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

There is no doubt that disabled people and their families find themselves at the sharp end of the cost-of-living crisis.

While all households have been affected by inflation, the fact of the matter is that not everybody starts from the same position. Even before the current increase in the rate of inflation, people with disabilities experienced one of the highest rates of poverty at over three times that of the general population. Too often, the needs of those with disabilities are shamefully neglected and viewed through a very narrow lens. Policy is not based on the voices and experiences of people living with those disabilities and their carers. If we were to shift that focus, it would quickly become clear that it is the way in which State services are structured and inadequately resourced that causes the most exclusion and inequality rather than the disability itself.

The assessment of need process is a clear example of this. The importance of this service cannot be overstated. It is supposed to be the first step in providing children with therapeutic and educational supports but the State constantly reneges on its obligations in this regard. Just yesterday, we heard that 4,000 children are waiting for a diagnostic assessment just to get a school place. This abject neglect has serious consequences. Delays in the assessment of need process not only result in many children being denied access to services, but also frequently mean that these children need more costly and complex interventions down the line as their conditions are allowed to deteriorate. By law, once an assessment of need application has been received, the assessment must start within three months and finish within a further three months but we know that this is simply not the case in practice. Some people have to wait years, and very often three to four years, for that assessment of need. This is a deplorable situation and it is the reason we must urgently ratify the optional protocol to the UN Convention on the Rights of Persons with Disabilities.

In those areas where early intervention and school age teams are still operating, many children are still waiting to be seen. These services are distinct from the assessment of need system and, crucially, no statutory timelines are set out in the Disability Act. Parents very often do not realise that when filing a complaint until they are told by the HSE. Wide variations in service regionally only add to the frustration for parents and to the sense of unfairness they feel. Access to adequate services should not depend on your address.

The delays in the assessment of need process also brings our two-tier health service into sharp focus. The failure to ensure assessments take place within a reasonable timescale means that many families are forced to go private. These families often have great difficulty in scraping the money together despite making sacrifices and frequently have to borrow the money. For many others, this is just not an option. The money is simply not there. It must be borne in mind that, the more this happens, the greater the pull factor for staff to go into private practice. I was concerned to hear the Minister of State speak at the weekend about her intention to outsource assessments of need. This will inevitably accelerate the creeping privatisation we see right across our health services. In addition to the pull factor I have mentioned, there is low morale among staff because of the high levels of stress and the high number of vacancies. All of that combines to make the job much more challenging. What is needed is a properly functioning and resourced universal public service that is available to all those who require it as of right. Difficulty with recruitment is not an acceptable excuse. It is a central role of a Minister to ensure proper workforce planning.

This stumbling from one crisis to another cannot continue. Instead, we must embed rights-based supports and services for all of those with disabilities. We need action now. This is not just about having a conversation; it is about looking for action from the Minister of State and her ministerial colleagues. We need to see that action as a matter of urgency.

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