James Browne (Wexford, Fianna Fail) | Oireachtas source

I thank the members of the Women's Parliamentary Caucus for their proposals to deliver a rights-based care economy in Ireland. It is a very timely motion and I commend them on it. My colleague, the Minister of State, Deputy Butler, very ably detailed the Government's response to the care needs of older people and the supports for carers provided throughout the social protection system. I will focus primarily on the Government's commitments to respond to the needs of people with disabilities and their carers, as well as the issues of gender equality and supports for foster carers.

Since the United Nations Convention on the Rights of Persons with Disabilities was ratified by Ireland in 2018, we have taken great strides in the development of services and supports for people with disabilities, their families and carers to ensure those services and supports are aligned with the principles set out in the UNCRPD. A critical milestone in this regard was the commencement of the Assisted Decision-Making (Capacity) Act 2015 and the amendment Act of 2022, which, on 26 April 2023, brought wardship to an end in the State. The legislation also provided for a number of key measures for further compliance with the UNCRPD. These measures were previously set out in the Disability (Miscellaneous Provisions) Bill, which lapsed with the last Dáil. The Government is determined to fulfil the programme for Government commitment to develop an implementation plan to co-ordinate implementation of the UNCRPD. To deliver on that, the development of a successor strategy to the national disability inclusion strategy is under way, with targeted stakeholder consultation focused on disabled persons' organisations.

The Disability Action Plan 2024-26, approved by the Government in July 2023, will support the implementation of the disability capacity review, in accordance with the programme for Government. Crucially, the action plan sets out targets for addressing demographic pressures, making significant progress on unmet needs, working to replace remaining congregated and institutional residential care settings with community-based models, and continuing the really important reform towards individualised, person-centred models of service while growing service capacity appropriately. Budget 2024 will see further increases to funding for specialist disability services, with a total of €2.8 billion committed for next year across a range of service areas, including residential, respite, children's services, adult day services, personal assistance and home support.

The HSE's Progressing Disability Services for Children and Young People, PDS, programme is enhancing the model of service delivery to ensure equitable access to standardised services across the country. The PDS roadmap for service improvement for 2023 to 2026 was launched by the HSE in October this year. In budget 2024, the Government allocated approximately €8.5 million in additional funding to children's disability services, focusing on funding for therapy assistant posts, educational places and targeted services. In budget 2023, approximately €11 million was allocated to address waiting lists for clinical assessments for people with disabilities. An additional €5 million will be provided for this purpose in 2024. A working group on workforce enhancement - disabilities has been established to examine, identify and provide solutions to matters that are constraining the supply of health and social care professionals to provide disability services.

Under the national service plan for 2023, the HSE will deliver an additional 70,370 personal assistant hours to expand and enhance the supports for people to live self-directed lives in their communities. Budget 2024 provides an additional €2 million for personal assistance services. In addition, approximately 3.12 million hours of home support services for people with disabilities are expected to be provided in 2023. At the end of September this year, there were 8,355 residential places for people with disabilities.

In 2023, funding was made available for 43 priority placements and as of September, 103 places had been delivered.

The forthcoming disability action plan is proposing the provision of additional residential care places to tackle unmet needs and ensure supply keeps pace with demographic changes. Increased investment has impacted positively on the provision of respite services for people with disabilities in successive years. Up to the end of September, 76,994 overnight sessions and 21,947 day-only sessions had been accessed by people with disabilities. The forthcoming disability action plan commits to increasing this level of respite provision by approximately one third. The HSE is examining the consolidation and appropriate expansion of existing centre-based respite, as well as alternatives to centre-based respite, to ensure the greatest number of beneficiaries can be supported, with approximately €10 million provided in 2024 for this purpose.

HSE-funded day programmes for people with disabilities support over 20,000 people and include a range of centre-based and community-based activities. They support people with disabilities on weekdays and include adult day services and training programmes, principally rehabilitative training. Substantial progress has been made over the past decade in supporting people to participate in mainstream activities and in the life of their communities under the New Directions policy. Since 2015, a process to attend to the needs of young people leaving school and rehabilitative training programmes has been implemented. It is now known as the school-leaver process. The Government has provided €18.2 million in new development funding for school leavers in 2024.

The HSE resourcing strategy sets out specific actions targeted at attracting and retaining our health workforce. Given the significant workforce challenges faced across disability services, the Department of Children, Equality, Disability, Integration and Youth is strongly of the view that a dedicated HSE disability-specific workforce strategy is required. To support the supply and retention of staff within disability services, a senior interdepartmental workforce steering group has been set up, which includes HSE personnel, to address immediate and longer-term staffing needs.

We recognise the challenges faced by section 39 organisations, so I was pleased to see that under the auspices of the Workplace Relations Commission, an agreement on funding for pay was recently accepted by members of trade unions representing section 39, section 56 and section 10 workers. The agreement amounts to an 8% increase in funding for pay and will benefit a great number of staff providing vital services on behalf of the Government. It will also help address staff recruitment and retention challenges in these voluntary organisations. It affords a measure of protection to the continuity of services and fairly recognises the contribution and commitment of workers in providing essential services to some of the most vulnerable people in society.

The Department of Children, Equality, Disability, Integration and Youth is supporting the HSE on an ongoing basis to improve the availability and quality of data on disability services. This is being achieved through initiatives such as the HSE's disability support application management tool, which provides a detailed profile of people with disabilities who require funded supports outside the current service quantum. An integrated community case management system is also being developed to support people’s journey through disability services.

Foster carers provide care to some of the most vulnerable people in society by providing a stable home environment for children who cannot live with their family of origin. I recognise the great and vital work of foster carers. Tusla has published the Strategic Plan for Residential Care Services for Children and Young People 2022-2025 and has appointed a Tusla national lead for foster care. The Government has substantially increased the foster care allowance in budget 2024 and is also providing a double week of foster care allowance and double child benefit in respect of each qualifying foster child before the end of the year. The issue of improved State pension eligibility in respect of foster carers has been raised with the Minister for Social Protection. Engagement between Department officials on this matter is ongoing.

Recognising that responsibility for caring rests disproportionately with women, the Government has announced its intention to hold a referendum on gender equality, as recommended by the citizens’ assembly and the special Joint Committee on Gender Equality. On Tuesday last, the Government approved proposals for two referendums, which will amend Article 41 of the Constitution to provide for a wider concept of family, delete Article 41.2 of the Constitution to remove text on the role of women in the home and insert a new Article 42B to recognise family care. The referendums will be held on 8 March 2024.

The programme for Government includes a commitment to develop a successor to the national strategy for women and girls. Consultations on the development of a new strategy will begin in 2024 and the successor strategy will include actions to address gender equality across government. In addition, the suite of statutory family leaves, which are aimed at assisting employees in managing their caring responsibilities with work, have undergone significant developments in recent years. Most recently, the Work Life Balance and Miscellaneous Provisions Act 2023 has introduced five days' leave for medical care purposes, which is a flexible short-term leave to complement longer term leave, and a right to request flexible working for parents and carers. More broadly, the ongoing enhancement of social protection supports for family carers and the expansion of care in the community under Sláintecare will mitigate the gender inequality that arises from the fact that the majority of unpaid carers are women.

I thank the Women's Parliamentary Caucus for the opportunity to discuss the progress being made on all these important fronts to deliver the rights-based care economy to which we are all committed.

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