Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:

acknowledges that: — Budget 2023 has failed to resource and fund disability support services and infrastructure that the Government itself has identified as essential to meet current and future unmet need for children and adults;

— the Government's additional Budget 2023 allocation of €29.3 million to build capacity in disability services falls woefully below the recommendations of the Disability Capacity Review to 2032 - A Review of Social Care Demand and Capacity Requirements to 2032 - published last year;

— the transfer of specialist disability services from the Department of Health to the new Department of Children, Equality, Disability, Integration and Youth has still not taken place, over two years since the formation of the Government;

— the Government has not published the disability capacity review action plan to 2025, or set out how the inadequate 2023 Budget allocation aligns with the reviews' recommendations;

— the Independent Living Movement Ireland completed a review of the Disability Capacity Review to 2032, and made a series of enhanced recommendations for the implementation of rights-based services;

— the Ombudsman for Children raised again their concern with the United Nations Committee of the Rights of the Child that the Disability Act 2005 is insufficiently child-focused and rights-based;

— the employment vacancy rate across the Children's Disability Network Teams (CDNTs) is over 28 per cent;

— there are 17,000 children waiting for "initial contact" with a CDNTs and 2,500 children whose Assessment of Needs are already overdue; and

— Sinn Féin have outlined a fully costed 10-year strategy to implement the disability capacity review, which would have started with an additional €153 million investment over and above existing levels of service requirements in independent living, decongregation, respite services, CDNTs, day services, residential care, home support and personal assistance packages, as well as investment in clinical rehabilitation teams and training and development funding for Disabled Persons Organisations (DPOs); commends the work of DPOs, advocate organisations and all those providing care and support to children and adults with disabilities;

cautiously notes the indication by the Tánaiste and Minister for Enterprise, Trade and Employment speaking in the Dáil on 29th September that there will be a new policy approach to the provision of Assessments of Needs and access to therapies and other supports; and

calls on the Government and Minister for Health, Stephen Donnelly TD, to: — publish the plan for the delivery of a new approach to assessing and meeting the needs of children with disabilities and neurodiverse children alluded to by the Tánaiste and Minister for Enterprise, Trade and Employment, including the funding that is being allocated to it and the timelines for delivery of same;

— ensure that any new policy approach or any review of the Disability Act 2005 will not be used to undermine the current rights of people with disabilities;

— immediately publish the disability capacity review action plan to 2025;

— ensure that the action plan adopts a rights-based approach which is in accordance with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD);

— increase the Budget 2023 additional allocation to disability services to meet the investment targets set out in the Disability Capacity Review to 2032;

— establish a high-level group, to include the Taoiseach and the Minister for Health and Minister for Further and Higher Education, Research, Innovation and Science to implement a 10-year health workforce strategy;

— progress delivery of the terms and conditions for Section 39 workers equal to their public service comparators; and

— ratify the Optional Protocol to the UNCRPD.

The current and previous Governments have continually under-invested in disability services. This is evidenced by the level of unmet need across disability services which was highlighted in the disability capacity review published in July 2021. The purpose of that review was to estimate the scale of current outstanding need for specialist disability services and how the scale and shape of need is likely to evolve over the years up to 2032. The review was a sensible and prudent undertaking as we need to know the challenges that are in front of us if we are to have a disability service that can deliver the social supports needed to enable people with disabilities live truly independent lives.

The review's findings are stark. It says that to address unmet need, alongside demographic change, would require current disability spending in 2032 to rise by €550 million to €1 billion above its 2018 level to deliver the capacity required. As well as that, additional capital spending for housing to complete the closure of residential institutions would cost in the region of €500 million to €800 million over the period to 2032.

With these figures in black and white the Government in budget 2023 has once again failed to resource and fund disability support services appropriately. This is the second budget since the capacity review was published so two opportunities have been missed.

The Government has not even published a plan to implement the recommendations of the capacity review although it initially committed to doing so by December 2021. This implementation plan must be published without delay. The Minister of State recently said it was already completed. Why was it not published before the budget so its recommendations could have been acted on? Sinn Féin has outlined a funded strategy to meet the needs of people with disabilities out to 2032 in our alternative budget this year. We would have invested an additional €153 million in disability services compared with the Government's dismal €29 million.

Regarding CDNTs, my constituency office is contacted every week by parents whose children have been on a waiting list for an assessment of need for between two and four years. Approximately 17,000 children are awaiting initial contact with a disability network team and assessments of needs for 2,500 children are overdue. The total extent of waiting lists for disability services is currently unknown due to poor data systems. Underinvestment in IT infrastructure is holding back the entire health service, including the disability services.

The staff working in CDNTs are under immense pressure to deliver interventions and assessments while there is a vacancy rate of approximately 28% across these teams. That is almost one third of its workforce not in place. How are they expected to deliver interventions and assessments in this situation? The backfilling of therapists who are on maternity or paternity leave is not funded and this makes up a significant portion of the vacancy rates. Why has this not been addressed? The Government simply does not have a plan to deal with this. It has not dealt with the problem of professional progression within CDNTs and the staff are leaving to go to primary care or the private sector. There is a disparity between HSE and non-HSE workers who are working together and carrying out the exact same jobs. The Government needs to publish a costed multi-annual plan to deal with waiting lists and staffing problems in disability services without further delay.

In response to a parliamentary question I submitted regarding the number of additional therapy courses being introduced for this academic year where the HSE has identified a significant skills shortage such as speech and language therapy, occupational therapy and physiotherapy, I was informed that an additional 15 physiotherapy places were to be made available, nine at level 7 and six at level 6. There was no indication in response that any additional places were made available for speech and language therapy or occupational therapy even though the Minister in response said that "the matter of health workforce planning and ensuring an appropriate pipeline of qualified healthcare workers within Ireland is a major priority for my Department." Is that really true? Are 15 additional posts the extent of what the Government considers a priority? I am hoping the information in the parliamentary question is somehow incorrect.

The Government urgently needs to address workforce challenges with a serious workforce planning group led by the Taoiseach, to include health and higher education. While I cautiously welcome the indication from the Tánaiste that there will be a new policy approach, it cannot be used to dilute the rights of people with disabilities in the Disability Act. We have already seen the Government try this approach and make the situation even worse. The Government must adopt a rights-based approach to disability services in line with the UN Convention on the Rights of Persons with Disabilities. It needs to publish a costed multi-annual plan to deal with waiting lists and staffing problems in disability services. Crucially it needs to ratify the optional protocol to the United Nations Convention on the Rights of Persons with Disabilities.

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