Violet-Anne Wynne (Clare, Independent)
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40. To ask the Minister for Children, Equality, Disability, Integration and Youth the status of the 19 key recommendations made by the Ombudsman, Information Commissioner, and Commissioner for Environmental Information of Ireland in his report (details supplied); and if he will make a statement on the matter. [25990/23]

Violet-Anne Wynne (Clare, Independent)
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As the Minister of State knows, the Ombudsman, Information Commissioner, and Commissioner for Environmental Information, Mr. Peter Tyndall, published his Wasted Lives report in 2021. He made 19 key recommendations in it. I would be grateful if the Minister of State could provide me with an update on progress in implementing those recommendations.

Anne Rabbitte (Galway East, Fianna Fail)
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A nursing home can be an appropriate care option where the person concerned has a clinically assessed complex medical and social care requirement that cannot be supported in the person’s home. However, as identified in the Ombudsman's report, Wasted Lives, for some people under the age of 65 nursing homes are not an appropriate placement and alternative, more suitable supported-living solutions are needed to give them greater independence and choice in their daily lives.

Measures to prevent young persons from entering nursing homes continue to be supported through a range of services, including respite, home support and personal assistance services. There is a clear Government commitment to reduce and provide a pathway to eliminate the practice of inappropriately accommodating young people with serious disabilities in nursing homes. Funding is being provided through the HSE national service plan to support appropriate transition of young people from nursing homes. The Ombudsman’s report contains a series of findings and 19 associated recommendations, action on 17 of which is being led by the HSE. Two recommendations are at Department level.

In October 2022, the HSE established an integrated steering committee to oversee the implementation of the recommendations, with membership drawn from acute hospitals, older persons, disability and primary care, along with clinical leads and representatives. Additionally, the HSE has established a programme office and an implementation team. This team has been divided into five workstreams addressing various areas of work. To date, work on 71% of the recommendations is under way across the workstreams. An important element of the work is ascertaining the needs of those who are under 65 and in nursing homes. Work is under way to establish this through the appropriate surveys. The information collected in these surveys will be used to identify people with a disability who may be inappropriately living in nursing homes and to enable planning for the most appropriate health and social care supports in the most appropriate setting.

Violet-Anne Wynne (Clare, Independent)
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I thank the Minister of State for the information she provided. The Ombudsman made very extensive recommendations in the report, as she outlined. However, I recently spoke again with Jennifer, who I am sure the Minister of State is aware of through previous representations. Jennifer is from north Clare, is in her mid-40s and has been in a nursing home for the past number of years. That is something that is against her wishes. She does not want to be there. As the Minister of State is aware, her rights under Article 19 of the UN Convention on the Rights of Persons with Disabilities are being ignored, as are the wishes of many others. Will the Minister of State please tell me what steps she will take to end this practice in line with commitments made in the programme for Government?

In trying to address this issue most appropriately, it is important to look at the reasons, as the Minister of State outlined, for these young people being in nursing homes. Professor Susan Coote of the University of Limerick and Ms Magdalen Rogers of the Neurological Alliance of Ireland, in their recent evidence before the Joint Committee on Health, alluded to the expansion of neurorehabilitation teams into every CHO as a measure that could serve to remove many younger people from nursing homes.

Anne Rabbitte (Galway East, Fianna Fail)
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I have put funding in place to ensure the HSE is able to recruit to that steering committee, and put staff and a pathway in place to start engaging with people who are inappropriately accommodated. To date, it has engaged with 412 individuals. As recently as last Thursday I was in County Longford, where I met three individuals who have moved into their own home, thank God. Three is so few in the overall context but 417 people are being engaged with as we speak.

On the neuro teams, I sought funding in the budget last year for CHO 2 and CHO 4 to stand up properly clinically governed teams so that we could have proper neuro teams. That is part of the development of the next phase in the neuro strategy of going right out into the communities.

Violet-Anne Wynne (Clare, Independent)
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I was delighted to be invited by the fantastic people in the Clare Leader Forum to address its public rally calling for a centralised personal assistance, PA, service. On the day, we heard many impassioned speeches from members of the Clare Leader Forum, who I acknowledge for speaking up and speaking out on the day. The assembled crowd heard from people with disabilities who have suffered greatly because they cannot get enough access to PA hours due to several factors. These people ultimately have to choose whether to get help with washing themselves or other essential daily duties in the house. They are not able to partake in social events and are often isolated in their own homes. Some cannot decide the time they want to go to bed at and are instead forced to go to bed at a time even my young children would struggle to go.

On foot of that rally, I wrote to the Minister, Deputy O'Gorman, to discuss how we can work towards parity of PA services. In the letter, I requested that he reform the distribution of PA hours to enable parity of services across CHO areas, meeting the social, personal and employment needs of those who avail of PA services.

Anne Rabbitte (Galway East, Fianna Fail)
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With the support of the Minister over the past number of years, I have built on the budget for PA hours. We cannot conflate what home support and PA hours are. They are two separate things. PA is the arms and legs of an individual to ensure that he or she has the right to participate in his or her community. I recently held a meeting where Ms Shelly Gaynor was my speaker on this matter, in addition to Home Care Direct. In fact, I am very passionate about a personalised budget and personalised hours. We cannot talk about decanting people from nursing homes if we are not in a position to put in place the PA support that is needed to incorporate people back into their communities so they can readjust into them.

In the context of employment, if you want to participate in employment you need to have that PA support piece. In the past, perhaps, it all went into the big black hole of health, and PA and home support all became the one thing. However, under the new Department, we are able to see and follow the funding line for PA support.