Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank the Leader of the House for giving me the opportunity to state once again the Government's commitment to the provision of effective and responsive public services for people with disabilities, including those with intellectual disabilities. The provision of disability services is not just for the Department of Health. Under the Disability Act, there is an onus on all Departments and public bodies to provide the same services to all citizens, including those with a disability. This is a fundamental pillar of the national disability strategy.

In 2015, funding of almost €1.5 billion will be provided for health and personal social services. To illustrate the range and complexity of services and supports which this entails, residential services will be provided by almost 60 agencies to around 9,000 people with disabilities at more than 1,200 locations, ranging from large congregated settings to community group homes to supported independent living. Day services will be provided to around 22,000 people at 850 different locations by 80 organisations. Approximately 1,400 young people who are due to leave school and rehabilitative training programmes in 2015 will receive new placements. Respite residential support totalling 190,000 overnights will be provided. The target for provision of personal assistance or home supports in 2015 is 3.9 million hours. A variety of other services is also provided under the disability services programme, including respite, early childhood-family support, community based medical, nursing and therapy services, rehabilitative training, aids and appliances.

Our focus in 2015 is to bring about reforms that will positively impact on the way in which people with disabilities are supported to live the lives of their choice. This process of reform is being guided by the value for money and policy review of disability services, or the VFM as I will refer to it from hereon in. The title is off putting and I was not responsible for it but the purpose of the VFM review is to transform our disability services and make them fit for purpose. This transformation will entail migration from a group-based and often segregated approach towards a model of person-centred and individually chosen community-based supports. This approach will be underpinned by a more effective method of assessing need, allocating resources and monitoring resource use. Supporting people with disabilities to live a fully inclusive life is fundamental to this transformation programme.

I wish to outline how disability services are supporting people from childhood onwards. The HSE's national programme on progressing disability services for children and young people, zero to 18 years, aims to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, what school the child attends or the nature of the individual child's difficulties. Implementation of the progressing disability services programme is taking place on a phased basis in consultation with stakeholders, including service users and their families. It is a key priority for the executive's social care directorate in 2015. Some €4 million was specifically allocated in 2014 to drive the programme forward, equating to approximately 80 additional therapy posts. A further additional €4 million has been allocated from 1 May this year to assist in implementing the programme in 2015, at a full year cost of €6 million. At 30 April 2015, 47 of the 2014 posts have been filled and a further 20 to 22 are at the stage of "post accepted" and the recruitment process is ongoing for the remaining ten to 12 posts. I am pleased to report that there has been a significant investment of additional resources into the health sector's primary care services in the past few years. Additional funding of €20 million was allocated in 2013 to strengthen the services and to support the recruitment of prioritised front-line primary care posts. I am confident that the additional resources being invested in primary and disability services will have a positive impact on the provision of clinical services to all children with disabilities, including those who may currently be on waiting lists to access therapy inputs.

This brings me to the matter of health funded supports for young people after they leave school. Every year, young people finish their second level education and progress to the next stage in their lives. For most, the hope is that they will progress directly to further education, vocational training or employment. However, young people who have more complex support needs will initially rely on life-skills training or day supports provided by the HSE. After completing a life-skills training programme many young people in this cohort will in time also progress to mainstream training and employment, with personal social supports provided by the HSE where required, while others will continue to require more intensive day supports. This year the HSE has allocated an additional €6 million at a full year cost of €12 million to provide training places and day services for this group. The provision of services to more than 1,000 young people and almost 500 life-skills graduates has in recent years posed a challenge to the HSE. Last year, thanks to a more streamlined approach by the HSE, almost 1,400 young people with disabilities who finished school or life-skills training received placements which fully met their needs. This is a remarkable achievement by all involved and a considerable improvement on the position in previous years. The HSE is building on last year's efforts and I am pleased to say that the HSE has informed me that it is on schedule to meet the day support needs of all young people with disabilities who are due to leave school or graduate from a life-skills programme in the coming weeks. Young people and their families will be notified by the end of June at the latest of the placement that will be available to them from September. One of the most significant projects being progressed by the HSE this year is the implementation of the person-centred approach to day services outlined in New Directions - Report on the National Working Group for the Review of HSE funded Adult Day Services. Service providers are actively engaged in delivering services with a more person-centred focus, person-centred planning is widely implemented, and a considerable quantum of service delivery is now community based.

There are now many excellent examples of progress in services in a more individualised and person-centred way. I have been very encouraged over the past two or three years to see the number of organisations and service users around the country that are immersing themselves wholeheartedly in the transformation programme. Many organisations are actively engaged in demonstration projects and are taking practical steps to support people with disabilities in the community and to explore new and innovative ways to do so. Organisations are also co-operating to share their experiences and provide mutual support. An example of this is the Next Steps Project which is a network of shared learning and support that has been set up by the National Federation of Voluntary Bodies which provides services to people with intellectual disabilities.

I am very pleased to tell Senators that the Next Steps Project received an international Zero Project innovative practices award earlier this year at the UN Headquarters in Vienna. Tomorrow, the federation will award all self-advocates and participating organisations with a certificate from the Zero Project at a special event. This will mark the hard work of each person who has participated in the project and each organisation that is working towards supporting people in living lives of their choosing. I want to take this opportunity to commend the National Federation of Voluntary Bodies and the project participants on this remarkable achievement.

An important element of supporting people with a disability to live in the community is housing. In July 2012, the national implementation framework was launched to support the Government's National Housing Strategy for People with a Disability 2011-2016 in continuation of the successful collaborative approach employed between the Department of Health and the Department of the Environment, Community and Local Government.

The implementation framework reflects the recommendations of the Government's mental health policy, A Vision for Change, and its disability policy entitled, Time to Move on from Congregated Settings - A Strategy for Community Inclusion, in regard to the phased movement, over seven years, of almost 5,000 people with intellectual, physical and mental health disabilities from institutions to community living. Time to Move on from Congregated Settings, which was published in 2011, proposes a new model of support in the community, is moving people from congregated settings to the community in line with Government policy. The report identifies that around 4,000 people with disabilities in Ireland, which is a figure based on the 2008 census, live in congregated settings that are defined as a residential setting where people live with ten or more people. At the end of 2014, this number had reduced to around 3,000. The HSE is planning for the transitioning of a further 150 people from congregated settings in 2015. I am aware that this poses significant challenges to many stakeholders, including clients, families, disability service providers, the HSE, various Departments and statutory bodies, and representative organisations. I am also aware that it will require a need for a major change programme. However, I have asked the HSE to ensure that the needs of people transitioning from congregated settings will be based on each individual's person-centred plan.

This Government is very committed to the protection and safety of our most vulnerable citizens. It placed regulation and inspection of residential disability centres on a statutory footing in November 2013. Every person who uses disability services is entitled to expect and receive care of the highest standard and to live in dignity and safety. Our aim must always be to ensure that people with a disability maximise their potential and live rich and fulfilling lives. They and their families trust us to care for them with kindness and compassion.

Compliance with HIQA standards for disability residential centres is a requirement under the service level arrangements between the HSE and voluntary service providers. Over 66% of designated centres for people with a disability were inspected by HIQA by the end of the quarter one of 2015, including inspections targeted by allegations of mistreatment. The lessons learned from them are continuing to improve the quality of services. Clients and their families can be assured that this regulatory regime is being rolled out across all residential facilities for people with a disability.

I am aware that HIQA has reported evidence of good practice, in the delivery of many residential services, to people with disabilities where the support and care needs of residents have been prioritised and there is a strong focus on the needs of service providers. I am also aware that the Department of Health has requested the HSE to develop action plans to address cases where HIQA has raised serious concerns regarding the level of care that people with a disability are receiving in a number of disability centres, including safeguarding the human rights of residents.

HIQA's findings can make for difficult reading. However, they serve as evidence that the regulatory process works effectively and in the interests of protecting vulnerable people in the care of the State. The HSE is implementing a comprehensive change programme of measures to improve the quality and safety of residential services for people with disabilities. Much work remains to be carried out to ensure that all facilities comply with the disability residential standards. While this is challenging for the HSE we must remember that the objective is to safeguard vulnerable people.

I welcome this opportunity to put on record the Government's position on services for people with disabilities. There is an onus on us all to use the substantial resources committed to disability services throughout the public sector more effectively and efficiently. We must also achieve better outcomes for this funding and bring about a real and substantial improvement in the lives of people with disabilities. This is a central tenet of the national disability strategy and a high priority for the Government, one to which I remain firmly committed. I thank the Cathaoirleach and the Members for giving me this opportunity.