy Finian McGrath, outlined, the Government has committed €2 billion in health service funding for specialist disability services in 2020.

The role of a personal assistant is to assist a person with a disability to maximise his or her independence through supporting him or her to live in integrated settings and access community facilities. The personal assistant works on a one-to-one basis in the home and the community with a person with a physical or sensory disability. A vital element of this personalised support is the full involvement of the individual in planning and agreeing the type and the times when support is provided. Supporting independent living must enhance the person's control over his or her life.

Personal assistant and home support services are provided either directly by the HSE or through a range of voluntary service providers. The majority, or 80%, of specialised disability provision is delivered through non-statutory sector service providers. To understand the progress made by the Government, we can compare the numbers in 2013 with those in 2018. In 2013, 2,057 people availed of a personal assistant, while in 2018 this number rose to 2,535. In 2013 the total number of personal assistance hours came to 1.3 million, but in 2018 it had risen to 1.64 million. In 2019 the combined budget for personal assistant and home support services came to €87 million or 5% of the budget for people with disabilities. That is a significant amount, but resources are finite and must be seen in the context of competing demands for priority funding.

It is important to note that the level of service delivered is varied to ensure each client's needs are reflected. Therefore, there is no average agreed number of personal assistance hours per person. Whereas many individuals are adequately provided for by the current level of support, we accept that many would benefit from more support hours. The Government supports the work of the HSE and agencies to explore various ways of responding to this need in line with the budget available. I acknowledge that the motion speaks about not conflating personal assistant services with home support services and the HSE measures and assesses both services distinctly. However, personal assistant services and home support services are closely linked and many people with disabilities require both home support services and personal assistance. In 2018 the State provided for the provision of 2.93 million hours of home support for adults and children with a disability, an increase of 180,000 hours on the 2017 target. As with every service, there is not a limitless resource available for the provision of personal assistant services and although the resources available are substantial, they are finite. In that context, the number of hours granted is determined by the available resources and other support services already provided for the person.

To understand the future service need for personal assistance and home support services, the Health Research Board provides for planning analysis through its national ability support system database. This is a key planning tool in respect of current service provision and the future service needs which is used by the Department of Health and the HSE. It is important to remember that an individual's number of personal assistance hours needs to be flexible and may be adjusted following a service review where service demand can result in one individual's service being reduced in order to address tje priority needs of other people with disabilities within that community.

The motion refers to legislation in some other countries. I assure the House that the Department of Health keeps abreast of research developments and international best practice and is committed to developing services that meet the needs of people within the constraints of the available resources. The Government acknowledges that in some areas there may be a shortfall in service. However, it is working to address it, most notably through the Slåintecare reform programme. It is the Government's aim to ensure all citizens can be offered the right care in the right place at the right time.

I have noted some of the concerns raised by Deputies and will bring them to the Minister of State, Deputy Finian McGrath. I have long had connections with people with disabilities in my family. It is important to understand that although there is a difficulty in providing services which the Minister of State is addressing, we do not have an infinite budget. I acknowledge the work being done by people on the ground, particularly by those involved in home help services and those who work with people with disabilities. I have a daughter working in the service. Since she started a couple of months ago, she has told me that she has been enriched by the people she helps on a daily basis in trying to bring them to their full potential. We are trying to ensure they can live independent lives. I fully understand the matters that have been raised, as they have also been raised by my constituents and people I have met as a Minister of State.

The motion raises concerns about consistency in access. The HSE is committed to introducing a standardised assessment process to identify and assess the needs of people with a disability. Work is ongoing in the HSE to select an information technology-based single assessment tool to ensure consistency in assessment nationally.

See this speech in context