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

I thank the Deputies for tabling this important motion this evening. I thank the Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman, for being present to receive it with me.

The motion before the House tonight addresses many issues regarding people with disabilities. However, I want to be clear from the outset, as Minister of State with responsibility for disability, I am completely dedicated to improving the lives of people with disabilities in Ireland, and to strengthening vital specialist disability services, from the very young to the very old, regardless of location or disability, visible or invisible. I have had the privilege of being in this role for two years. I do not for a moment underestimate the challenges faced by people with disabilities in Ireland, or the pressures that our services can face. It is in recognition of these challenges that just two weeks ago the Government announced the largest ever budget allocation to specialist disability services of more than €2.4 billion. The increase in the disability budget for 2023 follows significant additional funding for disability services in 2021 and 2022.

It marks a real consolidation in the investment in the sector and is testament to the Government's commitment to boosting and sustaining funding to disability services.

I will now share details of a combined package of €177 million in additional funding to specialist disability services for 2023. A total of €109 million is being provided to support existing levels of service, ELS, which takes into account demographics, changing need and pay awards, as well as some funding towards non-pay inflation factors, with additionalities for funding new developments including a progressing disability services, PDS, programme team for ChildVision, a new acute neurology unit, a community neurology unit, social farming and the Cappagh specialist children's team. Once-off funding is being provided for costs associated with activity earlier during Covid amounting to €39 million, of which €11.5 million will be spent specifically on assessments of needs.

As part of budget 2023, an inflation support fund of €100 million will be made available to support community-based voluntary organisations, including those providing disability services, an essential pillar in the provision of health services that will receive €65 million. This fund is being made available in recognition of the challenges faced by the sector in delivering and maintaining key health and social care services against a backdrop of increased inflationary pressures affecting energy, heating and related costs. The fund will be administered by the HSE and the details of this will be finalised in the coming weeks.

To respond to Deputy Funchion in regard to transport, there are 39 section 39 providers in community healthcare organisation, CHO, 5, where transport costs constitute a huge issue for it. They will receive a portion of their block grant, which they can dedicate directly to supporting transport. The cost is something in the region of €230,000 for the various organisations.

Many of those in the disability sector will be aware the disability capacity review has identified a significant level of under-provision of residential care places, with changing demographics adding to the numbers requiring residential care. As of August, there were 8,192 residential places for people with a disability, with approximately 90 service providers nationwide. To the end of August 2022, 60 new emergency residential places had been developed together, with 17 new intensive support packages.

The Government recognises how important respite can be for relieving pressure and improving quality of life for families. In 2020, the funding allocated amounted to approximately €70 million, representing around 3% of the total budget. In 2021, I secured €5 million and we built in an additional 10,400 respite nights. In 2022, in the three specialist centres, we have built in 4,032 nights, while for the nine remaining houses, there have been 9,408 nights.

The Government is committed to supporting people with disabilities to maximise their capacity to live independent lives. To that end, the HSE provides a range of assisted living services including personal assistant, PA, and home support services, with funding in place to enable the delivery of high-quality PA and home support services to circa 10,000 people with disabilities, including 1.7 million PA hours and more than 3.12 million home support hours.

As was mentioned by other Deputies in regard to the children’s disability network teams, over recent years 475 new posts have been added, along with the 133 that will be added this year, to address the return of therapists to special schools. To respond to Deputy Cullinane, I reiterate that the comprehensive PDS national team development programme has been provided to the CDNTs and has cascaded to all team members. This programme was designed to support the establishment of the new CDNTs and to support the implementation of the new model of service, which will support staff retention. Options regarding the recruitment of staff such as speech and language therapists, occupational therapists, OTs, and physiotherapists include targeted national recruitment for the CDNTs, high-profile international campaigns, targeted international recruitment for the CDNTs with the possibility of a relocation allowance, a sponsorship programme, an apprenticeship programme for therapy grades, the employment of graduates as therapy assistants as they await their CORU registration and an expansion of therapy assistance in the system with the HSE supporting individuals to return to education to qualify as therapists. The HSE has approved an attractive and competitive relocation package for the international recruitment of all therapies. The relocation package includes allowances payable to candidates to meet the initial costs of relocating, such as accommodation and flight allowances for all EU and UK candidates and non-EU candidates.

It is important for anyone listening to this debate to understand what is happening with therapists going back into schools. The reassigning of existing HSE staff to fill one third of posts happened in September, while a further one third is to happen by the end of October. In parallel with the first two phases, a number of initiatives will be commenced immediately, including a high-profile international recruitment campaign, as I outlined. The implementation is being monitored, with regular communication between the relevant stakeholders at a local and national level. Regrettably, the Fórsa trade union, which represents personnel involved, has issued an instruction of non-co-operation to its members regarding the reinstatement process. In that regard, the union has advised its members not to co-operate with the reassignment of staff to provide on-site health and social care supports to special schools. This instruction has impacted significantly on the HSE's capacity to progress the phase as it intends. Representatives of the HSE met Fórsa on 23 September to discuss this matter, and during the meeting the Fórsa representatives raised a number of issues and concerns with regard to the programme and the impact it has having. What I do not understand is that last year, I was able to reinstate 65 therapists to special schools and Fórsa had no issue; now I am reinstating 133 and it has a huge issue.

Ireland ratified the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, on 20 March 2018 and this marked an important milestone in a process to strengthen the rights of people with disabilities. The Government remains wholeheartedly committed to continually advancing the rights and obligations it has recognised and agreed to be bound by in ratifying the UNCRPD. My colleague the Minister, Deputy O'Gorman, will be further in addressing this issue later in the debate.

I believe I have addressed Deputy Funchion's questions. In regard to aids and appliances, which one of her party colleagues raised, if anybody is using an aid or appliance that is sitting on the resource allocation group, RAG, system, they should let me know. I should not know what a RAG system is, but it is where the aid or appliance has not been approved locally by the HSE. Deputy Cullinane will know what I am talking about. I say this to all my colleagues throughout the area. No child's aids or appliances should sit unapproved on a RAG system. If that is any Deputy's experience, I ask him or her to let me know. We just recently had the case of Eva in Cork and a car seat, which has now been approved. There was also the case of a child's bath. Those types of equipment should be approved. Let us be clear about this. These are aids and appliances needed by children and that support needs to happen.

I will take up the case of Alexis O'Mahony. In regard to Lough Ree Access for All, I was successful in funding the group €60,000 already but I will engage with it to ensure everyone will have the same access to leisure opportunities as the rest of us in being able to get into the water. I would be delighted to engage in that regard.

Not a month goes by in which I am not held to account in either House regarding the progress made, and not a day goes by in which I do not engage with all elements of the Opposition to ensure they are totally aware of where the funding is being spent and how it is being directed. I recognise the significant challenges, the stress and the strain and the frustration that parents and families are under but, as Minister of State within the Department, I am trying to be ambitious and think outside the box, looking at ChildVision, the neurology units and what we can do in Cappagh to ensure we have specialist teams to support families regardless of where they live.

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