Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank everybody who has contributed this evening. I will split my time in two. I will deal with the legislative side of the Bill, in addition to some of the issues that were brought up, in answer to some of the questions. Deputy Smith asked a number of very important questions regarding how it will all work and whether everyone in the Department of Children, Equality, Disability, Integration and Youth have to go back to the Department of Health with the begging cap to ask it for approval and so on. "No" is the answer to that. The Minister, Deputy O'Gorman, will deal directly with all budgetary matters with the Minister for Public Expenditure and Reform, Deputy McGrath. That is the way it will be set out.

The Bill recognises the enormous importance of both Departments working together. This is the key theme throughout the Bill. The HSE will report to both Ministers, but it will do so via one service plan, one capital plan and one corporate plan. This will minimise any silos. The Bill also provides for two Ministers to enter into arrangements for embedded co-operation. This will happen, specifically, on the budget. No Minister for Children, Equality, Disability, Integration and Youth will go through the Department of Health. When the transfer happens, the Minister with responsibility for equality will take over the vote expenditure and negotiate with the Department of Public Expenditure and Reform in respect of budget 2023. That is an important piece of it.

Deputy Shortall's question was around fears about moving the significant budget. She also talked about the sectoral plan in the context of section 51 of the Bill. The transfer is about a technical exercise and moving policy responsibility between Departments that is turning a page and allowing a fresh focus on this area. The scale of disability that will be related to the new Department means disability will take centre stage. Deputy Moynihan called disability the Cinderella of the Department of Health. It will now get the opportunity to flourish, grow and support people with disabilities and their families. The Bill is a step in the right direction and a very welcome one. The Disability Act 2005 already requires the Minister for Transport to create a sectorial plan. This Bill amends the 2005 Act to allow a transfer of certain responsibilities, but does not alter or weaken any existing requirements on sectorial plans.

Many of the contributions focused on service delivery. We acknowledge that it is a very technical Bill, but it is important that I reassure all the Deputes, and especially people listening in, that I have been doing the job for the past 18 months. I thank the Taoiseach for his foresight in making this decision, but when I arrived and he told me I was taking over as Minister of State with responsibility for disabilities, I was very quickly not on the welcoming email in the Department of Health. Thanks to the Minister, Deputy O'Gorman, I got an office in his Department, so I was out of the gap straightaway on 1 July. I never functioned within the Department of Health; I have always functioned with the equality hat, along with the Minister, Deputy O'Gorman. That is not to say I have not had a great working relationship with the Minister for Health and the team in that Department, but I have based myself where I was always going to end up.

I am delighted it did not all happen on day one because I have learned so much in the past 18 months, including where the pitfalls are. That is something that Deputy Smith asked - where are the problems? The problems are in the integrated piece in primary care and what will happen with aids and appliances. That is what we are working out at present. The memorandum of understanding is that if the two Ministers do not get on, what will happen? As Deputy Shortall said, who will be the referee? That is where the Taoiseach and the Cabinet will have to work it out.

I am very fortunate that since becoming Minister of State I have worked with everybody, including the Department of Health, the Minister for Housing, Local Government and Heritage, Deputy O'Brien, on the disability housing strategy - we have done that in the past number of weeks - and the Minister for Social Protection, Deputy Humphreys, on the ability programme to address employment. In respect of education, I have worked with the Minister, Deputy Norma Foley, and the Minister of State, Josepha Madigan, in the Department of Education on transition planning. I am working with the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Simon Harris, on higher education to ensure more students are taken onto the various course to meet therapy requirements, and with the Tánaiste on enterprise and entrepreneurship. Some 80% of all disabilities are acquired when a person is over 18; those people are not born with a disability. People have to change their focus. We have to look at enterprise and entrepreneurship and I acknowledge the role of Professor Cooney in Dublin City University on that.

We also have to talk about transport. Many of us here are from rural areas, where we do not have access to the DART or the Luas. We have to look at various areas in regard to transport. In recent weeks, I have reconvened the transport team, which has not met since 2017. I have brought all of them back around the table. I am looking at what worked in the past. The issue of allowances was mentioned. Allowances were cut, removed and so on. It is all back on the table.

On expenditure, the Minister, Deputy McGrath, has given me approximately €250 million in the past 18 months to ensure I can do the job within disabilities. Sometimes it is not all just about the money. There is a staffing issue at this time. If I could fill the vacant posts, the children's disability network teams would have a far different experience than what we are hearing about this evening.

The status of the disability capacity review under way in the Department of Health was raised. The framework and action plan on that is being put together. It is about putting the meat on the bones, which is bringing the Department of Public Expenditure and Reform into the room. We know the unmet need. It is now about calculating how much money I need and how much that Department will give me. On the issue of under-65s in nursing homes, while we had only a token allocation in budget 2021, it will be cranked up in budget 2022. On the national disability inclusion strategy, NDIS, the comprehensive employment strategy and the national disability strategy on housing, both are under my remit and I chair both. I keep on top of that.

I am not the Minister of good intentions; I am the Minister of action. I have the money and I want to deliver. Reference was made to "my intentions". I am action-based. I am fortunate that the Minister, Deputy O'Gorman, is a legislative individual because he will be taking over that side of things and I will be getting into the nuts and bolts of putting the practical steps in place. Much of what we are talking about here today is about getting into the HSE and the nuts and bolts of putting in place the network disability teams. Every team works differently and there are 91 teams. What we need is a standard operating procedure in regard to, for example, how a child comes in, the pathway through, how many children are looked after and how many have been seen at the end of the week. It is about key performance indicators, accountability and delivery of service. That is what I am looking for in that regard.

It was stated there is dragging of feet. There is nobody within the Department of Health or the Department of Children, Equality, Disability, Integration and Youth or any of my colleagues dragging their feet. Work is under way on the legislation on the decision support services and we are engaged in this transfer of function. All the while, we are also ensuring essential services are open. The Irish Sign Language Act will test Departments. That is a legal requirement. I worry about that. On the optional protocol, we are 100% committed to it. The Minister, Deputy O'Gorman, demonstrated that in his contribution.

Had this transfer happened on 1 July, I would not have learned how the HSE runs its own process internally. We learned that from the National Independent Review Panel, NIRP, piece. For me, it is about the break in culture and the change in the system. It is also about the powers of the Minister. The Ministers and Secretaries (Amendment) Act 1939 clearly sets out what powers Ministers have and what they can commission. Where I do see a pattern, and this is the important piece in regard to Brandon, it is incumbent upon me as Minister to call for an independent review, to look at issues through the lens of the social model and at how relationships work with Tusla, An Garda Síochána, social care and within the HSE such that people can be supported to do their jobs and they have confidence and trust in the system. I am working on that. I am speaking about where I see patterns, which I have seen. I do not need a NIRP to tell me there are issues in Donegal; I know there are issues there. I am working with the Department of Health and the Department of Children, Equality, Disability, Integration and Youth to ensure we come to a space where we can have that independent piece conducted.

A lot of work has gone into drafting this Bill. It is very technical, but when boiled down it is about making the Minister with responsibility for equality equal to the Minister for Health in regard to functions related to community-based disability services, which are complex needs. That is where the HSE will be answerable to both, but we will work uniformly on everything.

I look forward to the Bill progressing through Committee Stage. If I have missed any of the points raised today, I am sure I will be reminded of them as the Bill progresses.

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