Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome this Bill. I particularly welcome the move from a health-dominated approach to disability to an equality and rights-based one. It is a very welcome development. Viewing disability primarily through a health lens has created a very narrow focus, one that is so narrow that it has been rejected by people with disabilities, their advocates and people working in the field. In that respect, I welcome this move. There is no doubt there has been far too much emphasis on people's actual disabilities and not enough on the voices, experiences and abilities of people living with disabilities. As Des Kenny, chair of Independent Living Movement Ireland, put it, the Department must recognise "that it is how society is structured that disables people, and our lack of participation and inclusion in society is not due to our impairments". That is important. It is society, the structures and the system that need to change.

For decades, disability campaigners have sought to ensure the rights of people living with disabilities are addressed at a full ministerial level. The scale of disability in this country, the number of people living with disabilities, the scale of the services to be provided across a wide range of Departments, and the level of funding needed raise the question whether there is a need for a senior Minister. While the Bill is certainly an improvement, we have to ask ourselves what exactly is going to happen now. The fear is that all the Bill will entail is the movement of a Minister of State, albeit one who is able and has been a good fighter for the sector, from one Department to another. Is it much more than that? The detail of what is required to be done and the budget involved raise these questions.

Disability will now be the biggest element of the budget in the Department, at €2.3 billion. Yet, it is still a Minister of State dealing with that massive budget. This transfer will more than double the budget of the existing Department. If disability had a Department in its own right, it would have a budget greater than 11 other Departments. That puts some perspective on it. One has to ask why it is just added onto another Department. Some 13.5% of our population have a disability, yet we cannot find room in a Cabinet of 15 for a dedicated Minister. That is a problem.

Much of the focus on disability over the past decade has related to service provider funding, which has not yet recovered from cutbacks introduced in the recession. I know the Minister appreciates that. While this is undoubtedly an important issue, successive governments have forgotten about the service users caught in the middle of protracted stand-offs between the HSE and service providers. We have often lost sight of the fact that social exclusion is the predominant issue for people living with disabilities. A recent ESRI report found that Ireland has the fourth lowest employment rate in the EU for people living with disabilities, at a mere 36%.

Some 27% of the homeless population have a disability. More than 1,400 people living with disabilities under the age of 65 are actually in nursing homes. It is shameful that we are seeing this institutionalisation and that it still features so heavily in policy. These are the lived experiences of people with disabilities.

The publication of the disability capacity review last July after a long delay detailed the significant unmet needs of people living with disabilities. It estimated that in the next decade there will be a need for a further €550 million to €1 billion investment in disability services. Despite disability being an issue that affects so many families, the capacity review's estimate suggests that disability is generally one of the most underfunded areas of public expenditure.

Budget 2022, in my view, failed to tackle the historic underspend in disability with a more-of-the-same approach to addressing shortfalls. It is not good enough merely to recognise the issues faced by people living with disabilities. We must address them in a meaningful way. Instead, this Government is continuing to let issues fester until they become urgent or, in many cases, an emergency. We need to move from crisis interventions to rights-based supports.

The UNCRPD is clear on the need to eradicate poverty for people living with disabilities. Article 28, which is concerned with an adequate standard of living and social protection, requires states to "ensure access by persons with disabilities ... to social protection programmes and poverty reduction programmes". People living with disabilities in Ireland have among the highest rates of poverty – three times that of the general population. They are at the sharp end of our housing and cost of living crises. Additional costs, such as specialist aids and equipment, home adaptations, higher energy costs and extra transportation costs, particularly taxis, are realities of people's lives when they are living with disabilities. These additional costs must be addressed yet, in section 51, there is no mention of the Ministers for Transport; Housing, Local Government and Heritage; Education; or Further and Higher Education, Research, Innovation and Science, or their Departments, having a role in responding to the needs of people living with disabilities.

I do not know what the role of the Minister of State, Deputy Rabbitte, will be in relation to those Departments. She will need a big stick or a good pair of boots to deal with this matter. There needs to be clear roles and responsibilities outlined in relation to that. That raises the issue of the delegation of functions. I do not know if that has yet been resolved but it is traditionally a thorny issue within Departments and between senior Ministers and Ministers of State. It is essential that the Minister of State has clear delegation of functions in relation to not only the new Department but also the Departments of Health; Transport; and Housing, Local Government and Heritage, as well as the other relevant Departments. Transport and housing, in particular, are major issues for people living with disabilities.

In December 2021, the Department of Social Protection’s cost of disability report concluded that the typical annual costs faced by people living with severe disabilities amount to up to €12,300, and possibly up to €10,000 for people with more limited disabilities, in order to get by and have any kind of life that they can live with dignity. The full report details the lack of supports available to people living with disabilities and the severe challenges they face. It is all there in black and white. It cannot be disputed. It is set out and nobody can complain that they did not know. The report must not be allowed to gather dust on a shelf along with other reports on the cost of disability - one in the 1990s and one in the 2000s. It should immediately inform policy to address the extra cost of living with a disability, ensure our public services are accessible and create pathways to employment and other supports.

In 2018, 12 years after it was agreed by the UN, Ireland was the last EU country to ratify the UNCRPD. We find ourselves in a situation where there are still major questions about the Government's commitment to the optional protocol. Much of our national legislation remains out of sync with the convention. Disability legislation, such as the Assisted Decision-Making (Capacity) Act 2015, is still not fully commenced. I look forward to further detail on what the senior Minister announced earlier. Is it any wonder that this Government still has not ratified the optional protocol when it and the previous Government dragged their feet so much in relation to these essential elements of dealing with the issue of disability? The Government claims that it needs to do more work before signing this protocol but this is clearly a delaying tactic as the Government does not want to be held to account over its failures to uphold the rights of people living with disabilities.

On a related note, mental health comes under the remit of the UNCRPD. If we are truly committed to implementing the UNCRPD, people experiencing mental health difficulties will be using this convention to exercise their rights but the budget for mental health will sit apart from the Department with prime responsibility for the UNCRPD. That is another organisational issue that needs to be resolved because that responsibility will fall on the new Department.

The second class position of section 39 organisations is one of the key areas that needs to be addressed. People who use section 39 services are significantly disadvantaged over those who use section 38 and HSE services. This is primarily because of public funding and staffing arrangements. Because of a lack of funding, staff are paid at a lower rate in section 39 organisations even though in many cases they do the same work as in the HSE and section 38 organisations. This results in higher turnover of staff and much greater disruption for adults and children using these services. It also means that service providers have extra costs in recruitment, training and other areas. The funding system also leads to uncertainty with no multi-annual funding system, in spite of that being promised for some time. People who receive services from section 39 organisations really value them. The ethos and culture in those organisations is strong and supportive and this drives quality, dedication, commitment, specialisms and, fundamentally, a person-centred approach. However, to make the sector sustainable, the funding and staffing arrangements need to be sustainable.

Specifically on multi-annual funding, the HSE corporate plan published last year included a commitment to multi-annual funding. The Catherine Day report, from 2019, recommended it. The disability capacity review, published last July, recommended it. It was committed to as part of the consultation on the forthcoming disability social care action plan but there are rumblings that the Department of Public Expenditure and Reform is not signing up for this. I wonder if that is the case because there is a strong rumour that it is. It appears that the dead hand of the Department is striking again. Without multi-annual funding it will be impossible ever to plan properly for the services to be provided in the years ahead. It is critical to the success of this new arrangement. The promise of multi-annual funding needs to be kept and it needs to be delivered on this year.

It is positive that a review of the new arrangements is built into the Bill. This will be important for addressing any potential issues that arise.

The Minister of State said earlier that section 10 provides for:

... consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of appointments of executive board members. People with experience of advocacy in matters affecting recipients of services may now be selected as board members as well as those with experience in advocacy in matters affecting patients.

This is very welcome, as it will bring more lived experience to decision making. The selection of people for this role should seek to represent the very broad spectrum of disability in Ireland.

Section 64 appoints the Taoiseach as referee where there is a disagreement between Ministers. I wish him luck with that. How can the Taoiseach arbitrate on what in some cases will be a question of law? That issue must be resolved. Is it all very well for the Taoiseach to arbitrate. I hope he will arbitrate where there are disagreements about the adequacy of funding that is provided. The Minister has the clout to resolve those kinds of issues but in the case of questions of law, that is a harder one to understand.

Sections 3 and 59 appear to use different definitions of specialist community-based disability services. Again, that is something that needs to be resolved. On the question of resolving it, we do not have any clarity on the other Stages of this legislation. The Bill is scheduled to continue next week, and I wonder when we are likely to complete Second Stage. Given that this has been talked about for some time, the Bill appeared very quickly and there was very little time for various disability groups to give it adequate consideration. That is an issue that has been raised with me. I hope that prior to Committee and Report Stages, sufficient time will be allowed for the many organisations, individuals and advocacy groups to consider the full implications of the Bill and to have an input in terms of potential amendments. I hope the Minister of State will be open to considering those amendments.

I will leave it at that. I restate the point about the delegation of functions. It is particularly important. The Minister of State's role is a very difficult one, as she must negotiate between a number of Departments. If the role is to be meaningful, and if she is to have the necessary clout, there needs to be a very clear definition of functions.

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