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

I wish to thank the Members of this House for raising this important issue and providing me and my colleague, the Minister, Deputy O'Gorman, with the opportunity to have this discussion this evening. I also welcome to the Gallery the National Federation of Voluntary Bodies, FEDVOL, St. Christopher's Services, Cheeverstown, the Disability Federation of Ireland, the Irish Wheelchair Association, and Rehab Group. I also acknowledge any individuals or families who are looking in along with the new organisation, the Leaders Alliance.

It is crucial that disability services and supports are adequately funded so that the good work of our service providers can continue to be delivered to the highest possible standard. This has been a high priority for Government. In recent years, one would be forgiven for thinking tonight that this Government has invested nothing since I took this office in 2020. In the budget that landed last week, €700 million has been invested into disability services. That sits solely and speaks solely to me. That is for complex disabilities. In 2023, for example, €1.85 million was provided for more than 70,000 extra personal assistance hours. Funding was provided for five additional respite services and an increase of one service from part-time to full-time.

Furthermore, we have been able to make yearly provision for our school leavers, providing for, on average, 1,250 new day service placements each year.

We are doing more year on year and are seeking to do it better. Last year, our ELS was €109 million and our new developments were €29.3 million. It is important to look at the facts in the round. This year, our ELS has been €131 million, which I have been continuously criticised about, but that was an increase of 7.6% on last year. Our new development for this year is made up of €64 million. When people ask about ELS, it is important to put what it is made up of in context. It is the full year of our new measures.

On the previous year's new measures, in last year's budget I introduced €23.7 million for school leavers. There was social farming and a residential pilot, which everybody talks about, for supported independent living. I put that into the budget last year. I hope to grow on that this year and expand it in CHO 9, with St. John of God's. I have put in funding for Tusla, community neurorehabilitation and the ChildVision project, which involves specialist disability support for children. That was €30 million. There was another €83 million in the ELS allocation for residential, changing needs, Tusla placements, decongregation, intensive care support packages and children's services non-pay cost. I also had to make provision for Building Momentum. That is the make-up of the €131 million.

In 2021, I published the disability capacity review to 2032. As Members all know, this report sets out estimates of unmet need and demographic change, demonstrating the extra capacity required in disability services to 2032. The programme for Government commits to working towards implementing the recommendations of the review. To help drive this process, a detailed action plan was developed and approved by the Government and is currently being prepared for publication. This action plan will represent the first phase of implementation of the capacity review's recommendations. As the Minister said, the publication of the action plan, as well as the roadmap for children's disability services, will be keenly anticipated by people with disabilities and their families. For all watching, the PDS disability roadmap will be published next week. This is why the priority for budget 2024 will be to support the progressive roll-out of the action plan for disability services and the implementation of the roadmap for children's disability services through a focus on the enhancements of person-centred supports and services.

The Minister noted that of the €195 million in additional funding provided for disability services in 2024, €131 million will go towards supporting the existing level of service. That means adding it into the base. It is important to clarify that the remaining €64 million is largely geared towards delivering this action plan. This includes the following measures: €20.5 million for residential places; €10 million to increase the funding in respite; funding for 1,400 additional school leavers; increased funding for personal assistance and home support; €1.4 million for community neurorehabilitation teams; and an additional €8.5 million for children's services, which I will touch on shortly. This funding represents a good start in addressing the capacity review and builds on substantial extra funding in recent years. It is important to emphasise that our plans to increase capacity in disabilities are long term and multiyear. We will seek to continue to increase the funding for this area in order to ensure that unmet needs are addressed.

As well as funding, we will need to ensure that our service providers are adequately staffed and have the necessary resilience and seamless delivery services to support people with disabilities. Deputy Cullinane touched on the issue of once-off funding. At the moment, there are 700 unfilled vacancies. That equates to €56 million. I say to every service provider, when they are doing their service level agreement, SLA, that it is an opportunity to discuss the costs within their services. This area of the workforce is of higher importance and one that I have been paying particular attention to recently. To help support the delivery of the action plan for disability services, I have convened a high-level working group to drive workforce planning for specialist disability services, acknowledging the need for system-level workforce projections, and to explore innovative ways to expand the disability workforce in the short term as well as engaging on medium-term planning. This group will link in, as appropriate, with other bodies engaged in examining different aspects of the health and social care workforce.

Other significant work is ongoing in this area, especially children's services, where ongoing recruitment difficulties have impacted on the ability to deliver a satisfactory service. In budget 2024, an additional €8.5 million has been provided to: improve children's services, including the recruitment of additional therapy positions to bolster the CDNTs; increase third level places to develop additional capacity; and facilitate targeted supports for specialist children's disability services. These targeted initiatives are designed to provide specialist supports for children and address potential gaps in services for families by augmenting the CDNT capacity for centralised supports on issues such as hearing and visual impairment, motor function and dyspraxia. To complement this funding, significant efforts are ongoing in the HSE on recruitment at international and local level. These include: bespoke disability recruitment campaigns; targeted recruitment campaigns to recruit staff grade and senior clinicians, both national and international; recruitment of consultant paediatricians with a special focus on neurodisability; and sponsorship initiatives to increase the attractiveness of employment in the disability sector. The publication of the PDS roadmap next week will help to further support a drive for improvements in this area.

The systemic sustainability and stability of organisations in the health and social care sector is, therefore, a significant concern for the Government. I understand these challenges and recognise the ability of voluntary organisations to pay their staff, and to deliver services effectively and safely, is highly dependent on the State funding they receive. Staff recruitment and retention challenges are not new or unique to these organisations, but I remain committed to effectively working with all relevant parties to resolve these systemic issues.

As mentioned by the Minister, we are delighted to have been able to reach agreement with unions late last night in respect of the pay deal for the sector. I acknowledge the work of my assistant secretary general, Colm, and colleagues James, David, Anthony and Gary, along with the representative bodies, for the constructive and positive engagement in these talks. I am very hopeful that the offer put forward will be accepted by members. It was not just an offer of pay. There is the piece regarding the alignment of pay in future. For the benefit of anybody who thinks it all only happened from 2 p.m. yesterday, a lot of work was going on in the background to make it happen. From my engagement with service users and families, the announcement of potential service disruptions caused significant distress. Thankfully, this has been averted and service provision continued today.

As mentioned last week, I have also secured an additional €9 million in one-off funding for the delivery of bespoke transport and mobility initiatives, on which I will provide more detail in the coming weeks.

I previously indicated I am open to all options when it comes to supporting parents accessing services for their children, with the issue of assessments of need frequently raised with me. My hope is to establish a ring-fenced support mechanism in the coming months, which supports parents who access assessments of need privately. I hope to have more information next week. On the battle that Deputy Doherty spoke about, I hope that he and his colleagues will support me when I bring forward these developments.

I will also meet with my colleagues in the Department of Education over the coming weeks regarding the ongoing roll-out of therapies in special schools. The approach taken by St. Patrick's Special School in Wexford in recent weeks is something that can be used in other schools as an interim measure while assistant therapists are being recruited. Again, I will provide funding for this and more details will follow in the coming weeks.

The motion referenced matters that fall under the remit of Departments other than mine. I acknowledge the good work done by colleagues across the Government to improve the lives of people with disabilities. There are measures to improve access to employment through supporting jobseekers and employers from the Department of Enterprise, Trade and Employment, and measures to improve the accessibility and affordability of public transport from the Department of Transport. I acknowledge the work the Minister for Finance, Deputy Michael McGrath, did in extending the incapacitated tax credit, as well as the increases made by the Minister for Social Protection, Deputy Humphreys, to the disability and carer's allowances.

The Minister also reduced the eligibility threshold for the wage subsidy scheme from 21 hours to 15.

For the section 39 organisations watching this evening and concerned about the impact of any recruitment freeze on them, the HSE has confirmed to me that within the controls introduced there are mechanisms for approval to fill the priority posts. Mr. Bernard Gloster will meet me, the Minister, Deputy O'Gorman, and officials in the Department next week to ensure the recruitment freeze will not impact disability.

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