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

As Minister of State with responsibility for specialist disability services, I am pleased to be here to address the issues raised in this Private Members' motion on supporting people with disabilities and carers. The motion touches on a wide range of issues which span the remit of several Departments including mine and the Departments of Health; Housing, Local Government and Heritage; Social Protection; Education; and Further and Higher Education, Research, Innovation and Science. I will do my best in my allocated time to address as many of the issues raised as possible.

The Minister, Deputy O'Gorman, and I are open to the early ratification of the optional protocol, subject to the State being in a position to meet the obligations that arise. In order to map out the requirements for ratification my Department has commissioned external legal advice as part of an ongoing scoping exercise, which I expect to conclude shortly. Earlier today, the Minister, Deputy O'Gorman, briefed the Cabinet on plans to accelerate consideration of the issues around ratification and of the intention to establish an interdepartmental group, which the Minister will speak about later. The group will report back on its work in the coming months so that the Government can make a fully informed decision on the next steps toward ratification of the optional protocol.

Family carers provide care to children or adults with additional needs, including physical or intellectual disabilities, frail older people, those with palliative care needs or those living with chronic illnesses, mental ill-health or addiction. Work is progressing across the Government to improve supports to carers. The Government has taken an approach that includes increases to payments and to income disregards for means assessment as well as a significant cost-of-living bonus and double payments for people with disabilities and carers.

The Minister for Social Protection has announced the establishment of an interdepartmental group with the Department of Health, tasked with looking at the area of means-tested payments to family carers. The work of the interdepartmental working group will be informed by a broader review of means testing currently under way in the Department of Social Protection. The work of the interdepartmental group will also be considered in the context of the national carer's strategy, led by the Department of Health. There is also a range of other supports for carers provided by the Department of Social Protection which are not based on means assessment, such as the carer's support grant, carer's benefit and the domiciliary care allowance.

This year, the Department of Education will spend in excess of €2.7 billion, or more than 26% of the Department’s budget, on supporting children with special educational needs. This includes supporting children with special educational needs in mainstream classes; funding for new special classes and special school places; additional special educational teachers and special needs assistants; and funding for the National Educational Psychological Service, NEPS.

In the area of further and higher education, the Minister, Deputy Harris, announced in February the roll-out of higher education courses in ten higher education colleges that will provide significant opportunities for students with an intellectual disability.

In my Department and under my remit, the Action Plan for Disability Services 2024-2026 was published in December 2023. It sets targets for addressing a number of issues, namely 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 reform towards individualised, person-centred models of service while growing service capacity appropriately.

Budget 2024 saw increases in funding for specialist disability services, with a total of €2.9 billion committed for 2024 across a range of services including residential care, respite, children’s services, adult day services, personal assistance, home support and community neurorehabilitation teams.

Specifically, €74.1 million has been allocated for the new development measures, which will provide greater investment across a range of disability services and contribute to the progressive realisation of the action plan. It should be noted that unlike the position for capital expenditure, where multi-annual commitments are made within the national development plan, the Estimates process for current expenditure allocates funding on an annual basis. No formal mechanism currently exists to provide funding on a multi-annual basis to providers.

Regarding the services required to support people with disabilities and their carers, the motion notes barriers in accessing respite services. Respite is crucial for carers, families and those to whom care is given. It has been a particular ambition of mine to ensure respite provision is continually expanded. Additional funding for this purpose has been secured in successive budgets. Respite can occur in a variety of settings and for various lengths of time, depending on the needs of individual service users and their family or carer. Respite is not always centre-based overnight provision. It can be provided in a number of ways, including by means of extended day services, clubs or activities. I secured a significant €15 million in additional funding in budget 2024 for specialist disability respite services. In a full year, the provision for respite alone is €25 million.

My Department and the HSE are currently examining existing service levels across the country with a view to supporting the utilisation of existing centre-based capacity to the greatest extent possible - colleagues will have heard me talking about sweating the assets - while also supporting new respite options, particularly day respite. The HSE is endeavouring to give particular attention to areas where respite provision is currently lower than the national average. It is hoped that information can be provided imminently to CHOs with regard to the objectives and allocations for 2024.

The motion calls for an increase in home support and personal assistance services. The action plan commits to the delivery of 110,000 additional home support hours between 2024 and 2026 to address shortfalls in services and support people with disabilities living at home, in line with Article 19 of the UNCRPD. In addition, the action plan sets policy priorities in home support services in light of the UNCRPD. The proposed statutory home care scheme being led by the Department of Health will involve developing a formal policy and service description, including developing eligibility and prioritisation criteria. The action plan also commits to providing 800,000 additional personal assistance hours in the same period, with the delivery of 80,000 additional hours in 2024. A policy review of personal assistant services in light of the UNCRPD is already under way, with a working group involving key stakeholders and disabled people's organisations tasked with developing formal policy and service description, devising eligibility and prioritisation criteria and considering the best form of governance and regulation.

There were several queries about the filling of posts. A total of 500 people have applied for jobs on the various CDNTs. In Deputy Tully's area, 80 candidates are going forward for interview, with interviewing starting in the next week. In Deputy Cronin's area, CHO 8, 121 candidates have been selected for interviewing in the coming weeks.

It is important to note that apart from provision for respite, residential care, personal assistance and so on, additional provision was made in the budget this year. This provision includes funding for Chime, an organisation for people who are hard of hearing, Erb's palsy, the Central Remedial Clinic, the online partnering in occupational therapy telehealth services, POTTS, programme for dyspraxia, and ChildVision. Funding for Debra Ireland will for the first time ever be included in the plan, as well as provision for the Crann Centre in Cork. There is provision for the work by the National Rehabilitation Hospital clinical lead on a White Paper for the care of children with neurological conditions who are being discharged from hospital. Those children will be passed back to the relevant CDNT or community neurological team. We are also working with Foetal Alcohol Spectrum Disorder Ireland on developing its research hub in County Clare.

My ambition for 2024 is to continue to work with my Department and on an across-government basis to do the very best I can, along with the Minister, Deputy O'Gorman, for people with disabilities and their carers. I recognise there are further steps to be taken towards full alignment of services with the UNCRPD principles. I am firmly focused on ensuring services are progressively enhanced to deliver real and significant changes in the lives of people with disabilities.

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